Cognitive Training Exercises Research Articles

A qualitative analysis of participant experience during an EEG-linked auditory targeted cognitive training exercise: Implications for implementation and protocol optimization

Auditory-based targeted cognitive training (ATCT) is an emerging adaptive neuroplasticity-based intervention. Previous studies have shown that electroencephalographic (EEG) biomarkers of auditory information processing assessed at the start of ATCT have predicted cognitive, clinical, and functional gains from a full 30–40 hour ATCT program, but participant attitudes related to coupling EEG to ATCT are not well-known. This study assessed stakeholder feedback related to EEG biomarker collection as part of ATCT to optimize future EEG-informed ATCT studies. Semi-structured interviews assessed attitudes of ATCT-naïve participants (n=50) living with a range of psychiatric disorders and cognitive function who underwent EEG assessment associated with a 1 hour ATCT exercise. A deductive approach was used to code the data and an iterative approach was employed to identify key emerging themes. Interview data yielded 62 unique themes related to EEG biomarker collection and ATCT. Qualitative analysis identified positive and negative elements of participants’ experience of EEG-informed ATCT as well as ways to streamline the EEG experience. Results suggest EEG-informed ATCT studies may be optimized using actionable improvements to current protocols leveraged from themes identified.

FC7: Effects of a multidomain cognitive stimulation program in older adults

Objectives: The aim of this study was to ascertain the influence of a six-month multidomain stimulation program on cognitive functioning.Methods: The sample comprised 25 older adults 60 years-old and older (Mage = 66.08 years), of whom 96% were women and 54% had high education. The intervention program had a duration of six months and was implemented in a group format in one-hour sessions on a weekly basis. Lessons on neuroprotective factors, training in practical compensatory strategies to improve daily performance, cognitive training exercises and recreational cognitive stimulation activities were included. In order to analyze participants’ cognitive functioning the following instruments were used: Mini-Mental State Examination, Rey Complex Figure Test, Digit Span Test, Stroop Test, Trail Making Test (Part A and Part B), Verbal Fluency Test, Boston Naming Test (Short Form) and Neuropsi Verbal Memory Subtest. Wilcoxon test was performed to test the impact of the intervention program on participants cognitive functioning.Results: Statistically significant differences were found after the six-month intervention in verbal memory encoding (W= –2.772, p< 0.05), in spontaneous verbal memory retrieval(freerecall) (W= – 3.456, p< 0.001), inverbal recognition memory (W = –3.184, p < 0.001), in spontaneous visual memory retrieval (W = –2.056, p < 0.05), and in naming by visual confrontation (W = –2.521, p < 0.05). In all cases, participants increased their scores after taking part in multicomponent a six-month multidomain stimulationprogramConclusions: One of the biggest concerns among older people is the loss of cognitive abilities that may occur with ageing. Cognitive stimulation programs, if sufficiently comprehensive, can be a good tool to maintain and improve cognitive functions as we age.

Enhancing cognitive resilience: a narrative review of lifestyle interventions in cognitive decline prevention among older adults

Background: The increasing prevalence of cognitive decline and neurodegenerative disorders among ageing populations necessitates effective preventive strategies. Lifestyle interventions, including dietary modifications, cognitive training, and physical exercise, have emerged as promising avenues for enhancing cognitive resilience. This narrative review synthesizes current evidence on the efficacy of lifestyle interventions in preventing or delaying cognitive decline among older adults. Methods and Materials: A systematic search was conducted across databases, including PubMed and Google Scholar, using the PICO framework to formulate a precise research question. Inclusion criteria encompassed diverse study designs, focusing on older adults aged 65 years and above, diagnosed with mild cognitive impairment (MCI) or early-stage Alzheimer's disease (AD). Lifestyle interventions targeting cognitive health were compared against standard care or alternative non-pharmacological approaches, with primary outcomes including changes in cognitive function and activities of daily living (ADLs). Objectives: The review aimed to evaluate the effectiveness of lifestyle interventions, such as cognitive training, dietary modifications, and physical exercise, in preserving cognitive function and delaying cognitive decline among older adults. Results: The synthesis of evidence revealed significant benefits associated with lifestyle interventions. Dietary patterns rich in antioxidants, anti-inflammatory compounds, and essential fatty acids demonstrated neuroprotective effects and reduced cognitive decline risk. Physical exercise programs and cognitive stimulation interventions also showed promise in maintaining cognitive function. Multimodal approaches, personalized interventions, and long-term follow-ups emerged as key considerations for optimizing outcomes.

