Memory Training In Older Adults Research Articles

Effects of Strategy-Based Memory Training for Older Adults: Do Booster Sessions Prompt Long-Term Benefits?

This study examined the efficacy of a strategy-based memory training for older adults at short- and long-term with two (5- and 11 months) follow-ups. We also explored whether booster sessions (additional training before the first follow-up) facilitated the maintenance of benefits. Thirty-three older adults received a training based on the teaching of different effective memory strategies. One group completed three booster sessions before the 5 months follow-up. Training gains were examined using a word-list and a face-surname association recall tasks, and transfer effects with a grocery-word list (GL) recall task, a working memory (WM) measure, and a perceived memory functioning questionnaire. Training gains and transfer effects to the WM measure emerged and were maintained up to the second follow-up. No benefits for the GL and perceived memory functioning were found. The "boosted" group had only a slight advantage-in one of the transfer tasks-as shown by effect sizes. This pilot study confirms the efficacy of strategy-based memory training in supporting older adults' memory performance up to 11 months since training completion. However, booster sessions seem not to make a clear difference in prompting long-lasting benefits. Training features capable of fostering generalized, prolonged effects are worth investigating.

Designing a Mobile Application for Working Memory Training through Understanding the Psychological and Physiological Characteristics of Older Adults

Cognitive function declines with age, and when cognitive deterioration reaches a critical value and pathological changes occur, the brain neurons are irreversible. The aging of working memory even has profound adverse effects on older adults. This study aims to understand the psychological and physiological characteristics of older adults and to achieve mobile application design solutions that train working memory. According to the user study, the factors influencing the design of mobile applications for working memory training for older adults were mainly focused on six dimensions: training content, motivation, emotion, interaction, current state, and experience. Design opportunities were transformed, and seven new design strategies were obtained. Nine product functions with the highest priority were selected: daily practice, challenge mode, level-by-level difficulty selection, novice teaching, practice mode, sharing function, two-player mode, ranking, and desktop components. Finally, an interactive prototype was designed for usability testing, and the product solution was iterated based on expert evaluation and user feedback. The results indicate that the interface design provides a good user experience when applied daily. The process and results will be applied to make more solutions for training cognitive functions to be used in different situations.

Memory training in older adults with mild cognitive impairment: Positive effects are found five years after MEMO training compared to control intervention

AbstractBackgroundCognitive training was found to have a positive effect on the memory of healthy older adults, including long‐term benefits (Rebok et al, 2014). This finding offers hope that cognitive training could contribute to prevention approaches. However, little is known regarding the long‐term benefits of cognitive training in older adults with mild cognitive impairment (MCI), many of whom are in the early phase of Alzheimer’s disease. In a prior randomized controlled trial (Belleville et al, 2018), we reported a short‐term benefit of cognitive training on the delayed recall of older adults with MCI. The objective of this study was to assess the impact five years later.MethodThis is the five‐year follow‐up of a single‐blind randomized controlled trial (MEMO+). Participants with amnestic MCI were randomized to memory training or an active (psychosocial intervention) or passive (no‐contact) control condition. Interventions were provided in small groups over eight two‐hour sessions with a single booster session offered three months following training. In the initial study, participants were assessed post‐training, as well as three and six months after the intervention. The 127 participants with MCI, who completed the 6‐month post‐training assessment, were contacted five years post‐training. Primary outcomes included a 12‐word free recall task, a self‐reported strategy used in everyday life, and the Montreal Cognitive Assessment screening test (MoCA). Participants randomized to cognitive training were compared to those randomized to the control conditions.ResultParticipants with MCI, who were randomized to the cognitive training condition, showed a reduced 5‐year decline on the delayed recall task when compared to participants in the control conditions. Participants randomized to the cognitive training condition also demonstrated superior delayed recall and MoCA performance than those in the control condition, five years post‐training. There were no differences on self‐reported strategy use.ConclusionThe positive effect of cognitive training was found five years later on measures of delayed memory and global cognitive status in individuals with MCI. This indicates that the use of cognitive training is a valid preventive approach and has potential to delay the onset of dementia in at‐risk individuals.

