Effects Of Cognitive Training Research Articles

LOCATION MODERATES THE EFFECT OF COGNITIVE TRAINING ON CRASH RISK OVER 20 YEARS: AN ANALYSIS OF THE ACTIVE STUDY

Abstract Driving is a critical everyday function that helps older adults remain independent. The Advanced Cognitive Training in Vital Elderly (ACTIVE) study has shown cognitive training improves driving safety outcomes for older adults. Few studies have examined the longitudinal effects of cognitive training on crash risk beyond 5 years. To address this empirical gap, we aimed to determine the effects of cognitive training on crash risk over 20 years, and how urbanicity moderates these relationships. Using participants from the no-contact control and intervention (speed of processing, memory, and reasoning training) groups in the ACTIVE study (n=2170) and state-recorded crash reports, cox proportional hazards models were used to examine the effect of three cognitive training interventions as predictors of time to first at-fault crash over 20 years. Participants (mean age 73, 73% White, 23% Male) reported driving 90.6 miles/week on average and 12.6% experienced an at-fault crash. Overall, speed of processing training was the only intervention related to lower crash risk, but this varied by urbanicity. Namely, speed of processing training was related to lower crash risk for individuals living in rural environments (HR=.16, 95% CI [.04-.73], p=.018) but not for individuals in urban environments (HR=.89, 95% CI [.54-1.50], p=.679). Findings highlight the safety benefits of speed of processing training for older drivers living in rural environments where more fatal crashes occur. However, interventions are still needed to improve safety in urban environments where more crashes occur generally. Consideration of location in future interventions may help improve safe driving for older adults.

THE RELATIONSHIP BETWEEN 10-YEAR CHANGES IN COGNITIVE ABILITY AND SUBSEQUENT MORTALITY: FINDINGS FROM THE ACTIVE

Abstract Cognitive ability and cognitive decline have been linked with mortality in older adults. However, little was understood about the role of cognitive interventions on mortality outcomes in this population. Using twenty-year follow-up data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, we examined the association between cognitive change and mortality risk, and the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk. Mortality was ascertained through linkage to the National Death Index database. To model time to death as a function of cognitive change and training effect, we used shared growth-survival models with simultaneously estimated latent intercepts and slopes as predictors. Among the 2802 participants, 2021 died on or before the year 2019 (72.1%). Both higher baseline level and slower decline in global cognition were associated with lower hazards of all-cause mortality after adjusting for covariates (HR = 0.68, 95% CI 0.58, 0.79; HR = 0.42, 95% CI 0.40, 0.44, respectively). We did not observe any significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on all-cause mortality. Our findings demonstrated the association between the trajectory of cognitive change and mortality among older adults, independent of cognitive training interventions. More work is needed to identify relevant timing as well as modalities of non-pharmaceutical interventions that can promote healthy longevity.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room.

The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth, presenting a major public health concern. Some studies have shown that cognitive behavioral therapy (CBT) has a positive effect on maternal psychology during delivery, reducing stress and shortening labor time. Thus, CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth. To investigate the clinical effects of CBT training and psychological care during delivery, and their therapeutic effects on women in labor. This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023. The study subjects were randomized into two groups: control (n = 70) and observation (n = 70). Routine care, CBT training, and psychological care were provided to mothers in both groups. Psychological status scores, delivery time, and satisfaction with care pre- and post-delivery were compared, and the incidence of complications after receiving care was analyzed between the two groups. Although the psychological state of both groups improved significantly in the late stages of labor, the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group (P < 0.05). The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group (P < 0.05). The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group (P < 0.05). CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression, shorten labor duration, reduce postnatal complications, and improve nursing satisfaction and nurse-patient relationships. Its clinical application is effective and has popularization value, providing a new way to protect maternal mental health.

Effects of Virtual Reality Cognitive Training on Neuroplasticity: A Quasi-Randomized Clinical Trial in Patients with Stroke.

