Improvement In Global Cognition Research Articles

Effect of High-Intensity Power Training on Cognitive Function in Older Adults With Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Study.

We sought to determine the effects of 12 months of power training on cognition, and whether improvements in body composition, muscle strength, and/or aerobic capacity (VO2peak) were associated with improvements in cognition in older adults with type 2 diabetes (T2D). Participants with T2D were randomized to power training or low-intensity sham exercise control condition, 3 days per week for 12 months. Cognitive outcomes included memory, attention/speed, executive function, and global cognition. Other relevant outcomes included VO2peak, strength, and whole body and regional body composition. One hundred and three adults with T2D (mean age 67.9 years; standard deviation [SD] 5.9; 50.5% women) were enrolled and analyzed. Unexpectedly, there was a nearly significant improvement in global cognition (p = .05) in the sham group relative to power training, although both groups improved over time (p < .01). There were significant interactions between group allocation and body composition or muscle strength in the models predicting cognitive changes. Therefore, after stratifying by group allocation, improvements in immediate memory were associated with increases in relative skeletal muscle mass (r = 0.38, p = .03), reductions in relative body fat (r = −0.40, p = .02), and increases in knee extension strength were directly related to changes in executive function (r = −0.41, p = .02) within the power training group. None of these relationships were present in the sham group (p > .05). Although power training did not significantly improve cognition compared to low-intensity exercise control, improvements in cognitive function in older adults were associated with hypothesized improvements in body composition and strength after power training.

Associations of Depressive Symptoms and Cognition in the FINGER Trial: A Secondary Analysis of a Randomised Clinical Trial.

Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60–77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient −0.006, 95% CI −0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (−0.140, p = 0.005) and memory (−0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung −0.096, 95% CI −0.163 to −0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.

Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective: The purpose of this meta-analysis was to examine the effects of physical activity (PA) on cognition and activities of daily living in adults with Alzheimer’s Disease (AD). Methods: Six electronic databases (MEDLINE, CINAHL, PsycArticles, SPORTDiscus, EMBASE and CNKI) were used to search for potential studies from inception until October 2021. Randomized controlled trials (RCTs) investigating the effect of physical activity (PA) on cognition and activities of daily living in AD patients compared to a control condition were included. The effect sizes were synthesized using a random effects model with a 95% confidence interval (CI). Results: Sixteen articles including 945 participants (aged 70 to 88 years, 34.6% male) met the inclusion criteria. The pooled effect sizes demonstrated that PA intervention was associated with significant improvements in global cognition (Standard Mean Difference (SMD) = 0.41, 95% CI [0.24, 0.58], p < 0.01) and activities of daily living (SMD = 0.56, 95% CI [0.32, 0.79], p < 0.01) in AD patients. Subgroup analyses suggested that PA for 3–4 times per week for 30–45 min for more than 12 weeks had a relatively strong effect on improving global cognition in AD patients. The sensitivity analysis showed robust results. Conclusions: The findings from the current meta-analysis suggested that AD patients can improve their global cognition and Activities of Daily Living (ADL) through engaging in aerobic and mixed exercise (aerobic and anaerobic exercise).

The association between brain‐derived neurotrophic factor and improved cognition in mild cognitive impairment and Alzheimer's disease patients in an exercise‐primed transcranial‐direct current stimulation study

