scholarly journals Multi-component cognitive intervention for older adults with mixed cognitive levels: implementation and preliminary effectiveness in real-world settings

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui-Fen Mao ◽  
Athena Yi-Jung Tsai ◽  
Ling-Hui Chang ◽  
I-Lu Tsai
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Real World ◽  
Cognitive Skills ◽  
Cognitive Intervention ◽  
General Function ◽  
Group Leaders ◽  
Post Intervention ◽  
Test Part ◽  
Cognitive Levels

Abstract Background In most controlled studies of multi-component cognitive intervention, participants’ cognitive levels are homogenous, which is contrary to real-world settings. There is a lack of research studying the implementation of evidence-based cognitive intervention in communities. This study describes the implementation and preliminary effectiveness of a Multi-component Cognitive Intervention using Simulated Everyday Tasks (MCI-SET) for older adults with different cognitive levels in real-world settings. Methods Single group, pre-intervention assessment, post-intervention assessment, and 3-month follow-up research design. MCI-SET consists of 12 two-hour weekly sessions that include motor-cognitive tasks, cognitive training, and cognitive rehabilitation. One hundred and thirty participants, > = 65 and frail, dependence on > = one instrumental daily activity, or with confirmed dementia, from eight community centers were included. The primary outcome is general cognition (Montreal Cognitive Assessment-Taiwan, MoCA-T). Secondary outcomes are memory (Miami Prospective Memory Test, Digits Forward, Digits Backward), attention (Color Trail Test-Part 1), executive function (Color Trail Test-Part 2), and general function (Kihon Checklist-Taiwan). Results Pre-intervention workshop for group leaders, standardized activity protocols, on-site observation, and ten weekly conferences were conducted to ensure implementation fidelity. MCI-SET had an 85% retention rate and 96% attendance rate. The participants had a mean age of 78.26 ± 7.00 and a mean MoCA-T score of 12.55 ± 7.43. 73% were female. General cognition (Hedges’ g = 0.31), attention (Hedges’ g = 0.23), and general function (Hedges’ g = 0.31), showed significant post-intervention improvement with small effect size. Follow-ups showed maintained improvement in general cognition (Hedges’ g = 0.33), and delayed effect on attention (Hedges’ g = 0.20), short-term memory (Hedges’ g = 0.38), and executive function (Hedges’ g = 0.40). Regression analysis indicated that the intervention settings (day care centers vs neighborhood centers), the pre-intervention cognitive levels, and the pre-intervention general function of the participants were not associated with the outcomes. Conclusions MCI-SET is feasible and can improve the cognitive skills and general functions of older adults with heterogeneous cognitive skills or disabilities. It is essential to tailor programs to fit the interests of the participants and the culture of local communities. Group leaders must also have the skills to adjust the cognitive demands of the tasks to meet the heterogeneous cognitive levels of participants. Trial registration This study was retrospectively registered at clinicaltrials.gov (Identifier: NCT04615169).

scholarly journals Changes in Brain Volume Resulting from Cognitive Intervention by Means of the Feuerstein Instrumental Enrichment Program in Older Adults with Mild Cognitive Impairment (MCI): A Pilot Study

2021 ◽  
Author(s):  
Tzvi Dwolatzky ◽  
Rafi S. Feuerstein ◽  
David Manor ◽  
Shlomit Cohen ◽  
Haim Devisheim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Pilot Study ◽  
Deductive Reasoning ◽  
Cognitive Intervention ◽  
Cognitive Capacity ◽  
Voxel Based Morphometry ◽  
Post Intervention ◽  
Brain Volumes ◽  
Instrumental Enrichment