Cognitive Rehabilitation (CR) is a therapeutic approach designed to improve cognitive functioning after a brain injury, including stroke. Two major categories of techniques, namely traditional and advanced (including virtual reality-VR), are widely used in CR for patients with various neurological disorders. More objective outcome measures are needed to better investigate cognitive recovery after a stroke. In the last ten years, the application of electroencephalography (EEG) as a non-invasive and portable neuroimaging method has been explored to extract the hallmarks of neuroplasticity induced by VR rehabilitation approaches, particularly within the chronic stroke population. The aim of this study is to investigate the neurophysiological effects of CR conducted in a virtual environment using the VRRS device. Thirty patients with moderate-to-severe ischemic stroke in the chronic phase (at least 6 months after the event), with a mean age of 58.13 (±8.33) for the experimental group and 57.33 (±11.06) for the control group, were enrolled. They were divided into two groups: an experimental group and a control group, receiving neurocognitive stimulation using VR and the same amount of conventional neurorehabilitation, respectively. To study neuroplasticity changes after the training, we focused on the power band spectra of theta, alpha, and beta EEG rhythms in both groups. We observed that when VR technology was employed to amplify the effects of treatments on cognitive recovery, significant EEG-related neural improvements were detected in the primary motor circuit in terms of power spectral density and time-frequency domains. Indeed, EEG analysis suggested that VR resulted in a significant increase in both the alpha band power in the occipital areas and the beta band power in the frontal areas, while no significant variations were observed in the theta band power. Our data suggest the potential effectiveness of a VR-based rehabilitation approach in promoting neuroplastic changes even in the chronic phase of ischemic stroke.

Vision and Hearing Difficulty as a Modifier of the Effects of Cognitive Training Over 5 and 10 Years in Older Adults

AbstractBackgroundCognitive training interventions are delivered visually and/or aurally. Whether sensory loss modifies its effect in older adults is unknown. We assessed differences in the effect of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study, a randomized cognitive training intervention trial, by self‐reported vision and hearing difficulty.MethodsParticipants (65 years and older, cognitively/functionally healthy) were randomized to cognitive training in memory, reasoning, or speed of processing or a no‐contact control. Composite scores were created using multiple cognitive assessments in memory, reasoning, and speed of processing. Self‐reported near vision difficulty was defined as reading ordinary print in the newspaper (no difficulty/a little or some difficulty), and hearing loss was self‐reported (yes/no). Differences in the 10‐year effect of cognitive training on change in trained cognitive ability were assessed using linear mixed effect models adjusted for demographic and study design characteristics.ResultsAmong 2,788 participants, 22% reported vision difficulty and 43% reported hearing loss. Participants with sensory loss benefited from all cognitive training interventions (Figure 1); however, the magnitude of benefit of reasoning training was smaller among participants with vs. without vision difficulty (10‐year difference in reasoning ability [intervention vs. control]: vision difficulty: ‐0.25, 95% CI: [‐0.88, 0.39], no vison difficulty: 0.58, 95% CI: [0.28, 0.89]). Magnitude of benefit of memory training was greater for participants with vs. without hearing loss (10‐year difference in memory ability [intervention vs. control]: hearing difficulty: 0.17, 95% CI: [‐0.37, 0.72], no hearing difficulty: ‐0.20, 95% CI: [‐0.65,0.24]). Beneficial effect of speed of processing training was similar by sensory status.ConclusionParticipants with vision difficulty did not benefit as much from reasoning training, likely because training required more visually complex exercises (e.g., deciphering patterns across similar symbols). Memory training was more efficacious for participants with hearing loss, perhaps because training provided compensation strategies for overcoming cognitive load (increased effort for processing degraded auditory signals). Cognitive training interventions should consider sensory function in design and administration. Individuals with sensory loss have increased risk for cognitive decline and should not be excluded from cognitive training interventions as magnitude of benefit may be greater for these individuals.

Evaluating the effectiveness of dialectical behavior and motor perception training on the symptoms of attention deficit, cognitive avoidance and working memory of female students with attention deficit/hyperactivity disorder

Objective: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders that is observed in early childhood. The aim of this study was to investigate the effectiveness of dialectical behavior and cognitive motor training on attention deficit, cognitive avoidance and working memory in female students with attention deficit/hyperactivity disorder. Materials and Methods: The present study was quasi-experimental with pretest-posttest design. The statistical population consisted of 257 elementary school girls with attention deficit hyperactivity disorder and resident in district 2 of Tehran. Each meeting was given to participants. Data were collected using Cognitive Avoidance Questionnaire, Attention Deficit Disorder Scale and Wechsler Working Memory Test. Dialectical behavioral therapy sessions were held in 10 sessions and 12 sessions of cognitive and motor training were held in 12 one-hour sessions each week. For dialectical behavior therapy sessions, protocol therapy (Linehan, 1993) and McGinn Cognition and Motor Training (1970) were used. Data were analyzed using multivariate analysis of covariance and SPSS 27 software. Findings: The results showed that there was no significant difference between the experimental and control groups of cognitive avoidance, attention deficit and working memory including cognitive avoidance (P=0.672, F=0.40), attention deficit (F=0.04, P=0.442), working memory (P=0.477, F=0.75). Conclusion: It can be concluded that there is no significant difference between dialectical behavior therapy and cognitive and motor training on cognitive avoidance, attention deficit and working memory.

