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Randomized Controlled Trial of the Picture Book Reading Program on Cognitive Function in Middle-Aged People.

ABSTRACT: Background: To delay cognitive decline, it is important to engage actively in preventive activities from middle age (50-64 years of age). We have developed a cognitive intervention program using picture book reading, and demonstrated that it is effective for improving memory in older adults. However, the effect of the intervention on memory and other cognitive functions in middle-aged people has not been examined. The current study investigated the effects of the picture book reading program on cognitive function in middle-aged people. Methods: This single-blind (examiners were blinded) randomized controlled trial was conducted in Tokyo, Japan. A total of 65 participants were randomly assigned to the intervention group (IG) (n = 32), in which members attended 12 picture book reading classes held once a week, or the active control group (CG) (n = 33), in which members received lectures on health maintenance. Cognitive tests were conducted before and after the intervention. The primary outcome was memory, and the secondary outcomes were verbal function and executive function. Results: The results showed that there was no significant difference between the IG and the CG in change scores (post minus pre) for memory. On the other hand, there was a significant difference in change scores of the category fluency, which is a measure of verbal function, suggesting improvements in IG compared to CG. There were also no significant differences in executive function. Conclusions: The results indicated that our previous finding of an improvement in memory function in older adults was not found in middle-aged people. However, the findings suggest that the picture book reading program may affect lexical access ability in verbal function among middle-aged people. Because maintaining verbal function is important for daily communication, these findings suggest that this program may be a useful countermeasure for cognitive decline in middle-aged people. Clinical Trial Registration: University Hospital Medical Information Network Clinical Trial Registry, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048012, Identifier: UMIN 000042071.

SUBMITTER: Iizuka A

PROVIDER: S-EPMC8170038 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The relationship between mental exercise and mental aging is a controversial issue. People generally believe the so-called mental-exercise hypothesis, that is, the age-related decline in cognitive function is less pronounced for people who are mentally active, yet there is insufficient scientific evidence supporting this hypothesis. Previous randomized controlled trial studies showed convincing beneficial effects of cognitive training on directly targeted cognitive functions. In this study, we performed a single-blind, randomized controlled trial on cognitive intervention in 124 community-dwelling seniors (age range, 70 to 86) and estimated the beneficial effects of non-targeted cognitive functions. As for cognitive intervention, the subjects were asked to solve systematized basic problems in reading and arithmetic every day for 6 months. Neuropsychological measures were determined prior to and 6 months after the intervention (post-test) by mini-mental state examination (MMSE), frontal assessment battery at bed side (FAB), and digit-symbol substitution test (DST) of WAIS-R. The FAB and DST scores showed a statistically significant (p<0.001 and p<0.01, respectively) improvement in the post-test compared with the pre-test, such improvement was maintained up to 6 months of follow-up tests in only the experimental group. The transfer effect of cognitive intervention by reading and solving arithmetic problems on non-targeted cognitive functions was demonstrated in this study. This study shows that daily mental training can improve cognitive functions in normal adults. Although general interests in brain training have been increasing in the public, evidence for its beneficial effects, particularly the positive transfer effect on non-targeted cognitive function still remains insufficient. Here, we introduce a new cognitive intervention program for normal aged people, the concept of which is derived from the knowledge of both brain science and clinical studies. We performed a carefully designed single-blind, randomized controlled study, and the results of this study showed convincing evidence that cognitive training provides the beneficial transfer effect.

Project description:BackgroundGiven the increasing incidence of early-onset Alzheimer disease, strategies for early diagnosis and swift treatment interventions are crucial for mitigating cognitive problems in women and middle-aged individuals who face a high risk of cognitive impairment.ObjectiveThis study aimed to assess the effectiveness of individual cognitive training programs based on virtual reality (VR), a nonpharmacological intervention, on cognitive function and depression in middle-aged women at risk of cognitive impairment. It used VR technology, which has recently been recognized as a promising tool.MethodsWe administered a VR-based cognitive training program for 30 minutes daily, twice a week, for 12 weeks (24 sessions). This study included middle-aged women residing in older adults' welfare facilities in G-gu, Busan, from May to August 2021. A total of 60 participants were randomly divided into the training (n=30) and control (n=30) groups. Cognitive and depressive functions were assessed using the Korean versions of the Montreal Cognitive Assessment (K-MoCA), Digit Span Test (DST), Korean-Color Word Stroop Test (K-CWST), and Short Form of the Geriatric Depression Scale (SGDS-K) before the intervention. The training group underwent a VR-based cognitive training program, whereas the control group was educated to maintain regular daily activities. The same assessments were performed 12 weeks after treatment.ResultsA comparison of the mean scores before and after K-MoCA in the training group revealed a significant increase from 24.87 (SD 2.62) to 27.50 (SD 1.70; P<.01), indicating substantial cognitive improvement. Similarly, the mean DST forward scores increased significantly from 6.97 (SD 1.10) to 7.90 (SD 1.18; P<.01), suggesting enhanced short-term auditory memory and attention. The mean DST backward scores also showed a significant improvement from 4.10 (SD 0.71) to 4.77 (SD 1.2; P=.01). Notably, the mean SGDS-K scores decreased significantly from 3.97 (SD 2.51) to 2.13 (SD 1.87; P<.01), indicating a reduction in depression within the training group.ConclusionsThe VR-based cognitive training programs significantly enhanced cognitive function and reduced depression in middle-aged women. Consequently, these programs are considered beneficial nonpharmacological cognitive training interventions for middle-aged women at high risk of cognitive impairment.Trial registrationUMIN Clinical Trials Registry UMIN000049752; https://tinyurl.com/z5du989z.