There is increasing interest in identifying biological and imaging markers for the early detection of neurocognitive decline. In addition, non-pharmacological strategies including physical exercise and cognitive interventions may be beneficial for those developing cognitive impairment. The Feuerstein Instrumental Enrichment (FIE) Program is a cognitive intervention based on Structural Cognitive Modifiability and the Mediated Learning Experience (MLE) and aims to promote problem-solving strategies and metacognitive abilities. The FIE program uses a variety of instruments to enhance the cognitive capacity of the individual as a result of mediation. A specific version of the FIE program was developed for the cognitive enhancement of older adults, focusing on strengthening orientation skills, categorization skills, deductive reasoning and memory. We performed a prospective interventional pilot observational study on older subjects with MCI who participated in 30 mediated FIE sessions (two sessions weekly for 15 weeks). Of the 21 subjects who completed the study, there was a significant improvement in memory on the Neurotrax battery comparing pre- and post-intervention scores (pre: M=95.3, SD=12.2, post: M=101.2, SD=7.9, p<.05). Complete sets of anatomical MRI data for voxel-based morphometry, taken at the beginning and the end of the study, were obtained from 16 participants (mean age 83.5 years). Voxel-based morphometry showed an unexpected increase in grey matter (GM) in the anterolateral occipital border and the middle cingulate cortex. These initial findings of our pilot study support the design of randomized trials to evaluate the effect of cognitive training using the FIE Program on brain volumes and cognitive function.

scholarly journals Inhibitory control training in healthy and highly educated older adults

2021 ◽  
Vol 15 (3) ◽  
pp. 387-395
Author(s):  
Corina Satler ◽  
Edison Tostes Faria ◽  
Gabriel Neiva Rabelo ◽  
Ana Garcia ◽  
Maria Clotilde Henriques Tavares
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Response Time ◽  
Inhibitory Control ◽  
Error Rate ◽  
Learning Experience ◽  
Cognitive Intervention ◽  
Stop Signal ◽  
Training Methods ◽  
Executive Function Training

ABSTRACT. Executive function training is considered a promising tool for delaying the natural effects of aging on cognition. However, there are still few studies that propose a unimodal intervention with a focus on inhibitory control, and none of them has studied the effect of this type of intervention on older adults (OA). Objective: The aim of this study is to investigate the benefits of inhibitory control training in healthy OA by comparing the two assessment time points, namely, before and after training. Methods: Twenty-seven participants were included after interview and checking the inclusion criteria. The training was based on the stop-signal paradigm and carried out in 21 sessions. Results: Participants performed better after training by reducing the false alarm error rate (i.e., for stop-signal trials), reducing omission error rate, showing an increase in hit rate, Go response time (i.e., for go-signal trials), stop-signal response time, and showing a decrease in the level of anxiety. The executive function training had no significant impact on the scores obtained in the complementary neuropsychological tests. Conclusions: These results are consistent with previous studies that support the viability and effectiveness of cognitive intervention for executive functions in OA and suggest a positive effect of the intervention, which may be related to the learning experience of a new and challenging task.

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

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.

A theatrical evidence-based cognitive intervention for older adults

2021 ◽  
Vol 7 (1) ◽  
pp. 9-22
Author(s):  
Tony Noice ◽  
Helga Noice
Keyword(s):  
Older Adults ◽  
Learning Strategies ◽  
Cognitive Learning ◽  
Cognitive Intervention ◽  
Drama Therapy ◽  
Evidence Based ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Post Intervention ◽  
Data Comparison

This article describes a 35-year program devoted to determining the cognitive learning strategies of professional actors and then using those strategies to lower the risk factors for dementia in older adults. Details of a series of successful evidence-based theatrical interventions are provided along with the identification of areas in which our work directly overlaps drama therapy research. The methods involved in this endeavour include protocol analysis, behavioural testing and pre- and post-intervention data comparison. Most recently, these results have been verified by neuroscientists using functional magnetic resonance imaging (fMRI). It is hoped that drama therapists will find elements of this program that will be applicable to their work with older adults.

scholarly journals CAN COGNITIVE TRAINING USING A TABLET COMPUTER ENHANCE COGNITIVE FUNCTION OF HEALTHY OLDER ADULTS? AN ALTERNATING-TREATMENT DESIGN