Resting state brain networks activity and association with transfer of cognitive training gains

AbstractBackgroundAge‐related cognitive decline increases the need for cognitive interventions to maintain cognitive function. Cognitive training is considered an effective non‐pharmacological intervention. Transfer of training gains to untrained tasks is a key indicator for the effectiveness of cognitive training. However, the underlying brain mechanisms need to be further investigated. We implemented a cognitive training study to assess functional connectivity determinants of transfer of training gains.MethodA sample of 181 healthy older adults (mean age: 68 years) underwent a 4‐week cognitive training across three sites. The control group consisted of 54 older adults. To evaluate transfer and training effects, participants underwent a neuropsychological assessment before and after the training. A second follow‐up assessment was applied 12 weeks after the training. The training group was divided in subjects who had and who did not have successful transfer, which was defined as higher improvement in cognitive tasks than the control group. We used composite scores representing working memory, memory and executive functions to assess transfer and training effects. Baseline resting‐state functional magnetic resonance imaging was used to investigate the functional connectivity of brain networks associated with cognitive functions. We extracted brain resting state networks using the Independent Component Analysis (ICA) approach.ResultWe observed successful transfer of cognitive training gains in most of the participants. Our results demonstrated spatially restricted effects (p&lt;.01 uncorrected) for the association of transfer of gains with the resting‐state connectivity of brain networks, such as the Default Mode Network and Central Executive Network.ConclusionTransfer of training gains in aging is possible. A strong association between transfer of gains and resting‐state functional connectivity was not identified.

Impact of an exergame intervention on cognitive-motor functions and training experience in young team sports athletes: a non-randomized controlled trial

IntroductionTeam sports athletes need excellent perceptual-cognitive skills, particularly executive functions (EF) to strategically perform on the field. The transfer effect of cognitive training might be accomplished by the inclusion of cognitive stimuli into a physically active environment as these couplings are required in real game situations. A training approach that combines both components is exergaming. The primary objective of this study was to gain preliminary insights into the effects of exergaming on cognitive-motor functions in young team sports athletes. The secondary objective was to investigate participants' training experience and well-being over time.MethodsParticipants were assigned to the intervention or control group. In the intervention group, participants trained with the ExerCube—a mixed reality exergame. The training was planned for 10 weeks (two sessions per week à 25 min) but had to be shortened by 2 weeks due to COVID-19 restrictions. The control group had no additional training. Outcomes included a computer-based alertness test and a cognitive-motor test battery to assess different EF (flexibility, divided attention, and inhibition) via a FitLight Trainer setup.ResultsTwenty-four athletes [mean age (±SD) 15.0 ± 0.7 years], evenly split into the intervention group (N = 12; male N = 6; female N = 6; 14.7 ± 0.5 years) and the control group (N = 12; male N = 7; female N = 5; 15.3 ± 0.8 years), participated in the study. Participants in the intervention group performed on average 9.4 ± 3.3 training sessions over 8 weeks. Significant time x group interaction effects were evident for the cognitive-motor sub-tests flexibility (F = 12.176, p &amp;lt; 0.001, d = 1.488) and divided attention for auditive stimuli (F = 9.776, p = 0.002, d = 1.404) in favour of the intervention group. For the alertness test, a medium effect size (time x group interaction) was seen for the variability of the reaction time (F = 2.196, p = 0.138, d = 0.632) in favour of the intervention group. Training experience and well-being were consistently at medium to high levels.ConclusionThe ExerCube training yielded positive effects on concentration, flexibility, and divided attention indicating that exergaming can be an innovative training approach for team sports athletes.