Alleviated Anxiety Boosts Memory Training Gain in Older Adults with Subjective Memory Complaints: A Randomized Controlled Trial

Older adults with subjective memory complaints (SMC) have a higher risk of dementia and commonly demonstrate symptoms of depression and anxiety. The study aimed to examine the effect of a memory training program for individuals with SMC, and whether additional group counseling aimed at alleviating depression and anxiety would boost memory training gains. A three-armed, double-blind, randomized controlled trial. Community-dwelling older adults with SMC, age ≥60. Participants (n=124) were randomly assigned to memory training (MT), group counseling (GC), or GC+MT intervention. The GT+MT group received 3 sessions of group counseling followed by a 4-week memory training, while the MT group attended reading and memory training, and the GC group received group counseling and health lectures. Cognitive function and symptoms of depression and anxiety were assessed at baseline, mid-, and post-intervention. After group counseling, the GC+MT and GC groups showed reduced symptoms of anxiety compared to the MT group. Memory training enhanced associative learning in both MT and GC+MT groups compare with the GC group, but the GC+MT group demonstrated a larger memory improvement (Cohen's d=0.57) than the MT group (Cohen's d=0.44). Group counseling decreased symptoms of anxiety, memory training increased associative learning, and the combination of two intervention induced larger memory gain than memory training alone. The results suggest that it may need to integrate treatment for anxiety into memory training for older adults with SMC to achieve better intervention effect. ChiCTR-IOR-15006165 in the Chinese Clinical Trial Registry.

Using Virtual Reality to Assess and Promote Transfer of Memory Training in Older Adults With Memory Complaints: A Randomized Controlled Trial.

In this proof-of-concept study, we assessed the potential for immersive virtual reality (VR) to measure transfer following strategic memory training, and whether efficacy and transfer are increased when training is complemented by practice in an immersive virtual environment. Forty older adults with subjective memory complaints were trained with the method of loci. They were randomized to either a condition where they practiced the strategy in VR (n = 20) or a control condition where they were familiarized with VR using a non-memory task (n = 20). Training efficacy was measured with word recall, and transfer of the training benefit was measured with a recall task completed in two VR tasks (primary outcomes) as well as a self-report memory questionnaire (secondary outcomes). Testing was administered before (PRE), midway (POST 3), and after (POST 6) training. Participants improved their scores on word recall. Regarding transfer measures, participants improved their performance in the two VR recall tasks but not on the self-report memory questionnaire. No significant group effect was observed. Improvement was found when comparing PRE to POST 3 with no further improvement at POST 6. Thus, strategic memory training improved the memory of seniors with memory complaints on word recall and a transfer task relying on a VR scenario that resembles real-life. However, no evidence supporting an increase in transfer effects was found when enriching training with VR memory exercises.

Object-Location Memory Training in Older Adults Leads to Greater Deactivation of the Dorsal Default Mode Network

Substantial evidence indicates that cognitive training can be efficacious for older adults, but findings regarding training-related brain plasticity have been mixed and vary depending on the imaging modality. Recent years have seen a growth in recognition of the importance of large-scale brain networks on cognition. In particular, task-induced deactivation within the default mode network (DMN) is thought to facilitate externally directed cognition, while aging-related decrements in this neural process are related to reduced cognitive performance. It is not yet clear whether task-induced deactivation within the DMN can be enhanced by cognitive training in the elderly. We previously reported durable cognitive improvements in a sample of healthy older adults (age range = 60–75) who completed 6 weeks of process-based object-location memory training (N = 36) compared to an active control training group (N = 31). The primary aim of the current study is to evaluate whether these cognitive gains are accompanied by training-related changes in task-related DMN deactivation. Given the evidence for heterogeneity of the DMN, we examine task-related activation/deactivation within two separate DMN branches, a ventral branch related to episodic memory and a dorsal branch more closely resembling the canonical DMN. Participants underwent functional magnetic resonance imaging (fMRI) while performing an untrained object-location memory task at four time points before, during, and after the training period. Task-induced (de)activation values were extracted for the ventral and dorsal DMN branches at each time point. Relative to visual fixation baseline: (i) the dorsal DMN was deactivated during the scanner task, while the ventral DMN was activated; (ii) the object-location memory training group exhibited an increase in dorsal DMN deactivation relative to the active control group over the course of training and follow-up; (iii) changes in dorsal DMN deactivation did not correlate with task improvement. These results indicate a training-related enhancement of task-induced deactivation of the dorsal DMN, although the specificity of this improvement to the cognitive task performed in the scanner is not clear.