Effects of Serious Games in Older Adults With Mild Cognitive Impairment.

The rising prevalence of mild cognitive impairment (MCI) has spurred interest in innovative cognitive rehabilitation approaches, including serious games. This review summarizes randomized clinical trials (RCTs) exploring the impact of serious games on MCI patients. We conducted a comprehensive data search using key terms such as "gamification," "digital therapy," "cognition," "mild cognitive impairment," and "Alzheimer's disease." We exclusively considered published RCTs, excluding animal studies and basic research. We identified eight RCTs. Four RCTs examined the effects of serious games using cognitive training for MCI patients. Notably, one study found that non-specific training (Nintendo Wii) significantly enhanced cognitive function and quality of life compared to cognition-specific computer training (CoTras). Among the remaining three RCTs, one specifically demonstrated that personalized serious game-based cognitive training yielded superior cognitive outcomes and reduced depressive symptoms. One RCT focused on serious games incorporating physical exercise, highlighting the effectiveness of kinetic-based exergaming in enhancing overall cognition. Three RCT focused on combined cognitive training and physical exercise. A double-blind RCT revealed that progressive resistance training or standalone physical exercise outperformed the combined approach in improving executive function and global cognition. Two additional RCTs reported positive outcomes, including improvements in cognitive function and electroencephalogram patterns associated with game-based interventions. Serious games, whether focusing on cognitive training, physical exercise, or a combination of both, have potential to improve cognitive and functional outcomes in individuals with MCI. Further research and standardization of protocols are needed to better understand the full potential of serious games in MCI.

Efficacy and Concurrent Validity of Computerized Brain Training Based on Everyday Living (BTEL) Based on Instrumental Activities of Living for Cognitively Healthy Old Individuals: A Preliminary Study

Background: Interventions to prevent or attenuate cognitive decline and dementia in older adults are becoming increasingly important. Recently, cognitive training exercise can be via computer or mobile technology for independent or home use. Recent meta-analysis has reported that Computerized Cognitive Training (CCT) is effective at enhancing cognitive function in healthy older and Alzheimer’s disease adults, although little is known about individual characteristics of each computerized program. Objective: We developed a new CCT named Brain Training Based on Everyday Living (BTEL) to enhance cognitive capacity for Instrumental Activities of Daily Living (IADL). We aim to evaluate the efficacy of the BTEL among cognitively healthy old individuals and to explore its concurrent validity and construct concept. Methods: We conducted a double-blind study where 106 individuals aged 65 years and older (intervened = 53, control = 53) worked on the active and placebo tasks three times a week over three months (clinical trial: UMIN000048730). The main results were examined using ANCOVA and calculating correlation coefficients. Results: We found no effect on total score of the three tests; however, there was significant effect for the BTEL on: recognition in MMSE, and immediate recall in HDSR. The tasks are associated with prefrontal cortex. In addition, correlations indicated that each BTEL domain had some validity as a cognitive assessment tool. Different from previous CCT, we determined the neuropsychological characteristics of specific cognitive tasks of the BTEL to a certain degree. Conclusions: We found modest efficacy of the BTEL in cognitively healthy old individuals and confirmed its concurrent validity and the conceptual construct.

Comparing the Effectiveness of Computerized Cognitive Rehabilitation and Practical Neuropsychological Exercises on Working Memory and Clinical Symptoms of Children with Attention Deficit/Hyperactivity Disorder

Introduction: Considering the increase in the number of children suffering from attention deficit/hyperactivity disorder compared to previous years, as well as the need of the scientific community to have correct and accurate scientific information about this disorder, it is necessary to carry out scientific research and more detailed investigations in the society for treatment. This disorder should be treated. Aim: This research was conducted with the aim of comparing the effectiveness of computerized cognitive rehabilitation and practical neuropsychological exercises on working memory and clinical symptoms of children with attention deficit/hyperactivity disorder. Method: The research method was semi-experimental with a pre-test, post-test and follow-up plan with a control group. The population of this research was all children aged 7 to 11 with attention deficit/hyperactivity disorder who referred to pediatric psychiatrists and child psychologists in Tehran in the months of April to September 1401, and among them, 45 children were selected using a targeted sampling method. They were randomly selected and replaced in three equal groups of 15 people. To collect data, the Wechsler Working Memory Test (WISC-R), Children's Illness Symptoms Questionnaire (CSI-4), the fourth edition of the Swanson, Nolan and Pelham SNAP-IV scale and the Wechsler Children's Scale WISC-V DS21 subtest were used. SPSS software and multivariate covariance analysis tests were used for data analysis. Results: The results showed that both computerized cognitive rehabilitation intervention and neuropsychological practical exercises showed a significant difference in the post-test stage and follow-up on working memory and clinical symptoms of children with disorders. They have created attention deficit/hyperactivity disorder. Conclusion: The results show that in working memory variables and clinical symptoms, computerized cognitive rehabilitation training and practical neuropsychological exercises have the same effectiveness.