Efficacy of smartphone application-based multi-domain cognitive training in older adults without dementia

BackgroundAs the population ages and the prevalence of dementia increases, there is a growing emphasis on the importance of cognitive training to prevent dementia. A smartphone application-based cognitive training software program, BeauBrain Trainer (BBT), has been developed to provide better access to cognitive training for older adults. Numerous studies have revealed the effectiveness of cognitive training using a cognitive assessment tool. However, relatively few studies have evaluated brain activation using brain imaging as a result of improved cognitive function.MethodsAll participants were required to download the BBT, an Android-based application for cognitive training, onto their own smartphone or tablet computer and to engage in cognitive training at home. Older adults without dementia were enrolled in this study, including 51 participants in the intervention group and 50 participants in the control group. The BBT comprised a set of 12 cognitive tasks, including two tasks in each of the following six cognitive domains: attention, language, calculation, visuospatial function, memory, and frontal/executive function. Each cognitive task was divided into four blocks based on its level of difficulty. A 16-week cognitive training was designed to carry out cognitive tasks using a total of 48 blocks (12 tasks × 4 levels) for at least 1.5 h per day, 5 days per week. All participants in the intervention group were given BBT tasks that gradually increased in difficulty level, which they submitted through a smartphone application daily for 16 weeks. The researchers monitored the participants’ task performance records on the website and encouraged participants to engage in cognitive training through regular contact. This study was conducted to investigate the improvement in cognitive function and the activation pattern of the frontal cortex in older adults participating in smartphone application-based cognitive training. The cognitive assessment tool was the BeauBrain cognitive screening test (CST), a tablet-based computerized cognitive screening test. The activation pattern of the frontal cortex was measured using functional near-infrared spectroscopy (fNIRS). Additionally, this study aimed to determine the positive effects of cognitive training on everyday functioning and psychological states using a questionnaire.ResultsOf 101 participants, 85 older adults without dementia (84.1%) who completed the study protocol were included in the statistical analysis. There were 41 participants (80.3%) in the intervention group and 44 participants (88.0%) in the control group. A two-way repeated-measures analysis of variance (ANOVA) was used to compare the cognitive scores over a 16-week period between the intervention and control groups. According to the CST results, the intervention group exhibited a statistically significant increase in the language subtest scores, specifically the phonemic word fluency test, compared to those of the control group. The fNIRS results revealed greater activation in the dorsolateral prefrontal cortex during the STROOP incongruent task in the intervention group than did the control group. However, the effectiveness of cognitive training was not observed across a variety of rating scales, including everyday functioning, depression, self-efficacy, attention, and subjective memory complaints.ConclusionThis study revealed that a smartphone-based cognitive training application led to improvements in phonemic generative naming ability and activation of the prefrontal cortex in older adults without dementia. This study is meaningful because it confirmed that cognitive training is partially effective in enhancing frontal lobe function. It also provided information on the brain mechanisms related to the effects of cognitive training using fNIRS.

Comparing the Effectiveness of Cognitive Rehabilitation Training and Sensory Integration on Attention and Impulsivity of Hyperactive Students

Comparing the Effectiveness of Cognitive Rehabilitation Training and Sensory Integration on Attention and Impulsivity of Hyperactive Students

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.

Can cognitive training capitalise on near transfer effects? Limited evidence of transfer following online inhibition training in a randomised-controlled trial.

Despite early promise, cognitive training research has failed to deliver consistent real-world benefits and questions have been raised about the experimental rigour of many studies. Several meta-analyses have suggested that there is little to no evidence for transfer of training from computerised tasks to real-world skills. More targeted training approaches that aim to optimise performance on specific tasks have, however, shown more promising effects. In particular, the use of inhibition training for improving shoot/don't-shoot decision-making has returned positive far transfer effects. In the present work, we tested whether an online inhibition training task could generate near and mid-transfer effects in the context of response inhibition tasks. As there has been relatively little testing of retention effects in the literature to date, we also examined whether any benefits would persist over a 1-month interval. In a pre-registered, randomised-controlled trial, participants (n = 73) were allocated to either an inhibition training programme (six training sessions of a visual search task with singleton distractor) or a closely matched active control task (that omitted the distractor element). We assessed near transfer to a Flanker task, and mid-transfer to a computerised shoot/don't-shoot task. There was evidence for a near transfer effect, but no evidence for mid-transfer. There was also no evidence that the magnitude of training improvement was related to transfer task performance. This finding adds to the growing body of literature questioning the effectiveness of cognitive training. Given previous positive findings, however, there may still be value in continuing to explore the extent to which cognitive training can capitalise on near or mid-transfer effects for performance optimisation.