Working memory training in older adults: COMT Val158Met modulates the transfer of benefits in a virtual reality working memory task

AbstractBackgroundIndividuals with the Val/Val homozygous variation of the catechol‐O‐methyltransferase (COMT) gene possess lower prefrontal dopaminergic levels than Met/‐carriers and show more pronounced age‐related cognitive impairment (Papenberg et al., 2015). The aim of this study was to examine the impact of the COMT genotype profile on the transfer of working memory (WM) training effect in older adults.Method60 older adults were randomly assigned to inhibition or updating WM training conditions which were provided over 12 half‐hour sessions (3 sessions per week). Their COMT genotype was determined from a salivary sample collected using an Oragene OG‐500 collection kit. Transfer was measured with untrained complex WM tasks: Alpha‐span, Reading‐span, and a Virtual Reality dual‐task (VR‐WM) involving the detection of a visual road sign and a concurrent verbal memory task. Testing was done weekly, but to limit the bias of regression to the mean with small samples, the first two and the last two assessments were averaged.ResultMixed model analyses showed better performance for COMT Met/‐carriers (n = 43) than Val/Val carriers (n = 11) in the Reading‐Span task and improved performance on the three transfer tasks. There was a COMT x Time interaction on the VR‐WM task. Post‐hoc analyses showed that only the Val/Val group improved their performance following training, allowing them to reach levels similar to that observed in the Met/‐carriers group.ConclusionOur results indicate an effect of the COMT status on WM performance and training transfer. The observed pattern is similar to that previously reported in younger adults (Colzato et al., 2014) and emphasizes the role of dopaminergic regulation in WM and WM malleability. Colzato, L. S., van den Wildenberg, W. P. M., & Hommel, B. (2014). Cognitive control and the COMT Val158Met polymorphism: Genetic modulation of videogame training and transfer to task‐switching efficiency. Psychological Research, 78(5), 670–678. https://doi.org/10.1007/s00426‐013‐0514‐8. Papenberg, G., Lindenberger, U., & Bäckman, L. (2015). Aging‐related magnification of genetic effects on cognitive and brain integrity. Trends in Cognitive Sciences. Elsevier Ltd. https://doi.org/10.1016/j.tics.2015.06.008.

Comparing Web-Based and Classroom-Based Memory Training for Older Adults: The ACTIVE Memory Works™ Study.

To compare the efficacy of a web-based versus a classroom-based memory training program in enhancing cognition and everyday functioning in older adults, and program satisfaction and acceptability. Participants (N = 208; mean age = 71.1) were randomly assigned to a web-based or classroom-based training, or to a wait-list control condition. Cognitive and everyday functioning measures were administered at baseline, immediate, and 6 months post-training; both training groups evaluated program satisfaction and acceptability at immediate post-training. Repeated-measures analyses of variance assessed training effects on cognitive and functioning outcomes; independent-samples t tests assessed group differences in program satisfaction and acceptability. Compared to controls, neither training group showed a significant improvement on measures of memory or everyday functioning as assessed by dependence or difficulty on instrumental activities of daily living over time. Training effects did not transfer to non-trained cognitive abilities. The web-based group was as satisfied with the training as the classroom-based group (p > .05). Although no significant training effects were found, we demonstrated that a web-based platform is an acceptable and feasible mode to provide memory training to healthy older adults. Further studies are needed to investigate the potential of web-based memory training programs for improving cognition and function in cognitively healthy older adults.