423. Biomarkers of Auditory Information Processing and Neural Synchrony Predict Targeted Cognitive Training Exercise Completion in a Transdiagnostic Population

423. Biomarkers of Auditory Information Processing and Neural Synchrony Predict Targeted Cognitive Training Exercise Completion in a Transdiagnostic Population

Go4cognition: Evaluation of a Newly Developed Multicomponent Intervention in Mild Cognitive Impairment.

Cognitive training and physical exercise show positive effects on cognitive decline in subjects with mild cognitive impairment (MCI). Multimodal interventions for MCI patients, combining physical and cognitive training in a social context seem to slow down cognitive decline. Based on a previous study, a new mobile gamification tool (go4cognition; https://www.ontaris.de/go4cognition) has been developed to train cognitive and physical functions simultaneously in a group setting. It involves tasks targeting various cognitive functions (short-term memory, working memory, executive functions). The computer-based setup allows for individual performance analysis. This study evaluated the effects of this tool. 30 participants with MCI, as defined by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) cut-off-score, aged between 66 and 89 years, trained for one hour two days a week for twelve weeks. Additionally, standard neuropsychological assessment of memory and attention was carried out before and after the intervention. The go4cognition device is highly effective in improving various cognitive functions. A significant improvement in the CERAD total score resulting in re-classification of 70% of former MCI patients into non-MCI patients was found. Additionally, an improvement of verbal fluency, verbal memory, spatial memory, and attention was observed. Furthermore, the CERAD total score was significantly correlated with performance in the go4cognition tool. The results of the intervention support the idea of the effectiveness of a combined cognitive and motor intervention by incorporating neuropsychological paradigms in a group setting and suggest a close relation between combined cognitive and physical exercise and cognitive performance.

A multimodal group-based immersive virtual reality intervention for improving cognition and mental health in patients with post-covid-19 condition. A quasi-experimental design study.

Adults with Post-COVID-19 Condition (PCC) may show cognitive impairments in attention, processing speed, memory, and executive function. Multimodal programs that combine cognitive training, physical activity and emotional tasks, such as mindfulness-based interventions (MBIs), may offer a suitable alternative for improving PCC treatments. Immersive Virtual Reality (IVR) is a promising technology that can enhance traditional cognitive training, physical activity, and MBIs. The use of IVR technology may increase engagement with these interventions and potentially enhance the individual benefits of cognitive training, exercise and MBIs. The current study evaluated the impact of a multimodal IVR intervention, comparing this with a usual care intervention (control group), in order to assess changes in cognition and mental health in adults with PCC. We also aimed to assess user experience factors such as enjoyment, perceived improvement, and fatigue following each multimodal IVR session within the experimental group. Thirty-one participants with PCC symptoms were assigned to either the experimental group (IVR, n = 15) or the control group (usual care intervention, n = 16) in a quasi-experimental design study. The multimodal IVR intervention consisted of MBI, cognitive training and physical exercise and was delivered in a 60-min group session with 5 participants, twice a week, for 8 weeks (16 sessions in total). Measures of global cognition, attention, processing speed, verbal episodic memory and subjective memory complaints (primary measures), and depressive and anxiety symptoms and fatigue (secondary measures) were assessed at baseline and also after 8 weeks (post-intervention). Mixed between-group (group) and within-group (pre-post assessments) ANOVAs revealed significant group*time interactions in global cognition, simple attention, processing speed, memory and depressive symptoms, with large effect sizes (p < 0.05; partial η2 > 0.14). There was also a marginally significant group*time interaction for executive function (p = 0.05). Follow-up analyses comparing pre-and post-intervention outcomes for each group separately showed that the experimental group significantly improved in global cognition, processing speed, memory and depressive symptoms, while the control group showed no significant pre-post changes. Friedman tests showed a significant main effect of time (χ2(2) = 6.609, p = 0.04), with a gradual increase in enjoyment from the first, to the mid, and then to the final session. In addition, perceived improvement scores remained high throughout the intervention, and patient-reported fatigue levels did not fluctuate significantly throughout the intervention. To our knowledge, no previous research has combined cognitive training, physical exercise and MBI using an IVR paradigm in adults with PCC. Despite their inherent limitations, our findings mark a pioneering step toward improving cognition and mental health outcomes in PCC through the innovative use of new technology and multimodal approaches. This first study should be accompanied by more extensive, randomized clinical trials aimed at further exploring and refining these interventions.

