Dataset Information

The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials.

ABSTRACT:

Background

From the perspective of disease prevention, the enhancement of cognitive function among the healthy older people has become an important issue in many countries lately. This study aim to investigate the effect of cognitive-based training on the overall cognitive function, memory, attention, executive function, and visual-spatial ability of the healthy older people.

Methods

Cochrane, PubMed, EMBASE, MEDLINE, PsycINFO, and CINAHL of selected randomized controlled trials (RCTs), and previous systematic reviews were searched for eligible studies. The population focused on this study were healthy older people who participated in randomized controlled trials that investigated the effectiveness of cognitive-based training. The outcomes including change in overall cognitive function, memory, attention, executive function, and visual-spatial ability.

Results

We collected a total of 31 RCTs, the results showed that cognitive-based training has a moderate effect on overall cognitive function (g = 0.419; 95%CI = 0.205-0.634) and executive function (g = 0.420; 95%CI = 0.239-0.602), and a small effect on the memory (g = 0.354; 95%CI = 0.244-0.465), attention (g = 0.218; 95%CI = 0.125-0.311), and visual-spatial ability (g = 0.183;95%CI = 0.015-0.352) in healthy older people. Subgroup analysis indicated the intervention characteristics of ?3 times each week (p = 0.042), ?8 total training weeks (p = 0.003) and ?24 total training sessions (p = 0.040) yields a greater effect size.

Conclusions

Cognitive-based training is effective for the healthy older people. This improvement can represent a clinically important benefit, provide information about the use of cognitive-based training in healthy older people, and help the healthy older people obtain the greatest possible benefit in health promotion and disease prevention.

SUBMITTER: Chiu HL

PROVIDER: S-EPMC5411084 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials.

Chiu Huei-Ling HL Chu Hsin H Tsai Jui-Chen JC Liu Doresses D Chen Ying-Ren YR Yang Hui-Ling HL Chou Kuei-Ru KR

PloS one 20170501 5

<h4>Background</h4>From the perspective of disease prevention, the enhancement of cognitive function among the healthy older people has become an important issue in many countries lately. This study aim to investigate the effect of cognitive-based training on the overall cognitive function, memory, attention, executive function, and visual-spatial ability of the healthy older people.<h4>Methods</h4>Cochrane, PubMed, EMBASE, MEDLINE, PsycINFO, and CINAHL of selected randomized controlled trials ( ...[more]

PMID: 28459873

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Project description:BackgroundResults of previous studies have shown that exercise training can improve cognitive functions in healthy older people. Some studies have demonstrated that long-term combination exercise training can facilitate memory function improvement better than either aerobic or strength exercise training alone. Nevertheless, it remains unclear whether short-term combination exercise training can improve diverse cognitive functions in healthy older people or not. We investigate the effects of four weeks of short-term combination exercise training on various cognitive functions (executive functions, episodic memory, short-term memory, working memory, attention, reading ability, and processing speed) of healthy older people.MethodsA single-blinded intervention with two parallel groups (combination exercise training; waiting list control) is used. Testers are blind to the study hypothesis and the participants' group membership. Through an advertisement in a local newspaper, 64 healthy older adults are recruited and then assigned randomly to a combination exercise training group or a waiting list control group. Participants in the combination exercise training group must participate in the short-term combination exercise training (aerobic and strength exercise training) three days per week during the four weeks (12 workouts in total). The waiting list group does not participate in the combination exercise training. The primary outcome measure is the Stroop test score: a measure of executive function. Secondary outcome measures are assessments including the Verbal Fluency Task, Logical Memory, First and Second Names, Digit Span Forward, Digit span backward, Japanese Reading Test, Digit Cancellation Task, Digit Symbol Coding, and Symbol Search. We assess these outcome measures before and after the intervention.DiscussionThis report is the first of a study that investigates the beneficial effects of short-term combination exercise training on diverse cognitive functions of older people. Our study is expected to provide sufficient evidence of short-term combination exercise's effectiveness.Trial registrationThis trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (Number UMIN000007828).

Project description:The number of older adults is increasing globally. Aging is associated with cognitive and sensory decline. Additionally, declined auditory performance and cognitive function affect the quality of life of older adults. Therefore, it is important to develop an intervention method to improve both auditory and cognitive performances. The current study aimed to investigate the beneficial effects of auditory and cognitive training on auditory ability and cognitive functions in healthy older adults. Fifty healthy older adults were randomly divided into four training groups-an auditory-cognitive training group (AC training; n = 13), an auditory training group (A training; n = 13), a cognitive training group (C training; n = 14), and an active control group (n = 12). During the training period, we reduced the sound intensity level in AC and A training groups and increase training task difficulty in AC, A, and C training groups based on participants' performance. Cognitive function measures [digit-cancelation test (D-CAT); logical memory (LM); digit span (DS)], auditory measures [pure-tone audiometry (PTA)], and magnetic resonance imaging (MRI) scans were performed before and after the training periods. We found three key findings. First, the AC training group showed difference between other training groups (A, C, and active control training groups) in regional gray matter volume (rGMV) in the right dorsolateral prefrontal cortex, the left inferior temporal gyrus (L. ITG), the left superior frontal gyrus, the left orbitofrontal cortex, the right cerebellum (lobule 7 Crus 1). Second, the auditory training factor groups (ATFGs, the AC and A training groups) improved auditory measures and increased the rGMV and functional connectivity (FC) in the left temporal pole compared to the non-ATFGs (the C training group and active control group). Third, the cognitive training factor groups (CTFGs; the AC and C training groups) showed statistically significant improvement in cognitive performances in LM and D-CAT compared to the non-CTFGs (the A training group and active control group). Therefore, the auditory training factor and cognitive training factor would be useful in enhancing the quality of life of older adults. The current AC training study, the plasticity of the brain structure was observed after 4 weeks of training.

