Abstract
BackgroundNeuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations.ObjectiveThe main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions.MethodsA single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game.ResultsWe have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements.ConclusionsWe expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care.Trial RegistrationClinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB)
Highlights
BackgroundNeurocognitive frailty is the biggest threat to successful aging [1]
C-reactive protein (CRP), an acute-phase protein of hepatic origin that increases following interleukin-6 secretion by macrophages and T cells, has been identified as a hallmark of systemic inflammation, and it can be assessed by noninvasive methods in saliva [5]
A previous randomized controlled trial (RCT) conducted in our laboratory investigated the effects of nonaction video game training on a series of cognitive functions that decline with age and subjective well-being
Summary
There is overwhelming evidence that the number of inflammatory mediators increases vastly in pathological aging [2] and in healthy aging as well [3] This inflammation has a negative impact on cognition [4]. A key challenge that faces the aging society is to find new approaches to understand the aging mind and brain that could enhance successful, optimal aging [6] Another major challenge is to understand the factors that could reduce or delay the negative consequences of age-related cognitive decline [7]. The idea behind this randomized controlled trial (RCT) is that cognitive abilities could be strengthened by interventions that promote positive brain plasticity [8]. Previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations
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