AbstractBackgroundBrain derived neurotrophic factor (BDNF) has been associated with cognitive decline in Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Transcranial direct current stimulation (tDCS), a non‐invasive brain stimulation, has been found to improve cognitive functions in AD/MCI, particularly after priming. While the mechanism of tDCS response remains unclear, BDNF has been proposed to be involved with the beneficial effects of tDCS. However, few studies have investigated the direct relationship between cognition and BDNF in individuals receiving tDCS. With data from an ongoing clinical trial (the EXPRESS study), we examined the relationship between BDNF and changes in cognition before and after intervention in individuals with MCI/mild AD.MethodParticipants completed a 5‐week, blinded, randomized trial investigating the effects of exercise priming on tDCS. The Montreal Cognitive Asssessment (MoCA), to assess global cognition, was administered and blood samples were collected to quantify serum BDNF at baseline and endpoint visits. Baseline BDNF concentrations were log‐transformed prior to analyses. A Pearson’s partial correlation was used to assess the relationship between baseline BDNF and change in MoCA (ΔMoCA) over time across all participants.ResultIn 18 participants (10 males [55.6%], mean [±SD] age 73.9±8.5 years, education 17.1±2.0 years, and baseline MoCA score 21.5 ± 3.5), mean baseline BDNF concentration was 116.0 ± 40.9 (ng/mL). A Pearson’s partial correlation, controlling for age, showed a significant positive correlation between baseline BDNF concentrations and ΔMoCA score over time (rpartial(15) = .517, p = 0.034).ConclusionHigher baseline BDNF levels were correlated with greater improvement in global cognition over time in MCI/mild AD patients. This finding contributes to current literature that suggests BDNF as a therapeutic target in AD treatment. Further analyses upon unblinding will be done to evaluate the predictive capacity of baseline BDNF concentrations on cognitive improvement across treatment groups.

Findings from an Asian post‐stroke cognitive impairment intervention programme

AbstractBackgroundSingapore sees more than 7,000 ischemic stroke cases yearly, with majority having physical and cognitive sequelae. Previous reports demonstrate that Post‐stroke cognitive impairment (PSCI) occurs in 37.3% of stroke patients at the National Neuroscience Institute (NNI, Singapore) within 6 months post‐stroke. The severity of rising PSCI rates prompted the implementation of the NNI Stroke Memory Rehabilitation Programme (SMaRT) for ischaemic stroke patients with mild physical impairments. This study aims to evaluate the outcomes of the SMaRT programme on PSCI and post‐stroke coping over a 6‐month period.MethodThe SMaRT programme is a 8‐week group‐based post‐stroke cognitive rehabilitation programme focusing on healthy living habits, memory models, memory strategies and emotion regulation strategies. Patients with clinically diagnosed ischaemic strokes, mild functional and cognitive issues (modified Rankin Scale score≤3 and Mini Mental‐State Examination score≥20) were recruited from April 2018 to September 2020. Assessments were administered at baseline, 8 weeks and 6 months post‐SMaRT, measuring global cognition (Montreal Cognitive Assessment, Visual Cognitive Assessment Tool), visuospatial function/attention (Trail Making Test‐A), emotional coping (Geriatric Depression Scale‐15), daily functioning (Nottingham Extended Activities of Daily Living (NEADL)), subjective quality of life (Dementia Quality of Life (DemQOL)). Paired samples t‐tests compared scores between the three timepoints, adjusting for type I errors with Bonferroni correction.Result137 subjects (N males=90 (65.7.%); mean age=63.49 years, SD=9.38, mean years of education=9.50, SD=3.79) underwent SMaRT. Comparing week‐8 to baseline, there was significant improvement in global cognition (MoCA, VCAT: p&lt;.001), emotional coping (GDS, p&lt;.001), daily functions (NEADL, p&lt;.001), subjective quality of life (DemQOL: p=.008). Significant improvement was also observed comparing month‐6 to baseline scores in global cognition (MoCA, VCAT: p&lt;.001), emotional coping (GDS, p&lt;.001), daily functions (NEADL, p&lt;.001), subjective quality of life (DemQOL: p&lt;.001). In both analyses, decreasing trends in TMT‐A (seconds) were observed and approached significance.ConclusionThe SMaRT programme is effective in mitigating post‐stroke cognitive impairment, particularly in global cognition. Additionally, SMaRT improved mood, daily functioning and subjective quality of life, suggesting its ability to instill positivity and confidence in stroke patients. These suggest a group‐based structured cognitive rehabilitation programme is likely to benefit stroke patients and reduces incidence of PSCI.

