Examining the effectiveness of a cognitive intervention to improve cognitive function in a population of older adults living with HIV: a pilot study

Objective: The purpose of this randomized-controlled pilot study was to explore the effectiveness of a home-based computerized cognitive training intervention in improving cognitive function in a population of older adults with mild cognitive impairment who are living with HIV. Methods: In all, 24 participants were enrolled in this study. All study participants were impaired [defined as Montreal Cognitive Assessment (MoCA) score < 26]; 12 were randomly assigned to a computer-training intervention group and 12 to a control group. The intervention group used a home-based computerized cognitive training program for 8 weeks, while the control group received health-related newsletter via email and follow-up phone calls. Cognitive function was measured at study entry, immediately post intervention, and 8 and 16 weeks post intervention Results: This study achieved a 92% retention rate, losing two persons from the intervention group. Participants in the intervention group scored significantly higher on cognitive testing immediately post intervention compared to the control group: F(1, 19) = 4.92, p = 0.04. The partial Eta squared of 0.32 indicates a small to moderate effect size. Discussion: Cognitive improvement was seen immediately after the intervention, and cognitive improvement was still evident 16 weeks post intervention. Cognitive training could be considered as an option for older adults with HIV experiencing mild cognitive impairment.

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Effects of Cognitive Training on Cognitive Performance of Healthy Older Adults

The Spanish Journal of Psychology ◽

10.1017/sjp.2017.38 ◽

2017 ◽

Vol 20 ◽

Cited By ~ 5

Author(s):

Mariana Teles Santos Golino ◽

Carmen Flores Mendoza ◽

Hudson Fernandes Golino

Keyword(s):

Older Adults ◽

Cognitive Training ◽

Repeated Measures ◽

Digit Span ◽

Intervention Group ◽

Control Group ◽

Digit Symbol ◽

Transfer Effects ◽

Healthy Older Adults ◽

Picture Completion

AbstractThe purpose of this study was to determine the immediate effects of cognitive training on healthy older adults and verify the transfer effects of targeted and non-targeted abilities. The design consisted of a semi-randomized clinical controlled trial. The final sample was composed of 80 volunteers recruited from a Brazilian community (mean age = 69.69; SD = 7.44), which were separated into an intervention group (N = 47; mean age = 69.66, SD = 7.51) and a control group (N = 33; mean age = 69.73, SD = 7.45). Intervention was characterized by adaptive cognitive training with 12 individual training sessions of 60 to 90 minutes (once a week). Eight instruments were used to assess effects of cognitive training. Five were used to assess trained abilities (near effects), including: Memorization Tests (List and History), Picture Completion, Digit Span, Digit Symbol-Coding, and Symbol Search (the last four from WAIS-III). Two instruments assessed untrained abilities (far effects): Arithmetic and Matrix Reasoning (WAIS-III). The non-parametric repeated measures ANOVA test revealed a significant interaction between group by time interaction for Picture Completion [F(74) = 14.88, p = .0002, d = 0.90, CLES = 73.69%], Digit Symbol-Coding [F(74) = 5.66, p = .019, d = 0.55, CLES = 65.21%] and Digit Span [F(74) = 5.38, p = .02, d = 0.54, CLES = 64.85%], suggesting an interventional impact on these performance tasks. The results supported near transfer effects, but did not demonstrate a far transfer effects.

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AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

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A Home-Based Individual Cognitive Stimulation Program for Older Adults With Cognitive Impairment: A Randomized Controlled Trial

Frontiers in Psychology ◽

10.3389/fpsyg.2021.741955 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rosa Silva ◽