Effect of cognitive training on brain dynamics

The human brain is highly plastic. Cognitive training is usually used to modify functional connectivity of brain networks. Moreover, the structures of brain networks may determine its dynamic behavior which is related to human cognitive abilities. To study the effect of functional connectivity on the brain dynamics, the dynamic model based on functional connections of the brain and the Hindmarsh–Rose model is utilized in this work. The resting-state fMRI data from the experimental group undergoing abacus-based mental calculation (AMC) training and from the control group are used to construct the functional brain networks. The dynamic behavior of brain at the resting and task states for the AMC group and the control group are simulated with the above-mentioned dynamic model. In the resting state, there are the differences of brain activation between the AMC group and the control group, and more brain regions are inspired in the AMC group. A stimulus with sinusoidal signals to brain networks is introduced to simulate the brain dynamics in the task states. The dynamic characteristics are extracted by the excitation rates, the response intensities and the state distributions. The change in the functional connectivity of brain networks with the AMC training would in turn improve the brain response to external stimulus, and make the brain more efficient in processing tasks.

53 2-Back Performance Does Not Differ Between Cognitive Training Groups in Older Adults Without Dementia

Objective:Cognitive training is a non-pharmacological intervention aimed at improving cognitive function across a single or multiple domains. Although the underlying mechanisms of cognitive training and transfer effects are not well-characterized, cognitive training has been thought to facilitate neural plasticity to enhance cognitive performance. Indeed, the Scaffolding Theory of Aging and Cognition (STAC) proposes that cognitive training may enhance the ability to engage in compensatory scaffolding to meet task demands and maintain cognitive performance. We therefore evaluated the effects of cognitive training on working memory performance in older adults without dementia. This study will help begin to elucidate non-pharmacological intervention effects on compensatory scaffolding in older adults.Participants and Methods:48 participants were recruited for a Phase III randomized clinical trial (Augmenting Cognitive Training in Older Adults [ACT]; NIH R01AG054077) conducted at the University of Florida and University of Arizona. Participants across sites were randomly assigned to complete cognitive training (n=25) or an education training control condition (n=23). Cognitive training and the education training control condition were each completed during 60 sessions over 12 weeks for 40 hours total. The education training control condition involved viewing educational videos produced by the National Geographic Channel. Cognitive training was completed using the Posit Science Brain HQ training program, which included 8 cognitive training paradigms targeting attention/processing speed and working memory. All participants also completed demographic questionnaires, cognitive testing, and an fMRI 2-back task at baseline and at 12-weeks following cognitive training.Results:Repeated measures analysis of covariance (ANCOVA), adjusted for training adherence, transcranial direct current stimulation (tDCS) condition, age, sex, years of education, and Wechsler Test of Adult Reading (WTAR) raw score, revealed a significant 2-back by training group interaction (F[1,40]=6.201, p=.017, η2=.134). Examination of simple main effects revealed baseline differences in 2-back performance (F[1,40]=.568, p=.455, η2=.014). After controlling for baseline performance, training group differences in 2-back performance was no longer statistically significant (F[1,40]=1.382, p=.247, η2=.034).Conclusions:After adjusting for baseline performance differences, there were no significant training group differences in 2-back performance, suggesting that the randomization was not sufficient to ensure adequate distribution of participants across groups. Results may indicate that cognitive training alone is not sufficient for significant improvement in working memory performance on a near transfer task. Additional improvement may occur with the next phase of this clinical trial, such that tDCS augments the effects of cognitive training and results in enhanced compensatory scaffolding even within this high performing cohort. Limitations of the study include a highly educated sample with higher literacy levels and the small sample size was not powered for transfer effects analysis. Future analyses will include evaluation of the combined intervention effects of a cognitive training and tDCS on nback performance in a larger sample of older adults without dementia.

Twelve-month follow-up effects of cognitive training after heart valve surgery on cognitive functions and health-related quality of life: a randomised clinical trial

ObjectivesPostoperative cognitive decline (POCD) or decreased health-related quality of life (HQL) have been reported after cardiac surgery. A previous investigation showed beneficial effects of postoperative cognitive training on POCD and...

