Personalized cognitive training in unipolar and bipolar disorder: a study of cognitive functioning

Preliminary evidence for the feasibility of at-home online cognitive training with older adults

Increased levels of cognitive activity may improve general cognitive function in older adults and potentially increase cognitive reserve, protecting against the onset of dementia associated with syndromes like Alzheimer's disease. To test the efficacy of cognitive training administered online, 18 participants (11 cognitively healthy; 7 mild cognitive impairment) were recruited from a clinical population of older adults to complete an online training intervention (CogniFit™). Before and after training, participants completed a separate battery of assessment measures, including measures of quality of life and competency at everyday activities, as well as a series of tests assessing cognitive function. Participants generally adhered to the online training protocol and completed a computerized assessment battery pre- and post-training. However, participants with mild cognitive impairment (MCI) were somewhat less likely to adhere to the protocol, suggesting that more direct contact is needed with this population in intervention research. Furthermore, participants demonstrated significant improvement on a measure of working memory and also in processing speed across several assessments, though these data are tentative, as no control data exist. These results, along with the generally good adherence observed, suggest that online cognitive training is feasible for this population and a potentially valuable tool for the wider dissemination of cognitive training.

Cognitive training improves sleep quality and cognitive function among older adults with insomnia

Study Objectives

To investigate the effect of an eight-week, home-based, personalized, computerized cognitive training program on sleep quality and cognitive performance among older adults with insomnia.

Design

Participants (n = 51) were randomly allocated to a cognitive training group (n = 34) or to an active control group (n = 17). The participants in the cognitive training group completed an eight-week, home-based, personalized, computerized cognitive training program, while the participants in the active control group completed an eight-week, home-based program involving computerized tasks that do not engage high-level cognitive functioning. Before and after training, all participants' sleep was monitored for one week by an actigraph and their cognitive performance was evaluated.

Setting

Community setting: residential sleep/performance testing facility.

Participants

Fifty-one older adults with insomnia (aged 65–85).

Interventions

Eight weeks of computerized cognitive training for older adults with insomnia.

Results

Mixed models for repeated measures analysis showed between-group improvements for the cognitive training group on both sleep quality (sleep onset latency and sleep efficiency) and cognitive performance (avoiding distractions, working memory, visual memory, general memory and naming). Hierarchical linear regressions analysis in the cognitive training group indicated that improved visual scanning is associated with earlier advent of sleep, while improved naming is associated with the reduction in wake after sleep onset and with the reduction in number of awakenings. Likewise the results indicate that improved “avoiding distractions” is associated with an increase in the duration of sleep. Moreover, the results indicate that in the active control group cognitive decline observed in working memory is associated with an increase in the time required to fall asleep.

Conclusions

New learning is instrumental in promoting initiation and maintenance of sleep in older adults with insomnia. Lasting and personalized cognitive training is particularly indicated to generate the type of learning necessary for combined cognitive and sleep enhancements in this population.

Trial Registration

ClinicalTrials.gov NCT00901641