Cognitive response to testosterone replacement added to intensive lifestyle intervention in older men with obesity and hypogonadism: prespecified secondary analyses of a randomized clinical trial

Both obesity and hypogonadism are common in older men which could additively exacerbate age-related declines in cognitive function. However, little is known about the effects of lifestyle intervention plus testosterone replacement therapy in this population. In this secondary analysis of the LITROS (Lifestyle Intervention and Testosterone Replacement in Obese Seniors) trial, we examined whether testosterone replacement therapy would improve cognitive function when added to intensive lifestyle intervention in older men with obesity and hypogonadism. Eighty-three older, obese hypogonadal men with frailty were randomly assigned to lifestyle therapy (weight management and exercise training) plus testosterone (LT+Test) or lifestyle therapy plus placebo (LT+Pbo) for 6 mo. For this report, the primary outcome was change in the global cognition composite z score. Secondary outcomes included changes in z score subcomponents: attention/information processing, memory, executive function, and language. Changes between groups were analyzed using mixed-model repeated-measures ANCOVAs following the intention-to-treat principle. Global cognition z score increased more in the LT+Test than in the LT+Pbo group (mean change: 0.49 compared with 0.21; between-group difference: -0.28; 95% CI: -0.45, -0.11; Cohen's d=0.74). Moreover, attention/information z score and memory z score increased more in the LT+Test than in the LT+Pbo group (mean change: 0.55 compared with 0.23; between-group difference: -0.32; 95% CI: -0.55, -0.09; Cohen's d=0.49 and mean change: 0.90 compared with 0.37; between-group difference: -0.53; 95% CI: -0.93, -0.13; Cohen's d=1.43, respectively). Multiple regression analyses showed that changes in peak oxygen consumption, strength, total testosterone, and luteinizing hormone were independent predictors of the improvement in global cognition (R2=0.38; P<0.001). These findings suggest that in the high-risk population of older men with obesity and hypogonadism, testosterone replacement may improve cognitive function with lifestyle behaviors controlled via lifestyle intervention therapy.This trial was registered at clinicaltrials.gov as NCT02367105.

P.214 Improved Cognition After Endoscopic Third Ventriculostomy In Adult Obstructive Hydrocephalus Using Repeatable Battery For The Assessment Of Neuropsychological Status

Background: In addition to symptoms of raised ICP, adults with obstructive hydrocephalus often present with cognitive dysfunction. We previously reported the improvement of global cognition at 3 and 12 months following primary adult ETV using the Montreal Cognitive Assessment (MoCA). This abstract presents multidomain cognitive testing using the RBANS. Methods: Obstructive hydrocephalus was identified based on tri-ventriculomegaly on MRI findings with a site of obstruction. Cognitive function was measured using the RBANS and MoCA at two timepoints: pre-ETV and post-ETV. Within patient analysis was conducted using the Wilcoxon Signed Rank Test. Results: Nine adults underwent ETV, 7 primary and 2 secondary (ETV after shunt malfunction), and completed follow-up assessment. Mean age was 33 years old and 7 (78%) were female. Etiology: 3 (33%) congenital and 6 (67%) acquired. Mean follow-up time was 4.5 months. The RBANS total scaled score, attention, and delayed memory index scores were significantly improved post-ETV (p &lt; 0.05). Immediate memory, language, and visuospatial index scores were not significantly different. Secondary analysis shows that picture naming and figure recall subtests were significantly improved. MoCA total scores were not significantly different. Conclusions: ETV in adults with obstructive hydrocephalus results in improvements in global cognition, attention, and delayed memory on RBANS testing.

Mindfulness-Based Training Does Not Improve Neuropsychological Outcomes in Mild Cognitive Impairment More Than Spontaneous Reversion Rates: A Randomized Controlled Trial.

Current pharmacological and behavioral treatment options for mild cognitive impairment (MCI) are limited, motivating a search for alternative therapies that might slow the progression of cognitive decline. We investigated the effectiveness of a cognition-focused mindfulness-based intervention. An open-label, three arm randomized controlled trial was conducted at a public tertiary medical center. Older persons (ages 45-75; N = 76) diagnosed with MCI were recruited and randomized into either mindfulness-based training (MBT), cognitive rehabilitation therapy (CRT), or treatment as usual (TAU). Participants in the intervention arms received 8 weekly 2-h sessions delivered in a group setting and engaged in home practice. Primary outcomes measures included changes in index scores for attention, immediate memory, and delayed memory as measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Depression was a secondary outcome. Using intent-to-treat analysis, we found that participants receiving MBT showed significant improvements in global cognition (d = 0.26; [95%CI 0.03-0.56]) and delayed memory (d = 0.36; [95%CI 0.17-0.57]), with significantly greater improvements in delayed memory than CRT (ηp2 = 0.10). However, there was no benefit of MBT over TAU. No change in depression was observed in the MBT group. Reductions in depression were associated with improvements in cognitive functioning in the MBT group only. Our results suggest that a cognition-focused MBT did not improve cognitive functioning in MCI patients substantially more than spontaneous reversion rates, possibly as mood symptoms were not significantly alleviated in this group.