Elzbieta Bobrowicz-Campos ◽

Paulo Santos-Costa ◽

Ana Rita Cruz ◽

João Apóstolo

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Cognitive Impairment ◽

Controlled Trial ◽

Intervention Group ◽

Cognitive Stimulation ◽

Attrition Rate ◽

Control Group ◽

Randomized Controlled ◽

Home Based

Objective: This study aims to assess the feasibility and meaningfulness of a home-based individual cognitive stimulation (iCS) program delivered by caregivers to persons with cognitive impairment (PwCIs). It also aims to assess whether the older adults receiving this program improved their cognitive, neuropsychiatric, and depressive symptoms and quality of life and whether their caregivers improved their mental and physical health.Methods: A randomized controlled trial (RCT) was conducted with PwCI-caregiver dyads recruited from the community. Participants were allocated to two groups: intervention (n = 28) and control (n = 24). The intervention group received the European Portuguese version of the Individual Cognitive Stimulation Program—Making a Difference 3 (MD3-P). The control group received usual care. The iCS therapy program was implemented three times a week for 12 weeks. Caregivers were supported by the researchers to deliver the sessions at home. Participants were assessed at baseline and at the end of the intervention (week 13). Feasibility and meaningfulness were assessed through the attrition rate, adherence, and degree of satisfaction with the sessions. Four interviews were conducted (after week 13) to understand participants’ experiences.Results: The attrition rate was 23.1%. The dyads reported that they did not have high expectations about the iCS program before starting the study. Nevertheless, as the program evolved, caregivers noted that their family members had improved some areas of functioning. Intention-to-treat analysis based on group differences revealed a significant improvement in PwCIs’ cognition, specifically in their orientation and ability to follow commands. The intervention had no impact on other variables such as caregivers’ physical and mental health.Conclusion: The iCS program implemented by caregivers showed promising results in improving PwCIs’ cognition. The participants who completed the intervention attributed a positive meaning to the MD3-P, confirming it as a valid non-pharmacological therapeutic approach to reducing frailty in PwCIs in community settings.Clinical Trial Registration:www.ClinicalTrials.gov, identifier [NCT03514095].

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Feasibility of a Cognitive Training Game in Parkinson’s Disease: The Randomized Parkin’Play Study

European Neurology ◽

10.1159/000509685 ◽

2020 ◽

Vol 83 (4) ◽

pp. 426-432 ◽

Cited By ~ 1

Author(s):

Sjors C.F. van de Weijer ◽

Annelien A. Duits ◽

Bastiaan R. Bloem ◽

Nienke M. de Vries ◽

Roy P.C. Kessels ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Training ◽

Controlled Trial ◽

Intervention Group ◽

Waiting List ◽

Control Group ◽

Positive Effects ◽

Home Based ◽

Global Cognition

Cognitive training (CT) shows modest positive effects on cognitive function in patients with Parkinson’s disease (PD). Gamification may enhance adherence to traditional CT, but this has not been studied yet. Here, we investigated the feasibility of a gamified CT. We performed a randomized controlled trial including PD patients with mild cognitive impairment. Participants were randomly allocated to a 12-week home-based gamified CT intervention or waiting-list control group. Assessments were performed at baseline and at weeks 12 and 24. Forty-one patients were included (21 intervention and 20 waiting-list controls). Sixty-three percent of the intervention group trained >50% of the recommended sessions, while 81% voluntarily continued training after 12 weeks. After 24 weeks, 87.5% graded the game to be satisfactory. Global cognition scores improved after 24 weeks. Home-based gamified CT shows acceptable feasibility in patients with PD, and we observed preliminary indications for efficacy. Larger trials are needed to establish this efficacy.

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The feasibility and effects of virtual-reality motor-cognitive training in community-dwelling older people with cognitive frailty: A pilot randomized controlled trial (Preprint)

10.2196/preprints.28400 ◽

2021 ◽

Author(s):

Rick Yiu Cho Kwan ◽

Justina Yat Wa Liu ◽

Kenneth Nai Kuen Fong ◽

Harry Qin ◽

Philip Kwok-Yuen Leung ◽

...

Keyword(s):

Cognitive Function ◽

Older People ◽

Cognitive Training ◽

Walking Speed ◽

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Physical Frailty ◽

Cognitive Frailty

BACKGROUND Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment and is associated with many adverse health outcomes. While cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function We propose a virtual reality (VR) simultaneous motor-cognitive training program, which allows older people to practice performing daily activities in a virtual space mimicking real environments. OBJECTIVE We aimed 1) to explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and 2) to compare its effects with an existing motor-cognitive training program in the community on the cognitive function and physical function of older people with cognitive frailty. METHODS A two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for participants were: 1) age≥60 years, 2) community dwelling, and 3) with cognitive frailty. Those in the intervention group received cognitive training (i.e., cognitive games) and motor training (i.e., cycling on an ergometer) simultaneously on a VR platform, mimicking the daily living activities of older people. Those in the control group received cognitive training (i.e., cognitive games) on tablet computers and motor training (i.e., cycling on the ergometer) sequentially on a non-VR platform. Both groups received a 30-minute session twice a week for 8 weeks. Feasibility was measured by adherence, adverse outcomes, and successful learning. The outcomes were cognitive function, physical frailty level, and walking speed. RESULTS Seventeen participants were recruited and randomized into either the control group (n=8) or intervention group (n=9). At baseline, the median age was 74.0 years (IQR=9.5) and the median MoCA score was 20.0 (IQR=4.0). No significant between-group differences were found except in the number of chronic illnesses (P=0.043). At post-intervention, the intervention group (Z=-2.673, P=0.008) showed a significantly larger improvement in cognitive function than the control group (Z=-1.187, P=0.235). The reduction in physical frailty in the intervention group (Z=-1.730, P=0.084) was similar to that in the control group (Z=-1.890, P=0.059). The TUG-measured improvement in walking speed was moderate in the intervention group (Z=-0.159, P=0.110), and greater in the control group (Z=-2.521, P=0.012). The recruitment rate was acceptable (17/33, 51.5%). Both groups had a 100% attendance rate. The intervention group had a higher completion rate than the control group. Training was terminated for one participant (1/9, 11.1%) due to minimal VR sickness (VRSQ=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in both groups. CONCLUSIONS This study provides preliminary evidence that the VR simultaneous motor-cognitive training group experienced greater improvement in cognitive function than the control group, and reduced frailty and improved walking speed. VR training is feasible and safe for older people with cognitive frailty. CLINICALTRIAL ClinicalTrials.gov NCT0446726

