Abstract
BackgroundNeurocognitive disorders are an important societal challenge and the need for early prevention is increasingly recognized. Meta-analyses show beneficial effects of cognitive activities on cognition. However, high financial costs, low intrinsic motivation, logistic challenges of group-based activities, or the need to operate digital devices prevent their widespread application in clinical practice. Solving jigsaw puzzles is a cognitive activity without these hindering characteristics, but cognitive effects have not been investigated yet. With this study, we aim to evaluate the effect of solving jigsaw puzzles on visuospatial cognition, daily functioning, and psychological outcomes.MethodsThe pre-posttest, assessor-blinded study will include 100 cognitively healthy adults 50 years of age or older, who will be randomly assigned to a jigsaw puzzle group or a cognitive health counseling group. Within the 5-week intervention period, participants in the jigsaw puzzle group will engage in 30 days of solving jigsaw puzzles for at least 1 h per day and additionally receive cognitive health counseling. The cognitive health counseling group will receive the same counseling intervention but no jigsaw puzzles. The primary outcome, global visuospatial cognition, will depict the average of the z-standardized performance scores in visuospatial tests of perception, constructional praxis, mental rotation, processing speed, flexibility, working memory, reasoning, and episodic memory. As secondary outcomes, we will assess the eight cognitive abilities, objective and subjective visuospatial daily functioning, psychological well-being, general self-efficacy, and perceived stress. The primary data analysis will be based on mixed-effects models in an intention-to-treat approach.DiscussionSolving jigsaw puzzles is a low-cost, intrinsically motivating, cognitive leisure activity, which can be executed alone or with others and without the need to operate a digital device. In the case of positive results, these characteristics allow an easy implementation of solving jigsaw puzzles in clinical practice as a way to improve visuospatial functioning. Whether cognitive impairment and loss of independence in everyday functioning might be prevented or delayed in the long run has to be examined in future studies.Trial registrationClinicalTrials.gov, NCT02667314. Registered on 27 January 2016.
Highlights
Neurocognitive disorders are an important societal challenge and the need for early prevention is increasingly recognized
In the case of positive results, these characteristics allow an easy implementation of solving jigsaw puzzles in clinical practice as a way to improve visuospatial functioning
Whether cognitive impairment and loss of independence in everyday functioning might be prevented or delayed in the long run has to be examined in future studies
Summary
Neurocognitive disorders are an important societal challenge and the need for early prevention is increasingly recognized. We aim to evaluate the effect of solving jigsaw puzzles on visuospatial cognition, daily functioning, and psychological outcomes Neurocognitive disorders such as mild cognitive impairment and dementia become increasingly important healthcare issues [1]. Randomized controlled trials show beneficial cognitive effects of diverse cognitive activities such as cognitive training [5,6,7,8,9], video games [10,11,12,13], card and board games [14, 15], and educational programs such as computer, digital photography, or theater courses [16,17,18] These evidence-based cognitive activities are characterized by obstacles such as high financial costs, low intrinsic motivation, logistic challenges of group-based activities, or the need to use digital devices. We believe that these characteristics of currently investigated cognitive activities reduce their feasibility and implementation in clinical practice
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