Cognitive training for children with ADHD: composite cognitive score outcome in a randomized controlled trial

Purpose of the article Cognitive training for Attention Deficit/Hyperactivity Disorder (ADHD) has shown promising, although mixed results. In post-hoc analyses, we evaluate effects of cognitive training using a novel composite cognition score as the outcome for children attending at least 16 sessions of training, dose-response of training and associations between symptoms and cognitive functioning. Materials and methods Children (age 6–13) with ADHD were randomized to intervention (n = 26) or control (n = 34). For the current analysis, we restricted the intervention group to children, who completed at least 16 sessions of cognitive training (n = 26) and examined a dose response within that group. Results Cognition improved significantly in the intervention, but not control group. Amount of the completed training sessions correlated significantly with the amount of cognitive improvement. Conclusion Variations in dose and frequency of training may be an important source of the variance in previous studies.

At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial

Background Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults.MethodsA multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45–60 years old) and older adults (65–80 years old), as well as older hearing aid users (65–80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE’s StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia’s PERFORM Centre.DiscussionThis research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss.Trial registrationIdentifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998

Developing digital interventions for a post-Covid world: A smartphone-based approach-avoidance training to reduce alcohol craving.

Harmful alcohol use is a major public health issue. In-person treatment has been hindered by the restrictions necessary during the Covid-19 pandemic. This study examined the effects of an at-home smartphone-based cognitive bias modification training in heavy drinkers. Experiment 1 tested the effect of a short 20-30-min smartphone-based approach-avoidance training (AAT) on image-induced craving at a 1-day follow-up. Sixty-two participants consuming 14+ units of alcohol/week were allocated to either the training or waitlist group. Experiment 2 used an updated version of the same short AAT intervention with a sample of n = 107 participants who consumed 20+ units of alcohol/week. Training effects at 1-week follow-up were compared to an active control group. Experiment 1 showed a significant reduction in image-induced craving for the training group at 1-day follow-up. Experiment 2 found that AUDIT weekly scores were significantly reduced at 1-week follow-up for the training group, all the while craving for soft drinks remained unchanged. Experiment 1 served as a first proof of concept for the efficacy of the new smartphone-based AAT training, and experiment 2 suggested that training effects on problem alcohol use hold at 1-week follow-up.

Effects of Cognitive Training on Alzheimer's Disease and Related Dementias: The Moderating Role of Social Determinants of Health.

Objective: We examined whether social determinants of health (SDoH) are associated with Alzheimer's disease and related dementias (ADRD) risk and the effects of cognitive training over a 20-year follow-up period. Methods: Data were obtained from 1605 participants in ACTIVE. SDoH measures were created using baseline data at the individual and neighborhood level. Incident ADRD was defined using administrative claims data (1999-2019). Cause-specific hazard models estimated associations between SDoH and claims-based diagnosed ADRD. Results: Higher scores on neighborhood and built environment were associated with lower ADRD risk. Trained participants obtained a greater degree of protection from ADRD when they had higher scores for SDoH domains associated with health care and education access. However, there were fewer significant SDoH moderation effects on cognitive training than expected. Discussion: Future work should continue to explore culturally tailored cognitive training interventions to reduce ADRD risk associated with SDoH that disproportionately affects racially diverse aging populations.

Compensatory Cognitive Training for Psychosocial Outcomes and Self-Stigma in Individuals With Schizophrenia: A Randomized Controlled Trial Study

Individuals with schizophrenia often experience poor psychosocial outcomes and self-stigma. This study aimed to investigate the effect of compensatory cognitive training (CCT) on self-esteem, self-efficacy, quality of life, and self-stigma in schizophrenia. Forty-six participants with schizophrenia were randomly assigned to intervention (CCT group, n = 24) or treatment as usual (TAU group, n = 22). The Rosenberg Self-Esteem Scale (RSES), the General Self-Efficacy Scale (GSES), the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4), and the Internalized Stigma of Mental Illness Scale (ISMIS) were administered at pretest (T0), posttest (T1), and 1-month follow-up (T2). A significant result was found at T2 in the SQLS-R4 score between CCT and TAU groups ( P = 0.001). A significant result was also noted at T2 in the ISMIS score ( P = 0.004). These findings show that CCT contributes to improvement in quality of life and self-stigma in individuals with schizophrenia. Accordingly, CCT may enhance the effectiveness of psychiatric rehabilitation programs. [ Psychiatr Ann . 2023;53(10):473–481.]