Pilot testing of Dual-task Zumba Gold (DTZ) for community-dwelling people with mild cognitive impairment: A mixed-methods study

Dual-tasking (e.g., enrichment of physical activities with mental exercises) is an innovative strategy to enhance older adults’ cognition. Meanwhile, Zumba is a popular dance program, but research is limited about its utility on older people or those with mild cognitive impairment (MCI). This study assessed the feasibility of a new intervention called dual-task Zumba Gold (DTZ) for people with MCI. A mixed-methods feasibility study involving ten people aged ≥55 years with MCI was conducted from December 2020 to March 2021. Nine participants completed the study (90%) with high intervention acceptability. Program adherence (90.3%) and implementation fidelity (92.2%) were high. Participants also expressed the program's benefits, challenges, and facilitators. Moreover, pilot test results suggested improvements in global cognition (Z=-2.680; p=0.007), quality of life (Z=-2.688; p=0.008), and mobility (Z=-2.333; p=0.020). Hence, DTZ is feasible and acceptable for people with MCI, offering potential multidomain effects. Future randomized controlled studies should confirm these outcomes.

Effect of Advanced Glycation End Products on Cognition in Older Adults with Type 2 Diabetes: Results from a Pilot Clinical Trial

Background: Dietary advanced glycation end-products (AGEs) are linked to cognitive decline. However, clinical trials have not tested the effect of AGEs on cognition in older adults. Objective: The aim of the current pilot trial was to examine the feasibility of an intervention to reduce dietary AGEs on cognition and on cerebral blood flow (CBF). Methods: The design is a pilot randomized controlled trial of dietary AGEs reduction in older adults with type 2 diabetes. Seventy-five participants were randomized to two arms. The control arm received standard of care (SOC) guidelines for good glycemic control; the intervention arm, in addition to SOC guidelines, were instructed to reduce their dietary AGEs intake. Global cognition and CBF were assessed at baseline and after 6 months of intervention. Results: At baseline, we found a reverse association between AGEs and cognitive functioning, possibly reflecting the long-term toxicity of AGEs on the brain. There was a significant improvement in global cognition at 6 months in both the intervention and SOC groups which was more prominent in participants with mild cognitive impairment. We also found that at baseline, higher AGEs were associated with increased CBF in the left inferior parietal cortex; however, 6 months of the AGEs lowering intervention did not affect CBF levels, despite lowering AGEs exposure in blood. Conclusion: The current pilot trial focused on the feasibility and methodology of intervening through diet to reduce AGEs in older adults with type 2 diabetes. Our results suggest that participants with mild cognitive impairment may benefit from an intensive dietary intervention.

Effectiveness of Personalized Cognitive Stimulation in Older Adults with Mild Possible Cognitive Impairment: A 12-month Follow-up Cognitive Stimulation in Mild Cognitive Impairment

ABSTRACT Objective The objective of this study was to analyze the long-term effects of a personalized cognitive stimulation (PCS) program on the global cognition, cognitive aspects, activities of daily living (ADLs), anxiety, and depression in older adults with possible mild cognitive impairment (MCI). Methods A 12-month follow-up analysis was carried out in a single-blind, randomized clinical trial to research the long-term effects of a 10-week PCS program evaluating the cognitive level, depression, and anxiety of older adults with possible MCI. Results Fifty older adults were assessed 12 months after the CS program, 23 in the intervention group and 27 in the control group. There were significant differences between the groups at 12 months in the global cognition (p = .002), in global orientation (p < .001), and in spatial orientation (p = .004) in favor of the intervention group, measured with the Spanish version of the Mini-Mental Status Examination (MEC-35). Conclusions A PCS program could be effective in improving global cognition and global and spatial orientation. Clinical implications A PCS program based on cognitive levels in older adults with possible MCI achieves improvements in global cognition and global and spatial orientation. PCS programs can be applied successfully by trained occupational therapists.