Working Memory Training for Older Adults After Major Surgery: Benefits to Cognitive and Emotional Functioning

Cognitive and mood changes can affect postoperative recovery in hospitalized older adults undergoing major surgical procedures, but few studies have considered postoperative cognitive interventions to sustain such patients' cognitive functioning and mood. The aim of this pilot study was to assess the efficacy of working memory training in improving cognitive functioning and mood, or emotional functioning, in older adults undergoing major surgery. Thirty-four older adults (from 64 to 75 years of age) hospitalized for partial or total arthroplasty of the knee were randomly assigned to either a trained group (N = 18) or an active control group (N = 16). The former received working memory training during the postoperative period, while the latter engaged in alternative activities. In addition to specific training gains in a working memory task similar to the one used in the training (criterion task), transfer effects to cognitive abilities (short- and long-term memory, and cognitive inhibition), and mood or emotional functioning (signs of depression or anxiety) were investigated. Immediately after the training, results showed a main effect of group (in favor of the trained group) in the criterion task, in one of the short-term memory measures, and in cognitive inhibition. In addition, only the trained group showed a decrease in depression and anxiety scores. The results of this pilot study suggest that cognitive training targeting working memory administered in the postoperative period after major surgery can sustain older adults' cognitive and emotional functioning, and especially their mood.

Verbal working memory training in older adults: an investigation of dose response

The WM training protocol proposed by Borella et al. found specific and transfer effects among seniors, however, the studies were carried out in the same socio-cultural context and variations in the procedure were never tested. The present study aimed at analyzing the efficacy of Borella et al.’s training, in terms of short and long-term benefits, in a different socio-cultural context (Study 1), and the effect of change in the training's length (duplicating the number of sessions (Study 2). Participants were randomly assigned to a trained group (N = 18 for Study 1, and N = 23 for Study 2) and active control group (N = 28 for Study 1, and N = 27 for Study 2), and evaluated at pre, post-test and six-month follow-up for verbal WM task (criterion task), and for visuospatial and verbal WM, inhibition, processing speed, executive function, and fluid intelligence measures (transfer tasks). The trained groups had higher performance in all tasks when compared with active control groups after training and at 6 month follow-up. The longer training (Study 2) generated similar gains as the original protocol, with some advantage in far transfer tasks at post-test and follow-up. Study limitations include the small sample sizes. In conclusion, this training was effective in a different socio-cultural context and adding three sessions to the protocol did not significantly change training impact.

Interference reconditioning after visual memory training in older adults

Interference reconditioning after visual memory training in older adults

Is working memory training in older adults sensitive to music?

Evidence in the literature suggests that listening to music can improve cognitive performance. The aim of the present study was to examine whether the short- and long-term gains of a working memory (WM) training in older adults could be enhanced by music listening-the Mozart's Sonata K448 and the Albinoni's Adagio in G minor-which differ in tempo and mode. Seventy-two healthy older adults (age range: 65-75years) participated in the study. They were divided into four groups. At each training session, before starting the WM training activities, one group listened to Mozart (Mozart group, N = 19), one to Albinoni (Albinoni group, N = 19), one to white noise (White noise group, N = 16), while one served as an active control group involved in other activities and was not exposed to any music (active control group, N = 18). Specific training gains on a task like the one used in the training, and transfer effects on visuo-spatial abilities, executive function and reasoning measures were assessed. Irrespective of listening condition (Mozart, Albinoni, White noise), trained groups generally outperformed the control group. The White noise group never differed from the two music groups. However, the Albinoni group showed larger specific training gains in the criterion task at short-term and transfer effects in the reasoning task at both short-and long term compared to the Mozart group. Overall the present findings suggest caution when interpreting the effects of music before a WM training, and are discussed according to aging and music effect literature.