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Effects of a Brief Behavioral Training Program on Sleep Quality in Older Adults With Moderate Sleep Disturbances

International Electronic Journal of Medicine ◽

10.34172/iejm.2020.02 ◽

2020 ◽

Vol 9 (1) ◽

pp. 7-13

Author(s):

Maryam Eshghizadeh ◽

Mahboubeh Esmaeili ◽

Shahnaz Ahrari

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Training Program ◽

Sleep Disturbances ◽

Adult Population ◽

Intervention Group ◽

Control Group ◽

Behavioral Training ◽

Post Intervention ◽

Subjective Sleep Quality

Background: Sleep disturbances are very common among elderly population and mostly remain incurable. Practical, brief, and effective interventions are needed to promote sleep quality in older adults with moderate sleep disturbances. This study aimed to investigate the effectiveness of a brief behavioral training program in ameliorating sleep quality in older adults suffering from moderate sleep disturbances. Materials and Methods: This study was conducted on 64 older adults with moderate sleep disturbances, as defined by Pittsburgh Sleep Quality Index (PSQI) score ≥5. Participants were randomly allocated to either intervention (n=32) or control (n=32) group. Older adults in the intervention group received a brief behavioral-based sleep training program which was delivered in a single in-person session followed by four telephone sessions during 4 weeks. While their peers in the control group did not receive any intervention. The main outcome of the study was scores on the PSQI which was compared at pre- and post-intervention between both groups. Data were analyzed using the SPSS software version 19.0. Results: At 4 weeks, PSQI scores decreased in older adults receiving intervention, as compared with the scores of participants to the control group (P<0.001). Subjects in the intervention group also showed significant improvements in sleep latency, subjective sleep quality, sleep duration, and sleep efficiency (P<0.05). Conclusion: Brief behavioral interventions may be promising and useful for older adult population with moderate problems, and can be considered an efficacious and non-invasive intervention approach to improve elderly’s sleep quality.

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EFFECTS OF MINDFUL FELDENKRAIS EXERCISES AND STRENGTH TRAINING ON COGNITIVE EXECUTIVE FUNCTION IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.2410 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S649-S649

Author(s):

Gerhild Ullmann ◽

Yuhua Li ◽

Meredith A Ray

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Strength Training ◽

Group Intervention ◽

Independent Living ◽

Low Cost ◽

Controlled Trial ◽

Control Group ◽

Post Intervention

Abstract Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to significant burden for individuals, families, and the health care system. This 3-arm randomized controlled trial (RCT) responds to the urgent need to identify strategies which can enhance and/or maintain cognitive vitality in older adults. The study is funded by the National Institute on Aging, and aims to examine the effects of both the mind-body exercise Feldenkrais and strength training on cognitive executive function in independent living older adults (N=90) age 65 to 85. Participants of the first wave (n=45) were randomized to a (1) Feldenkrais group, (2) strength training and (3) no-intervention control group. Intervention groups met twice a week for 12 weeks. Cognitive and physical performance measures of the NIH-Toolbox were used at baseline, post-intervention and at a 3-month follow-up. Results of changes in cognitive executive functions within and across groups will be presented. The findings will suggest if such interventions would be a viable low-cost option for older adults to maintain cognitive vitality and thereby impact the development of programs and guidelines for combatting decline in cognitive function.

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Effects of Semi-Immersive Virtual Reality-Based Cognitive Training Combined with Locomotor Activity on Cognitive Function and Gait Ability in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9070814 ◽

2021 ◽

Vol 9 (7) ◽

pp. 814

Author(s):

Na-Kyoung Hwang ◽

Jong-Bae Choi ◽

Dae-Kil Choi ◽

Jae-Min Park ◽

Chang-Wan Hong ◽

...