Can Cochlear Implantation in Older Adults Reverse Cognitive Decline Due to Hearing Loss?

Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.

Transcranial direct current stimulation as an adjunct to cognitive training for older adults with mild cognitive impairment: A randomized controlled trial.

Cognitive training (CT) for individuals with mild cognitive impairment (MCI) may not be optimal for enhancing cognitive functioning. Coupling CT with transcranial direct current stimulation (tDCS) may maximize the strength of transmission across synaptic circuits in pathways that are stimulated by CT. The synergistic effects arising from this combination could be superior to those with administration of CT alone. To investigate whether the receiving tDCS combined with CT is superior to CT alone on domain-specific and task-specific cognitive outcomes in older adults with MCI. This double-blind, sham-controlled randomized trial included 67 older adults with MCI assigned to 3 groups: 1) tDCS combined with CT (tDCS+CT), 2) sham tDCS combined with CT (sham tDCS+CT) and 3) CT alone. Nine sessions of computerized CT were administered to the 3 groups for 3 weeks. In addition, tDCS and sham tDCS was delivered to the left dorsolateral prefrontal cortex to the tDCS+CT and sham tDCS+CT groups, respectively, simultaneously with CT. Standardized cognitive assessments were performed at baseline, post-intervention, and at 6-week follow-up. Participants' performance in the CT tasks was rated every session. The 3 groups showed improvements in global cognition and everyday memory (P<0.017) after the intervention and at follow-up, with larger effect sizes in the tDCS+CT than other groups (d>0.94) but with no significant differences between groups. Regarding CT outcomes, the groups showed significant differences in favour of the tDCS+CT group in decreasing the completion and reaction times of working memory and attention activities (P<0.017). tDCS combined with CT was not superior to sham tDCS with CT and CT alone in its effects on domain-specific cognitive outcomes, but it did provide comparatively larger effect sizes and improve the processing speed of task-specific outcomes. CLINICALTRIALS.GOV: NCT03441152.

"Train Your Brain" Cognitive Intervention Group Program for Singaporean Older Adult Patients With Mild Cognitive Impairment: A Pilot Feasibility Study.

The "Train Your Brain" (TYB) cognitive intervention group program was developed based on previous research with the goal of remediating cognitive impairments for elderly Singaporean people with mild cognitive impairment (MCI). This study reports a pilot evaluation of feasibility (defined as participant attendance, retention rate, satisfaction and usefulness) and preliminary efficacy of the TYB program. Nineteen participants with MCI aged ≥ 50 years were recruited from a memory clinic in Singapore, with 14 receiving the TYB intervention. Participants were allocated in order of recruitment into consecutive identical groups for a 9-session program on brain health and cognitive training. Participants received pre- and post-intervention measures of cognition and completed feedback forms reporting on satisfaction with, and utility of, the TYB program. TYB was well attended (85% attendance for the first 6 sessions; 83% for the full 9-session TYB program). Participant satisfaction was high, with positive participant feedback reporting that TYB offered useful cognitive strategies which participants could implement in their daily life. Despite the small sample size and absence of control group, repeated-measures t-tests revealed significant pre- to post-intervention intra-individual improvement in global cognition measured by the Montreal Cognitive Assessment, and in executive function on the Brixton Spatial Anticipation Test. This pilot study provides supportive preliminary evidence for feasibility of TYB, with suggestions of efficacy of this program as a culturally and linguistically appropriate intervention for English-speaking older adults with MCI in Singapore.

Cognitive training interventions for dementia and mild cognitive impairment in Parkinson's disease - A cochrane review summary with commentary.

The majority of people living with Parkinson's disease will develop impairments in cognition. These impairments are associated with a reduced quality of life. The Cochrane Review aimed to investigate whether cognitive training improves cognition in people with Parkinson's disease and mild cognitive impairments or dementia. A Cochrane Review by Orgeta et al. was summarized with comments. The review included seven studies with a total of 225 participants. There was no evidence for improvements in global cognition when cognitive training was compared to control conditions. Observed improvements in attention and verbal memory measures after cognitive training could not be confirmed in a subsequent sensitivity analysis. There was no evidence for benefits in other cognitive domains or quality of life measures. The certainty of the evidence was low for all comparisons. The effectiveness of cognitive training for people with Parkinson's disease and cognitive impairments remains inconclusive. There is a pressing need for adequately powered trials with higher methodological quality.

