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Wu Z, Pandigama DH, Wrigglesworth J, Owen A, Woods RL, Chong TTJ, Orchard SG, Shah RC, Sheets KM, McNeil JJ, Murray AM, Ryan J. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open 2023; 6:e2323690. [PMID: 37450299 PMCID: PMC10349343 DOI: 10.1001/jamanetworkopen.2023.23690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Importance Lifestyles enriched with socially and mentally stimulating activities in older age may help build cognitive reserve and reduce dementia risk. Objective To investigate the association of leisure activities and social networks with dementia risk among older individuals. Design, Setting, and Participants This longitudinal prospective cohort study used population-based data from the ASPREE Longitudinal Study of Older Persons (ALSOP) for March 1, 2010, to November 30, 2020. Community-dwelling individuals in Australia aged 70 years or older who were generally healthy and without major cognitive impairment at enrollment were recruited to the ALSOP study between March 1, 2010, and December 31, 2014. Data were analyzed from December 1, 2022, to March 31, 2023. Exposures A total of 19 measures of leisure activities and social networks assessed at baseline were classified using exploratory factor analysis. Main Outcomes and Measures Dementia was adjudicated by an international expert panel according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Cox proportional hazards regression examined dementia risk over 10 years, adjusting for education, socioeconomic status, and a range of health-related factors. Results This study included 10 318 participants. Their median age was 73.8 (IQR, 71.6-77.2) years at baseline, more than half (52.6%) were women, and most self-identified as White (98.0%). In adusted analyses, more frequent engagement in adult literacy activities (eg, writing letters or journaling, using a computer, and taking education classes) and in active mental activities (eg, playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0% (adjusted hazard ratio [AHR], 0.89 [95% CI, 0.85-0.93]) and a 9.0% (AHR, 0.91 [95% CI, 0.87-0.95]) lower risk of dementia, respectively. To a lesser extent, engagement in creative artistic activities (craftwork, woodwork, or metalwork and painting or drawing) (AHR, 0.93 [95% CI, 0.88-0.99]) and in passive mental activities (reading books, newspapers, or magazines; watching television; and listening to music or the radio) (AHR, 0.93 [95% CI, 0.86-0.99]) was also associated with reduced dementia risk. In contrast, interpersonal networks, social activities, and external outings were not associated with dementia risk in this sample. Conclusions and Relevance These results suggest that engagement in adult literacy, creative art, and active and passive mental activities may help reduce dementia risk in late life. In addition, these findings may guide policies for geriatric care and interventions targeting dementia prevention for older adults.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Danushika H. Pandigama
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Monash School of Medicine, Monash University, Melbourne, Australia
| | - Jo Wrigglesworth
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Melbourne, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Raj C. Shah
- Department of Family and Preventive Medicine, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kerry M. Sheets
- Division of Geriatric and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis, Minnesota
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Ishibashi GA, Santos GD, Moreira APB, Verga CER, Silva GAD, Ordonez TN, Moraes LCD, Lessa PP, Brucki SMD, Silva TBLD. Effects of cognitive interventions with video games on cognition in healthy elderly people: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:484-491. [PMID: 37257469 DOI: 10.1055/s-0043-1764413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Currently, studies using video games as an intervention to improve cognitive functions in the elderly are on the rise. OBJECTIVE To investigate and evaluate the effects of cognitive interventions using video games on cognition in healthy elderly people published in the last ten years. METHODS A systematic review involving a qualitative analysis carried out between July and September 2021on the SciELO, LILACS and MEDLINE databases.. RESULTS A total of 262 articles were identified in the initial search. After exclusion of duplicates, analysis of titles/abstracts and of the full text, a final total of 9 studies were included in the review. The objectives of the studies included investigating the effects on cognition of cognitive training (CT) programs using video games compared to programs using entertainment games or to low-intensity CT games. Despite the growing number of studies, many of them were focused on cognitive rehabilitation in elderly people with some degree of cognitive impairment, and few involved training among healthy elderly people. CONCLUSION According to the studies analyzed, the interventions involving CT with video games promoted significant improvements in processing speed and working memory, but no improvements in executive functions.