The effect of strategic memory training in older adults: who benefits most?

In total, 44 older adults (60-83 years) participated in a strategic memory training. We examined memory training benefits by measuring changes in memory practiced (word list learning) and non-practiced tasks (grocery list and associative learning). In addition, a battery of cognitive measures was administered in order to assess crystallized and fluid abilities, short-term memory, working memory, and processing speed. Results confirmed the efficacy of the training in improving performance in both practiced and non-practiced memory tasks. For the practiced memory tasks, results showed that memory baseline performance and crystallized ability predicted training gains. For the non-practiced memory tasks, analyses showed that memory baseline performance was a significant predictor of gain in the grocery list learning task. For the associative learning task, the significant predictors were memory baseline performance, processing speed, and marginally the age. Our results indicate that older adults with a higher baseline memory capacity and with more efficient cognitive resources were those who tended to benefit most from the training. The present study provides new avenues in designing personalized intervention according to the older adults' cognitive profile.

Working memory training in older adults: Bayesian evidence supporting the absence of transfer.

The question of whether working memory training leads to generalized improvements in untrained cognitive abilities is a longstanding and heatedly debated one. Previous research provides mostly ambiguous evidence regarding the presence or absence of transfer effects in older adults. Thus, to draw decisive conclusions regarding the effectiveness of working memory training interventions, methodologically sound studies with larger sample sizes are needed. In this study, we investigated whether or not a computer-based working memory training intervention induced near and far transfer in a large sample of 142 healthy older adults (65 to 80 years). Therefore, we randomly assigned participants to either the experimental group, which completed 25 sessions of adaptive, process-based working memory training, or to the active, adaptive visual search control group. Bayesian linear mixed-effects models were used to estimate performance improvements on the level of abilities, using multiple indicator tasks for near (working memory) and far transfer (fluid intelligence, shifting, and inhibition). Our data provided consistent evidence supporting the absence of near transfer to untrained working memory tasks and the absence of far transfer effects to all of the assessed abilities. Our results suggest that working memory training is not an effective way to improve general cognitive functioning in old age. (PsycINFO Database Record

Direct-Current Stimulation Does Little to Improve the Outcome of Working Memory Training in Older Adults

The promise of transcranial direct-current stimulation (tDCS) as a modulator of cognition has appealed to researchers, media, and the general public. Researchers have suggested that tDCS may increase effects of cognitive training. In this study of 123 older adults, we examined the interactive effects of 20 sessions of anodal tDCS over the left prefrontal cortex (vs. sham tDCS) and simultaneous working memory training (vs. control training) on change in cognitive abilities. Stimulation did not modulate gains from pre- to posttest on latent factors of either trained or untrained tasks in a statistically significant manner. A supporting meta-analysis (n = 266), including younger as well as older individuals, showed that, when combined with training, tDCS was not much more effective than sham tDCS at changing working memory performance (g = 0.07, 95% confidence interval, or CI = [−0.21, 0.34]) and global cognition performance (g = −0.01, 95% CI = [−0.29, 0.26]) assessed in the absence of stimulation. These results question the general usefulness of current tDCS protocols for enhancing the effects of cognitive training on cognitive ability.