Stroke memory rehabilitation (SMaRT) programme for mild ischemic stroke: Preliminary findings

AbstractBackgroundThere are 6000‐7000 stroke survivors yearly in Singapore with about 40% being at risk for post‐stroke cognitive impairment (PSCI). Stroke Memory Rehabilitation (SMaRT) programme was designed to reduce the incidence of PSCI, facilitate transition back to the community, improve the mood and quality of life of patients with mild ischemic strokes. We report the preliminary outcomes of the program.MethodParticipants who attended the programme from April 2018 to Dec 2019 were included in this study. Each patient attended 8 two‐hour sessions over 8 weeks, focusing on cognitive processes (episodic memory, executive function and visuospatial function); healthy lifestyle habits, relaxation techniques and goal setting. All patients were administered neuropsychological assessments and questionnaires pre‐programme, 8 weeks and 6 months post‐programme. Paired sample t‐tests were applied to evaluate the changes in scores over the four time points on each outcome measure, subject to Bonferroni correction for family‐wise errors.Result156 participants (mean age=63.53 years, SD=9.63; mean education=9.95 years SD=4.18, 65.4 % male). Significant improvements in all outcome measures were observed from pre‐programme to all other time points. Cognitive scores significantly improved from pre to post‐programme and pre to 6 months post‐programme on the Montreal Cognitive Assessment (24.52 to 25.36; p&lt;.001 and 25.05 to 25.98; p&lt;.001 respectively); Visual Cognitive Assessment Test (VCAT) Score (22.67 to 24.14; p&lt;.001 and 22.63 to 24.92; p&lt;.001). Scores for Trail Making Test‐A only significantly shortened from pre‐ to 6 months post‐programme (52.00 to 45.52; p&lt;.001). Depression levels significantly reduced on the Geriatric Depression Scale (4.01 to 3.29; p=.001 and 3.46 to 2.33; p&lt;.001). Activities of daily living measured on the NEADL significantly improved (52.24 to 55.15; p&lt;.001 and 52.48 to 56.27; p&lt;.001). Quality of life (DemQOL) also significantly improved (88.77 to 91.88; p=.006 and 91.83 to 95.52; p&lt;.001).ConclusionPreliminary findings demonstrate encouraging improvement in global cognition, executive function, quality of life, depression and activities of daily living from pre‐programme to 8 weeks and 6 months post‐programme. A multi‐approach structured cognitive rehabilitation programme for stroke survivors may thus be useful in preventing post‐stroke dementia.

Auditory versus visual neuroscience-informed cognitive training in schizophrenia: Effects on cognition, symptoms and quality of life

BackgroundCognitive impairments are related to deficits in primary auditory and visual sensory processes in schizophrenia. These impairments can be remediated by neuroscience-informed computerized cognitive trainings that target auditory and visual processes. However, it is not clear which modality results in greater improvements in cognition, symptoms and quality of life. We aimed to investigate the impact of training auditory versus visual cognitive processes in global cognition in patients with schizophrenia. MethodsSeventy-nine schizophrenia participants were randomly assigned to either 40 h of auditory or visual computerized training. Auditory and visual exercises were chosen to be dynamically equivalent and difficulties increased progressively during the training. We evaluated cognition, symptoms and quality of life before, after 20 h, and after 40 h of training. ClinicalTrials.gov (1R03TW009002-01). ResultsParticipants who received the visual training showed significant improvements in global cognition compared to the auditory training group. The visual training significantly improved attention and reasoning and problem-solving, while the auditory training improved reasoning and problem-solving only. Schizophrenia symptoms improved after training in both groups, whereas quality of life remained unchanged. Interestingly, there was a significant and positive correlation between improvements in attention and symptoms in the visual training group. ConclusionsWe conclude that the visual training and the auditory training are differentially efficient at remediating cognitive deficits and symptoms of clinically stable schizophrenia patients. Ongoing follow-up of participants will evaluate the durability of training effects on cognition and symptoms, as well as the potential impact on quality of life over time.