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Cognitive Function ◽

Locomotor Activity ◽

Cognitive Training ◽

Community Dwelling ◽

Control Group ◽

Immersive Virtual Reality ◽

Community Dwelling Older Adults ◽

Experimental Group

This study aimed to investigate the effects of semi-immersive virtual reality-based cognitive training (VRCT) combined with locomotor activity on cognitive function, balance, and gait ability in older adults. Eighteen community-dwelling older adults participated in this study. Subjects who met the selection criteria were assigned to an experimental group (n = 9) and a control group (n = 9). The experimental group received VRCT combined with locomotor activity for 30 min a day, three times a week, for 6 weeks. The control group received tabletop activity-based cognitive training for the same amount of time. Before and after the training, the Korean Mini-Mental State Examination (K-MMSE), Trail Making Test (TMT; A and B), and Digit Span Test (DST; forward and backward) were used to evaluate cognitive function; and the Timed Up and Go (TUG) test and 10-m Walking Test (10MWT) were used to evaluate the improvement in the balance and gait ability parameters. After the intervention, the experimental group showed a significantly greater improvement in the TMT-A (p = 0.045) and DST-backward (p = 0.012) scores compared with the control group. Regarding the gait ability variable, the experimental group showed a significant improvement in the 10MWT test (p = 0.001). This study confirmed that semi-immersive VRCT combined with locomotor activity is useful for improving cognitive function and gait ability in older adults. Therefore, VRCT combined with locomotor activity can be used as a simultaneous intervention for cognitive rehabilitation and functional capacity improvement in older adults.

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Simplified olfactory reminiscence to help maintain the mental health in community-dwelling older adults

Ageing and Society ◽

10.1017/s0144686x21000076 ◽

2021 ◽

pp. 1-14

Author(s):

Hideaki Hanaoka ◽

Toshiaki Muraki ◽

Fumiko Kaneko ◽

Shingo Yamane ◽

Hitoshi Okamura

Keyword(s):

Mental Health ◽

Older Adults ◽

Cognitive Function ◽

Intervention Group ◽

Community Dwelling ◽

Analysis Of Covariance ◽

Cognitive Test ◽

Control Group ◽

Significant Difference ◽

Community Dwelling Older Adults

Abstract The purpose of this study was to examine the effects of simplified reminiscence practice using olfactory stimuli on depression and cognitive function in community-dwelling older adults in Japan. Accordingly, 61 individuals were randomly divided into two groups. In the intervention group, 12 sessions of reminiscence were performed using olfactory cards. In the control group, reminiscence sessions were similarly performed, but with language cards. The Geriatric Depression Scale-15 (GDS-15) was used to measure mental health status and the Five Cognitive Test was used to measure cognitive function at baseline and after completion of the intervention. The final sample included 27 participants in the intervention group and 23 participants in the control group. Basic characteristics of the participants at baseline were compared and a significant difference was observed between the two groups in age (p = 0.029). Repeated-measures analysis of covariance with age as the covariate revealed a significant interaction between time and group on the GDS-15 (p = 0.04). Furthermore, a before and after comparison using a paired t-test showed a significant difference only in the intervention group (p = 0.01). The results of this study suggest that simplified reminiscence practice using olfactory cards could serve as an intervention to help maintain the mental health of community-dwelling older adults.

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Teaching and Practicing Cognitive-Behavioral and Mindfulness Skills in a Web-Based Platform among Older Adults through the COVID-19 Pandemic: A Pilot Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010563 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10563

Author(s):

Stav Shapira ◽

Ella Cohn-Schwartz ◽

Daphna Yeshua-Katz ◽

Limor Aharonson-Daniel ◽

Avram Mark Clarfield ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Group Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Post Intervention ◽

Web Based ◽

Wait List Control

The outbreak of the COVID-19 pandemic has led to an acceleration in the development of web-based interventions to alleviate related mental health impacts. The current study explored the effects of a short-term digital group intervention aimed at providing cognitive behavioral and mindfulness tools and skills to reduce loneliness and depression and to increase social support among older adults in Israel. This pilot randomized controlled trial included community-dwelling older adults (n = 82; aged between 65–90 years; 80% female) who were randomized either to an intervention group (n = 64) or a wait-list control group (n = 18). The intervention included seven online sessions, over 3.5 weeks. Depression, loneliness, and social support measures were administered at baseline, immediately post-intervention, and at 1-month follow-up. Repeated measures ANOVA revealed statistically and clinically significant reductions in depression in the intervention group, with results maintained at one-month follow-up. Loneliness levels also significantly decreased post-intervention; however, this benefit was not maintained at one-month follow-up. Social support slightly increased both post-intervention and 1-month follow-up—but these changes were not statistically significant. There were no overall changes for the wait-list control group. Our intervention provided promising evidence regarding the effectiveness of an online group intervention to alleviate mental health effects and to promote the coping of older adults during the COVID-19 pandemic. This relatively simple model can be effectively utilized by communities globally to help connect lonely and isolated older inhabitants, both during the pandemic and in more routine times.

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