The Efficacy of a Brief Psychoeducational Intervention to Improve Engagement in Computerized Cognitive Training Exercises in Major Depressive Disorder

The Efficacy of a Brief Psychoeducational Intervention to Improve Engagement in Computerized Cognitive Training Exercises in Major Depressive Disorder

Cognitive and Exercise Training Improves Intraindividual Variability in Cognitive Performance in Older Adults: Secondary Findings of A Randomized Controlled Trial

AbstractBackgroundIncreased intraindividual variability of cognitive performance is a marker of cognitive decline. Whether computerized cognitive training (CCT) and aerobic exercise counteracts cognitive decline by reducing intraindividual variability is unknown. We investigated the effects of CCT with or without aerobic exercise on reaction time intraindividual variability in older adults.MethodThis was a secondary analysis of an 8‐week randomized controlled trial. Older adults (aged 65‐85 years) were randomized to CCT alone (n = 41), CCT with aerobic exercise (n = 41), or an active control group (n = 42). The CCT group trained using the Fit Brains® platform 3×/week for 1 hour (plus 3×/week of home‐based training). The CCT with aerobic exercise group received 15 min of walking plus 45 min of Fit Brains® 3×/week (plus 3×/week of home‐based training). The control group received sham exercise and cognitive training (3×/week for 1 hour). We extracted reaction times from the Dimensional Change Card Sort Test, Flanker Inhibitory Control and Attention Test (Flanker), and Pattern Comparison Processing Speed Test (PACPS). Intraindividual variability was measured as residual intraindividual standard deviation (residual ISD) of raw reaction time latencies. Residual ISD is an unbiased measure of variability that accounts for within and between participant source of variation that could influence reaction time latencies. We also calculated reaction time intraindividual SD (raw‐score ISD) and intraindividual coefficient of variation (ICV).ResultCompared with the control group, residual ISD improved in a processing speed task (PACPS) following CCT alone (mean difference [95% confidence interval]: ‐0.147 [‐0.230 to ‐0.065], p&lt;0.001) and CCT with aerobic exercise (‐0.111 [‐0.195 to ‐0.027], p&lt;0.01). Also, for processing speed, both CCT (‐0.173 [‐0.261 to ‐0.084], p&lt;0.001) and CCT with aerobic exercise (‐0.122 [‐0.213 to ‐0.032], p&lt;0.01) showed greater reduction in raw‐score ISD compared with controls, while only CCT reduced ICV for this task (‐0.108 [‐0.176 to ‐0.040], p&lt;0.001). Inhibitory attention (Flanker) improved only after CCT with aerobic exercise (congruent = ‐0.128 [‐0.250 to ‐0.006], incongruent = ‐0.121 [‐0.237 to ‐0.005], both p&lt;0.05).ConclusionA CCT program promoted cognitive health via reductions in intraindividual variability of cognitive performance and combining it with aerobic exercise resulted in broader benefits.

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial.

Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior. In this study, we tested the effects of web-based targeted cognitive and social cognitive training (TCT) delivered in conjunction with an innovative digital smartphone app called Personalized Real-Time Intervention for Motivational Enhancement (PRIME). The PRIME app provides users with a motivational coach to set personalized goals and secure social networking for peer support. This study investigated whether deficits in cognition and motivation in people with a psychosis spectrum disorder (N=100) can be successfully addressed with 30 hours of TCT+PRIME as compared with 30 hours of a computer games control condition (CG) plus PRIME (CG+PRIME). Here, we describe our study procedures, the feasibility and acceptability of the intervention, and the results on all primary outcomes. In this double-blind randomized controlled trial, English-speaking participants completed all cognitive training, PRIME activities, and assessments remotely. Participants completed a diagnostic interview and remote cognitive, clinical, and self-report measures at baseline, posttraining, and at a 6-month follow-up. This study included participants from 27 states across the United States and 8 countries worldwide. The study population was 58% (58/100) female, with a mean age of 33.77 (SD 10.70) years. On average, participants completed more than half of the cognitive training regimen (mean 18.58, SD 12.47 hours of training), and logged into the PRIME app 4.71 (SD 1.58) times per week. The attrition rate of 22% (22/100) was lower than that reported in our previous studies on remote cognitive training. The total sample showed significant gains in global cognition (P=.03) and attention (P<.001). The TCT+PRIME participants showed significantly greater gains in emotion recognition (P<.001) and global cognition at the trend level (P=.09), although this was not statistically significant, relative to the CG+PRIME participants. The total sample also showed significant improvements on multiple indices of motivation (P=.02-0.05), in depression (P=.04), in positive symptoms (P=.04), and in negative symptoms at a trend level (P=.09), although this was not statistically significant. Satisfaction with the PRIME app was rated at 7.74 (SD 2.05) on a scale of 1 to 10, with higher values indicating more satisfaction. These results demonstrate the feasibility and acceptability of remote cognitive training combined with the PRIME app and that this intervention can improve cognition, motivation, and symptoms in individuals with psychosis. TCT+PRIME appeared more effective in improving emotion recognition and global cognition than CG+PRIME. Future analyses will test the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning. ClinicalTrials.gov NCT02782442; https://clinicaltrials.gov/study/NCT02782442.