Effects of Brain Games on Global Cognition among Older Filipinos

Objective. This study ascertained the effects of brain games on global cognition among older Filipinos. Methods. A quasi-experimental design was used. The participants were 60 elderly Filipinos, aged 60 to 93 years, residing in Baguio City, and were not engaging in any physical or nutritional interventions to improve cognitive function. None have subclinical cognitive impairments as screened using the Mini-Cognitive Examination. The Addenbrooke's Cognitive Examination-III (ACE-III) tool which correlated significantly with standard neuropsychological tests, and provided a high internal reliability score of 0.88, was used. Data were analyzed using descriptive and inferential statistics.Results. Pretest mean scores of both active control and experimental groups increased in the posttest. Additionally, both coloring and brain games had extremely significant effects on global cognition (p=0.0001). Lastly, the unrelated t-test revealed extremely significant difference between the effects of brain games and coloring on global cognition (p=0.0001).Conclusions. Based on the results, brain games showed evidence of effectiveness in improving global cognition, and that compared to coloring, it is more effective in improving global cognition among older Filipinos. Variables like motivation and expectancy effects influence the improvement in global cognition among older Filipinos. Lastly, cognitive training using brain games show promise as a non-pharmacologic intervention to address cognitive decline.

Computerized cognitive training using virtual reality on everyday life activities for patients recovering from stroke

Purpose Recent studies argue that the use of virtual reality tasks depicting activities daily living may be effective means for cognitive rehabilitation. The aim of this study was to test an ecologically oriented approach in virtual reality resembling the demands of everyday life activities for cognitive rehabilitation following stroke. Materials and Methods The sample comprised 30 sub-acute stroke patients recovering from stroke in a rehabilitation hospital. They were assessed in a single-arm pre-post intervention study on global cognition, executive functions, memory and attention abilities. The intervention consisted of virtual reality in a multidomain cognitive training approach depicting everyday life tasks (preparing food, choosing clothes, shopping, etc.). Results Improvements were found in the assessed cognitive domains at 6 to 10 post-treatment sessions. In-depth analysis through reliable change scores has suggested larger treatment effects on global cognition. Conclusions Overall results suggest that the use of virtual reality-based exercises on everyday life activities may be a useful cognitive rehabilitation approach to provide short-term gains in cognition following stroke. Implications for rehabilitation Virtual reality-based cognitive rehabilitation resembling everyday life activities may provide short-term gains in cognition of stroke patients; Consistent improvements in executive functions may require higher treatment dosage than for improvements in global cognition.

Increased global cognition correlates with increased thalamo-temporal connectivity in response to targeted cognitive training for recent onset schizophrenia

Patients with schizophrenia exhibit disrupted thalamocortical connections that relate to aspects of symptoms and deficits in cognition. Targeted cognitive training (TCT) of the auditory system in schizophrenia has been shown to improve cognition, but its impact on thalamocortical connectivity is not known. Here we examined thalamocortical connections that may be neuroplastic in response to TCT using a region of interest (ROI) approach. Participants were randomly assigned to either 40 h of TCT (N = 24) or an active control condition (CG; N = 20). Participants underwent resting state fMRI and cognitive testing both before and after training. Changes in thalamocortical connectivity were measured in 15 ROIs derived from a previous study comparing a large sample of schizophrenia subjects with healthy controls. A significant group by time interaction was observed in a left superior temporal ROI which was previously found to exhibit thalamocortical hyper-connectivity in patients with schizophrenia. Changes in this ROI reflected thalamic connectivity increases in the TCT group, while the CG group showed decreases. Additionally, the relationship between connectivity change and change in global cognition showed a slope difference between groups, with increases in thalamo-temporal connectivity correlating with improvements in global cognition in TCT. No significant relationships were observed with changes in clinical symptoms or functioning. These findings demonstrate that TCT may influence intrinsic functional connections in young individuals with schizophrenia, such that improvements in cognition correspond to compensatory increases in connectivity in a temporal region previously shown to exhibit thalamic hyper-connectivity.