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Affiliation(s)
- Graciela Akina Ishibashi
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Instituto Supera de Educação, São José dos Campos SP, Brazil
| | - Gabriela Dos Santos
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Ana Paula Bagli Moreira
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Cássia Elisa Rossetto Verga
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Guilherme Alves da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Tiago Nascimento Ordonez
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Luiz Carlos de Moraes
- Instituto Supera de Educação, São José dos Campos SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Patrícia Prata Lessa
- Instituto Supera de Educação, São José dos Campos SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Thais Bento Lima da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
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Coley N, Giulioli C, Aisen PS, Vellas B, Andrieu S. Randomised controlled trials for the prevention of cognitive decline or dementia: A systematic review. Ageing Res Rev 2022; 82:101777. [PMID: 36336171 DOI: 10.1016/j.arr.2022.101777] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/02/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Dementia prevention research has progressed rapidly in recent years, with publication of several large lifestyle intervention trials, and renewed interest in pharmacological interventions, notably for individuals with Alzheimer's disease biomarkers, warranting an updated review of results and methodology. We identified 112 completed trials testing the efficacy of single-domain pharmacological (n = 33, 29%), nutritional (n = 27, 24%), physical activity (n = 18, 16%) and cognitive stimulation (n = 13, 12%), or multidomain (n = 22, 20%) interventions on incident dementia, or a relevant intermediate marker (e.g. cognitive function, biomarkers or dementia risk scores) in people without dementia. The earliest trials tested pharmacological interventions or nutritional supplements, but lifestyle interventions predominated in the last decade. In total, 21 (19%) trials demonstrated a clear beneficial effect on the pre-specified primary outcome (or all co-primary outcomes), but only two (10%) were large-scale (testing blood pressure lowering (Syst-Eur) or multidomain (FINGER) interventions on incident dementia and cognitive change in cognitive function, respectively). Of the 116 ongoing trials, 40% (n = 46) are testing multidomain interventions. Recent methodological shifts concern target populations, primary outcome measures, and intervention design, but study design remains constant (parallel group randomised controlled trial). Future trials may consider using adaptive trials or interventions, and more targeted approaches, since certain interventions may be more effective in certain subgroups of the population, and at specific times in the life-course. Efforts should also be made to increase the representativeness and diversity of prevention trial populations.
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Affiliation(s)
- Nicola Coley
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France.
| | - Caroline Giulioli
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Bruno Vellas
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital, France
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
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Yang C, Han X, Jin M, Xu J, Wang Y, Zhang Y, Xu C, Zhang Y, Jin E, Piao C. The Effect of Video Game-Based Interventions on Performance and Cognitive Function in Older Adults: Bayesian Network Meta-analysis. JMIR Serious Games 2021; 9:e27058. [PMID: 34967759 PMCID: PMC8759017 DOI: 10.2196/27058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/22/2021] [Accepted: 10/12/2021] [Indexed: 01/29/2023] Open
Abstract
Background The decline in performance of older people includes balance function, physical function, and fear of falling and depression. General cognitive function decline is described in terms of processing speed, working memory, attention, and executive functioning, and video game interventions may be effective. Objective This study evaluates the effect of video game interventions on performance and cognitive function in older participants in terms of 6 indicators: balance function, executive function, general cognitive function, physical function, processing speed, and fear of falling and depression. Methods Electronic databases were searched for studies from inception to June 30, 2020. Randomized controlled trials and case-controlled trials comparing video game interventions versus nonvideo game control in terms of performance and cognitive function outcomes were incorporated into a Bayesian network meta-analysis. All data were continuous variables. Results In total, 47 studies (3244 participants) were included. In pairwise meta-analysis, compared with nonvideo game control, video game interventions improved processing speed, general cognitive function, and depression scores. In the Bayesian network meta-analysis, interventions with video games improved balance function time (standardized mean difference [SMD] –3.34, 95% credible interval [CrI] –5.54 to –2.56), the cognitive function score (SMD 1.23, 95% CrI 0.82-1.86), processing speed time (SMD –0.29, 95% CrI –0.49 to –0.08), and processing speed number (SMD 0.72, 95% CrI 0.36-1.09), similar to the pairwise meta-analysis. Interventions with video games with strong visual senses and good interactivity ranked first, and these might be more beneficial for the elderly. Conclusions Our comprehensive Bayesian network meta-analysis provides evidence that video game interventions could be considered for the elderly for improving performance and cognitive function, especially general cognitive scores and processing speed. Games with better interactivity and visual stimulation have better curative effects. Based on the available evidence, we recommend video game interventions for the elderly. Trial Registration PROSPERO CRD42020197158; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197158
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Affiliation(s)
- Chao Yang
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Xiaolei Han
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Mingxue Jin
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Jianhui Xu
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China
| | - Yiren Wang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Yajun Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | | | - Yingshi Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Enshi Jin
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China.,Information Construction Department, Liaoning National Normal College, Shenyang, China
| | - Chengzhe Piao
- Department of Ethnic Culture and Vocational Education, Liaoning National Normal College, Shenyang, China.,Information Construction Department, Liaoning National Normal College, Shenyang, China
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Nguyen L, Murphy K, Andrews G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 2021; 32:601-630. [PMID: 34251578 DOI: 10.1007/s11065-021-09515-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/15/2021] [Indexed: 12/31/2022]
Abstract
The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.
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Affiliation(s)
- Lan Nguyen
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Karen Murphy
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
| | - Glenda Andrews
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
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Small BJ. Cognitive Interventions in Later Life: Introduction to the Special Section. J Gerontol B Psychol Sci Soc Sci 2020; 75:1130-1131. [DOI: 10.1093/geronb/gbaa032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brent J Small
- School of Aging Studies, University of South Florida, Tampa
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