The Interplay Between Table Tennis Skill Development and Sports Performance: A Comprehensive Review

This study presents a comprehensive literature review on skill development in table tennis, focusing on various factors that influence expertise in the sport. The research synthesizes findings from multiple studies to understand the effectiveness of mental training programs, the relationship between cognitive functions and table tennis skills, differences between elite and sub-elite players, the impact of visual attention on performance, the effects of plyometric training on serve performance, and the comparison of practice schedules for skill learning and retention. Additionally, the paper explores the stages of tennis forehand attacking technique development, encompassing generalization, differentiation, consolidation, and automation stages, while discussing individual and environmental factors influencing skill development, highlighting the importance of early learning experiences, motivation, intelligence, and family support. Furthermore, the research delves into the history of table tennis performance evaluation methods, including video observation, expert interviews, and the four-stage index evaluation, establishing the reciprocal relationship between skill development and sports performance, emphasizing how enhanced athletic performance fosters skill mastery and vice versa. The findings underscore the significance of mental preparation, cognitive functions, technical proficiency, visual attention, and practice structuring in the pursuit of expertise in table tennis, indicating that incorporating mental training, cognitive training, specialized practice, and plyometric exercises can be beneficial for skill development and performance improvement in the sport.

Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: A systematic review and meta-analysis.

Although front-line doctors recommend medications, this kind of treatment has limited efficacy in improving executive functions (EFs) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This study explored the effects of non-pharmacological intervention on EFs in children and adolescents with ADHD. In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, we searched seven electronic databases: APA PsycINFO, CINAHL Complete, EMBASE, ERIC, Medline, Pubmed, and Web of Science, from inception to March 2022. Two authors independently screened studies for eligibility, extracted data, and assessed bias risk using the Physiotherapy Evidence Database scale. Our analyses included randomized controlled trials and non-randomized comparison studies of non-pharmacological interventions and assessed EFs through neurocognitive tasks in children and adolescents between 5 and 18 years. Sixty-seven studies with 3147 participants met the inclusion criteria. The final meta-analysis included 74 independent interventions categorized into six categories: cognitive training, EF-specific curriculum, game-based training, mindfulness practice, neurofeedback training, and physical exercise. Overall, non-pharmacological interventions (combined) produced significant moderate to large effects on overall EFs in children and adolescents with ADHD (g=0.673). Physical exercise had a large positive effect on domain-specific EFs, including inhibitory control (g=0.900) and cognitive flexibility (g=1.377). Cognitive training had a large training effect on working memory (g=0.907), and an EF-specific curriculum had a small to moderate beneficial effect on planning performance (g=0.532). Non-pharmacological interventions, particularly physical exercise, cognitive training, and an EF-specific curriculum, appear to have beneficial effects on EFs in children and adolescents with ADHD.

Automatic planning in cognitive training: application to multiple sclerosis

ABSTRACT Multiple sclerosis (MS) is the second-most common cause of neurological disability among young adults. Cognitive impairment, which typically worsens over time, is a major symptom of MS. Signs of cognitive impairment can be observed in many cognitive domains, often including executive-function disorders. Planning is one of the main skills related to executive functions and is fundamental for many cognitive and motor tasks. Brain games, initially available in paper-and-pen format, have been designed to improve planning abilities. Current computerized cognitive training tools also include this kind of exercises; however, they have several limitations, which can be addressed exploiting automated planning. This solution enables advanced forms of human-computer interaction, but poses several design challenges. We tested the usability of two cognitive training exercises for executive functions based on automated planning, which include various features and interaction mechanisms. We present the results of a multidomain cognitive training addressed to individuals affected by MS, including the exercise that performed better in the test. The aim of this study is to clarify design issues concerning executive-function exercises based on automated planning, showing that they can be used in a multidomain cognitive training by participants affected by MS.