2021 ◽  
pp. 2140044
Author(s):  
JIN-HYUCK PARK
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Intervention ◽  
Tablet Computer ◽  
Trail Making Test ◽  
Healthy Older Adults ◽  
Trail Making ◽  
Alternating Treatment Design ◽  
Treatment Design ◽  
Productive Engagement

Even though a variety of cognitive interventions have been conducted to ameliorate age-related cognitive declines, the effects of cognitive intervention using activities in everyday life are still unknown. The purpose of this study was to compare the effects between tablet computer-based productive and receptive cognitive engagement using an alternating-treatment design. Three healthy older adults performed a total of 19 sessions consisting of three baseline periods and 16 alternating training sessions. The training sessions were divided into four blocks and each block involved four treatment sessions. Productive and receptive engagements were randomly allocated to four treatment sessions. All participants alternatively received productive engagement that requires learning new practical applications and receptive engagement requiring little new learning such as listening to music. Prefrontal cortex (PFC) activity using functional near-infrared spectroscopy and executive function through the Trail Making Test were assessed at the baseline and the end of each session. All data were visually analyzed. Visual analysis results showed that the productive engagement was associated with higher PFC activity and faster performance in the Trail Making Test, compared to those utilizing receptive engagement. These results suggest that productive engagement might be effective in facilitating PFC activity and improving the executive function of healthy older adults, indicating cognitively challenging activities are more beneficial relative to nonchallenging activities.

scholarly journals Long-Term Cognitive Effects From a Real-World Multi-Skill Learning Intervention in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 520-520
Author(s):  
Leah Ferguson ◽  
Debaleena Sain ◽  
Esra Kürüm ◽  
Carla Strickland-Hughes ◽  
George Rebok ◽  
...  
Keyword(s):  
Real World ◽  
Cognitive Abilities ◽  
Cognitive Skills ◽  
Digit Span ◽  
Cognitive Learning ◽  
Skill Learning ◽  
Post Intervention ◽  
Older Adulthood ◽  
Learning Intervention

Abstract Previous cognitive learning interventions have focused primarily on learning one or two novel real-world skills at a time, or utilizing computer-based programs to enhance specific cognitive skills (Ball et. al 2002; Park et. al, 2014). While these studies yielded immediate cognitive improvements in participants, the long-term benefits of continuing to learn several real-world skills in older adulthood is unclear. In the present two studies, the long-term (1-year post-intervention) benefits of a multi-skill learning intervention were investigated with older adult participants. Study 1 (a pilot sample) included 6 participants (67% female, M = 66.33 years, SD = 6.41, range = 58–74 years old) and Study 2 included 27 participants (67% female, M = 69.44 years, SD= 7.12, range = 58–86 years old). Following a three month intervention which entailed simultaneously learning at least three real-world skills, such as photography, drawing, and Spanish, participants’ cognitive abilities were assessed using four tasks (Flanker, Set-Shifting, Dot Counting, and N-Back), as well as RAVLT and Digit Span. Follow-up assessments were completed at three-, six-, and 12-month follow-ups after the interventions. Linear mixed-effects regression models revealed significant cognitive improvements across time points up to one year following the intervention compared to baseline assessments. These promising results support the idea that intense learning experiences may lead to considerable cognitive growth in older adulthood, as they do earlier in the lifespan.

scholarly journals EXECUTIVE FUNCTION AND PHYSICAL DECLINE TRAJECTORIES IN COMMUNITY DWELLING NON-DEMENTED OLDER ADULTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 801-801
Author(s):  
V. Del Panta ◽  
M. Colpo ◽  
G. Sini ◽  
B. Stefania
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Community Dwelling ◽  
Physical Decline

scholarly journals Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 287-288
Author(s):  
Jeffrey Hausdorff ◽  
Nofar Schneider ◽  
Marina Brozgol ◽  
Pablo Cornejo Thumm ◽  
Nir Giladi ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Executive Function ◽  
Dual Task ◽  
Gait Speed ◽  
Negative Impact ◽  
Virtual Reality Environment ◽  
Dual Tasking ◽  
Concurrent Performance ◽  
Dual Task Cost

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p<0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p>0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.

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