Abstract
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 23 subjects who completed the study, there was a significant improvement in memory on the NeuroTrax cognitive assessment battery. 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 interesting and 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.
Highlights
Aging is often associated with physical and cognitive comorbidity
Deterioration in cognitive function may lead to mild cognitive impairment (MCI) and subsequently to dementia
Voxel-based morphometry maps of the relative changes in brain tissues over one year in those who participated in cognitive training showed an increase in grey matter (GM) in two regions (Figure 2A and Table 2): (1) The anterolateral occipital lobe, bordering the parietal and temporal lobes of the left cerebral hemisphere
Summary
Aging is often associated with physical and cognitive comorbidity. Deterioration in cognitive function may lead to mild cognitive impairment (MCI) and subsequently to dementia. There is increasing evidence supporting the value of timely recognition and diagnosis of deteriorating cognitive function [1]. The discovery of reliable markers will allow for the initiation of pharmacologic and nonpharmacologic interventions that may hopefully delay the onset of cognitive symptoms [2]. The practice guidelines of the American Association of Neurology do not support the use of pharmacological agents for the treatment of MCI. Non-pharmacological strategies, such as physical exercise and cognitive interventions, are recommended [5,6]. There is increasing interest on the effects of cognitive training on brain plasticity in MCI and early dementia [7]
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