MSK1 is required for the beneficial synaptic and cognitive effects of enriched experience across the lifespan.

Positive experiences, such as social interaction, cognitive training and physical exercise, have been shown to ameliorate some of the harms to cognition associated with ageing. Animal models of positive interventions, commonly known as environmental enrichment, strongly influence neuronal morphology and synaptic function and enhance cognitive performance. While the profound structural and functional benefits of enrichment have been appreciated for decades, little is known as to how the environment influences neurons to respond and adapt to these positive sensory experiences. We show that adult and aged male wild-type mice that underwent a 10-week environmental enrichment protocol demonstrated improved performance in a variety of behavioural tasks, including those testing spatial working and spatial reference memory, and an enhancement in hippocampal LTP. Aged animals in particular benefitted from enrichment, performing spatial memory tasks at levels similar to healthy adult mice. Many of these benefits, including in gene expression, were absent in mice with a mutation in an enzyme, MSK1, which is activated by BDNF, a growth factor implicated in rodent and human cognition. We conclude that enrichment is beneficial across the lifespan and that MSK1 is required for the full extent of these experience-induced improvements of cognitive abilities, synaptic plasticity and gene expression.

Effects of home-based computerized cognitive training and tai chi exercise on cognitive functions in older adults with mild cognitive impairment

Background A randomized trial was conducted to investigate the effects of computerized cognitive training (CCT) and tai chi exercise (TCE) vs. health education (HE) on cognitive functions in 189 older adults with mild cognitive impairment (MCI). Methods Cognitive functions were assessed by the five-domain Mattis Dementia Rating Scale (MDRS) (attention, initiation/perseveration, construction, conceptualization, and memory) and the modified Telephone Interview of Cognitive Status (TICS-M), while the timed up and go (TUG), Tinetti’s balance, activities of daily living (ADLs), and Activities-specific Balance Confidence (ABC) were also evaluated. Each intervention was delivered once a week for 6 months. All outcomes were followed up at 6 and 12 months of the study. Results Compared to HE, CCT increased scores on the MDRS’s total, initiation/perseveration, construction, and conceptualization domains and on the TICS-M at 6 months and those on the MDRS’s total, attention, construction, conceptualization, and memory domains and on the TICS-M at 12 months; TCE increased scores on the MDRS’s total and construction domains and on the TICS-M at 6 months and those on the MDRS’s total, attention, initiation/perseveration, and conceptualization domains and on the TICS-M at 12 months. Moreover, CCT improved the TUG at 6 and 12 months and Tinetti’s balance at 12 months, and TCE improved the TUG at 6 and 12 months, Tinetti’s balance, and ABC at 6 and 12 months, and ADLs at 12 months. Conclusions The effects of CCT and TCE on improving global cognition and certain cognitive domains for older MCI adults may have been small but they lasted for at least 12 months.

Effect of environmental enrichment on relapse rates in patients with severe alcohol use disorder: protocol for a randomised controlled trial

IntroductionAlcohol use disorder (AUD) ranks among the most prevalent psychiatric disorders worldwide. Despite current treatments, more than half of patients relapse within weeks after treatment. In animal models, exposure to...

Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis

Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis. This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment. Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate. Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning. Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods. PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa.

Evidence-based interventions for people with mild cognitive impairment (MCI): Where are we now?

As increasing attention is focused on the experiences of people living with mild cognitive impairment (MCI), this paper reviews where we stand regarding evidence-based interventions. From simpler offers of information, psychoeducation, and ‘living well’ programmes, to more structured approaches that include cognitive stimulation, rehabilitation, and training, mindfulness, and mind-body exercise. Amongst studies of varying quality, there are notable trends emerging: evidence supports cognitive stimulation and combined mind-body programmes to improve neurocognitive function, yet there is still no clear picture regarding the efficacy of rehabilitation, cognitive training, or mindfulness-based approaches. Increasingly, it is multi-component interventions that are currently associated with more positive outcomes for cognitive health and wellbeing. However, it remains challenging to know what will work for whom when implementing these interventions in clinical practice.