Effects of smartphone-based memory training for older adults with subjective memory complaints

IntroductionBrain health has garnered increasing attention as a requisite condition for healthy aging. The rapid growth in mobile health and increasing smartphone ownership among older adults has paved the way for smartphones to be utilized as effective tools for improving mental fitness.ObjectivesThere are few studies that have explored the efficacy of smartphone-based cognitive training. The present study examined the memory-enhancing effects of smartphone-based memory training for older adults.AimsWe explored whether newly developed application “Smartphone-based brain Anti-aging and memory Reinforcement Training (SMART)” improved memory performance in older adults with subjective memory complaints.MethodsA total of 53 adults (mean age: 59.3 years) were randomised into either one of two smartphone-based intervention groups (SMART vs. Fit Brains®) or a wait-list group. Participants in the intervention groups underwent 15–20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and executive function (inhibition, fluency, etc.). In addition, we included self-report questionnaires to assess levels of subjective memory complaints.ResultsThe performance on WM test increased significantly in the SMART group (t[17] = 6.27, P < 0.0001) but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only (t[18] = 2.12, P = 0.048).ConclusionsUse of an 8-week smartphone-based memory training program may improve working memory function in older adults. However, objective improvement in performance does not necessarily lead to decreased subjective memory complaints.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial

ABSTRACTObjectives: We explored whether newly developed application (Smartphone-based brain Anti-aging and memory Reinforcement Training, SMART) improved memory performance in older adults with subjective memory complaints (SMC).Method: A total of 53 adults (range: 50-68 years; 52.8% female) were randomized into either one of two intervention groups [SMART (n = 18) vs. Fit Brains® (n = 19)] or a wait-list group (n = 16). Participants in the intervention groups underwent 15-20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and response inhibition. In addition, we included self-report questionnaires to assess levels of SMC, depression, and anxiety.Results: Total WM quotient [t(17) = 6.27, p < .001] as well as auditory-verbal WM score [t(17) = 4.45, p < .001] increased significantly in the SMART group but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only [t(18) = 2.12, p < .05).Conclusion: Use of an 8-week smartphone-based memory training program may improve WM function in older adults. However, objective improvement in performance does not necessarily lead to decreased SMC.

No Evidence for Improved Associative Memory Performance Following Process-Based Associative Memory Training in Older Adults.

Studies attempting to improve episodic memory performance with strategy instructions and training have had limited success in older adults: their training gains are limited in comparison to those of younger adults and do not generalize to untrained tasks and contexts. This limited success has been partly attributed to age-related impairments in associative binding of information into coherent episodes. We therefore investigated potential training and transfer effects of process-based associative memory training (i.e., repeated practice). Thirty-nine older adults (Mage = 68.8) underwent 6 weeks of either adaptive associative memory training or item recognition training. Both groups improved performance in item memory, spatial memory (object-context binding) and reasoning. A disproportionate effect of associative memory training was only observed for item memory, whereas no training-related performance changes were observed for associative memory. Self-reported strategies showed no signs of spontaneous development of memory-enhancing associative memory strategies. Hence, the results do not support the hypothesis that process-based associative memory training leads to higher associative memory performance in older adults.

Supplemental Material for Working Memory Training in Older Adults: Bayesian Evidence Supporting the Absence of Transfer

Supplemental Material for Working Memory Training in Older Adults: Bayesian Evidence Supporting the Absence of Transfer

Benefits in tasks related to everyday life competences after a working memory training in older adults.

The impact of working memory (WM) training on everyday life functioning has rarely been examined, and it is not clear whether WM training gains are transferred to reasoning abilities. The aim of this study was to assess the efficacy of a verbal WM training in older adults, in terms of specific gains and transfer effects to everyday life and reasoning abilities. Thirty-six community dwelling older adults (from 65 to 75 years of age) were randomly assigned to a training or an active control group. The specific gains in a WM task similar to the one trained were assessed. Transfer effects to everyday life and reasoning abilities were also examined using (i) objective performance-based tasks (the Everyday Problem Test and the Timed Instrumental Activities of Daily Living Scale) and (ii) the Cattell test and Raven's Standard Progressive Matrices, respectively. Only the trained group showed specific benefits and transfer effects to one of the everyday abilities measures (the Everyday Problem Test) and in the two reasoning tasks. These results suggest that WM training can positively impact cognitive functioning and, more importantly, older adults' abilities in everyday living. Copyright © 2016 John Wiley & Sons, Ltd.