Project description:There is limited evidence on the efficacy and social utility of cognitive training. To address this, we have designed a randomized controlled trial to assess the effectiveness of memory training workshops for healthy older people in terms of their short- and long-term impact on cognitive function, health-related quality of life, and functionality.A randomized controlled trial will be performed in health care centers in Barcelona (Spain) through comparison of a group of individuals participating in memory training workshops (experimental group) with another group with similar characteristics not participating in the workshops (control group). The intervention will consist of twelve 90-minute group sessions imparted once a week by a psychologist specialized in memory training. The groups will each comprise approximately 15 people, for a total number of 230 patients involved in the study. Each session has its own objectives, materials and activities. The content of the intervention is based on memory training from different perspectives, including cognitive and emotional aspects and social and individual skills. Data will be collected at baseline, at 3-4 months and at 6 months. To assess the efficacy of the intervention on cognitive function, health-related quality of life and functionality, a statistical analysis will be performed by fitting a repeated-measures mixed effects model for each main outcome: Self-perceived memory, measured by a Subjective Self-reported Memory Score (from 0 to 10) and by the Memory Failures in Everyday life questionnaire (MFE); Everyday memory, measured using the Rivermead Behavioural Memory Test-3 (RBMT-3) and Executive control abilities, measured in terms of visual-perceptual ability, working memory and task-switching ability with the Trail Making Test (TMT) and with the digit span scale of the Wechsler Adult Intelligence Scale III (WAIS III).The results of this study will be highly useful for social and public health policies related to older people. Given the continuous increase in the prevalence of older people, a large number of interventions targeting memory loss are funded by public resources. To ensure transparency and effective prioritization, research such as the present study is needed to provide evidence of the effectiveness and usefulness of these interventions.Number: NCT02431182 .

Project description:BackgroundNew effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT) is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors.Methods and findingsWe systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥ 4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I(2) = 29.92%). There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model) for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29). Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38); verbal memory, g = 0.08 (95% CI 0.01 to 0.15); working memory (WM), g = 0.22 (95% CI 0.09 to 0.35); processing speed, g = 0.31 (95% CI 0.11 to 0.50); and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54). No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and only weak evidence for sessions less than 30 min. These results are limited to healthy older adults, and do not address the durability of training effects.ConclusionsCCT is modestly effective at improving cognitive performance in healthy older adults, but efficacy varies across cognitive domains and is largely determined by design choices. Unsupervised at-home training and training more than three times per week are specifically ineffective. Further research is required to enhance efficacy of the intervention. Please see later in the article for the Editors' Summary.

Project description:BackgroundCognitive frailty refers to the coexistence of physical frailty and cognitive impairment, and is associated with many adverse health outcomes. Although cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function. We proposed a virtual reality (VR) simultaneous motor-cognitive training program, which allowed older people to perform daily activities in a virtual space mimicking real environments.ObjectiveWe aimed to (1) explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and (2) 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.MethodsA two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial was employed. The eligibility criteria for participants were: (1) aged ≥60 years, (2) community dwelling, and (3) with cognitive frailty. Those in the intervention group received cognitive training (ie, cognitive games) and motor training (ie, 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 (ie, cognitive games) on tablet computers and motor training (ie, 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.ResultsSeventeen participants were recruited and randomized to 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 Montreal Cognitive Assessment score was 20.0 (IQR 4.0). No significant between-group differences were found in baseline characteristics except in the number of chronic illnesses (P=.04). At postintervention, the intervention group (Z=-2.67, P=.01) showed a significantly larger improvement in cognitive function than the control group (Z=-1.19, P=.24). The reduction in physical frailty in the intervention group (Z=-1.73, P=.08) was similar to that in the control group (Z=-1.89, P=.06). Improvement in walking speed based on the Timed Up-and-Go test was moderate in the intervention group (Z=-0.16, P=.11) and greater in the control group (Z=-2.52, P=.01). The recruitment rate was acceptable (17/33, 52%). 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%) due to minimal VR sickness (Virtual Reality Sickness Questionnaire score=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in either group.ConclusionsThis study provides preliminary evidence that the VR simultaneous motor-cognitive training is effective at enhancing the cognitive function of older people with cognitive frailty. The effect size on frailty was close to reaching a level of significance and was similar to that observed in the control group. VR training is feasible and safe for older people with cognitive frailty.Trial registrationClinicalTrials.gov NCT04467216; https://clinicaltrials.gov/ct2/show/NCT04467216.

Dataset Information

The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials.

Background

Methods

Results

Conclusions

Publications

The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials.

Similar Datasets

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