Project description:To test associations between statin use and cognitive impairment in adults with childhood-onset type 1 diabetes (T1D).In 2010-13, n = 108 middle-aged participants from ongoing observational Pittsburgh Epidemiology of Diabetes Complications Study underwent neurocognitive assessment (mean age and T1D duration of 49 and 41 years, respectively). All were diagnosed with childhood-onset (i.e., prior to age 18) T1D between 1950 and 1980 and were seen within one year of diagnosis at Children's Hospital of Pittsburgh. Self-reported statin use (yes/no and if yes, name of statin) was collected biennially from parent study baseline (1986-1988) to time of neurocognitive testing. Logistic regression models tested associations between statin use groups and cognitive impairment (defined as having two or more cognitive test scores 1.5SD or worse than published norms) while linear regression models tested associations between statin use groups and cognitive domain z-scores (domains: Verbal IQ, memory, executive function, psychomotor speed, and visuo-construction). All models controlled for education and age. To address confounding by indication, models were repeated using a propensity score for statin use.Of the 108 participants, 51 reported never using statins. Median duration of statin use among the 57 ever users was 6 years. These 57 ever statin users were split to create two groups (≤ or > median years of statin use): 1-6 years (n = 25), and 7-12 years (n = 32). Compared with never users, using statins 1-6 years tripled the odds of cognitive impairment (OR = 3.16; 95%CI: 0.93-10.72; P = 0.06) and using statins 7-12 years almost quintupled the odds of cognitive impairment (OR = 4.84; 95%CI: 1.63-14.44; P = 0.005). Compared with never users, using statins 1-6 or 7-12 years was related to worse performance in the memory domain (β = -0.52; P = 0.003, and -0.39; P = 0.014, respectively). Adjusting for coronary artery disease, low density lipoprotein cholesterol, and Apo E4 status did not substantially alter results, and none of these covariates were significantly related to cognitive outcomes (all P > 0.05). Propensity score analyses support that associations between poor cognitive outcomes and statin use were not due merely to confounding by indication.Statin use was associated with cognitive impairment, particularly affecting memory, in these middle-aged adults with childhood-onset T1D, whom at this age, should not yet manifest age-related memory deficits.

Project description:Background: Numerous benefits of green tea have been reported. However, the effects of green tea on cognitive function remain disputable and the mechanism is still unclear. Objective: To investigate the relationship of green tea consumption with cognitive function and related blood biomarkers among Chinese middle-aged and elderly people. Methods: A total of 264 participants aged 50-70 years old were enrolled from Zhongnan Hospital of Wuhan University. They were interviewed about green tea consumption patterns and underwent neuropsychological tests covering five main cognitive domains to assess cognition including Montreal Cognitive Assessment (MoCA) and the other 10 scales. Then we detected serum oxidative stress biomarkers including Superoxide Dismutase (SOD), Malondialdehyde (MDA), Glutathione Peroxidase (GPx), Glutathione Reductase (GR), and Alzheimer's disease (AD) markers including β-amyloid (Aβ)40, Aβ42, and phosphorylated tau-181 (pTau181). Results: In the tea-consuming group, the MoCA scores (P = 0.000), Hopkins Verbal Learning Test (HVLT) immediate recall (P = 0.012) and delayed recall (P = 0.013) were significantly higher while Trail Making Test-B (P = 0.005) and Victoria Stroop test interference (P = 0.000) were lower. In terms of oxidative stress markers, the tea-consuming group had lower serum MDA levels (P = 0.002) and higher serum SOD (P = 0.005) and GPx (P = 0.007) levels. In terms of AD markers, serum pTau181 (P < 0.000), Aβ42 (P = 0.019) and total Aβ levels (P = 0.034) but not serum Aβ40 levels, were lower in the tea-consuming group. In the logistic regression analysis, there was a significant negative correlation between green tea consumption and cognitive impairment (OR = 0.26, 95 % CI 0.13 0.52 for high group). Conclusion: Regular green tea consumption is associated with better cognitive function among Chinese middle-aged and elderly people, mainly reflected in memory and executive function. It may achieve protective effects by reducing AD-related pathology and improving anti-oxidative stress capacity and higher levels of tea consumption have a stronger protective effect.

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Randomized Controlled Trial of the Picture Book Reading Program on Cognitive Function in Middle-Aged People.

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