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Granland KA, Thompson CL, Dong Y. "Train Your Brain" Cognitive Intervention Group Program for Singaporean Older Adult Patients With Mild Cognitive Impairment: A Pilot Feasibility Study. J Geriatr Psychiatry Neurol 2022; 35:442-449. [PMID: 33733903 DOI: 10.1177/08919887211002661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Kim A Granland
- Department of Psychology, 208640James Cook University, Singapore, Singapore
| | - Claire L Thompson
- College of Psychology, 6939Central Queensland University, Rockhampton, Australia
| | - Yanhong Dong
- Alice Lee Centre for Nursing Studies, 63751Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Huang V, Hogan DB, Ismail Z, Maxwell CJ, Smith EE, Callahan BL. Evaluating the Real-World Representativeness of Participants with Mild Cognitive Impairment in Canadian Research Protocols: a Comparison of the Characteristics of a Memory Clinic Patients and Research Samples. Can Geriatr J 2020; 23:297-328. [PMID: 33282050 PMCID: PMC7704078 DOI: 10.5770/cgj.23.416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Studies of mild cognitive impairment (MCI) employ rigorous eligibility criteria, resulting in sampling that may not be representative of the broader clinical population. Objective To compare the characteristics of MCI patients in a Calgary memory clinic to those of MCI participants in published Canadian studies. Methods Clinic participants included 555 MCI patients from the PROspective Registry of Persons with Memory SyMPToms (PROMPT) registry in Calgary. Research participants included 4,981 individuals with MCI pooled from a systematic literature review of 112 original, English-language peer-reviewed Canadian studies. Both samples were compared on baseline sociodemographic variables, medical and psychiatric comorbidities, and cognitive performance for MCI due to Alzheimer’s disease and Parkinson’s disease. Results Overall, clinic patients tended to be younger, more often male, and more educated than research participants. Psychiatric disorders, traumatic brain injury, and sensory impairment were commonplace in PROMPT (up to 83% affected) but > 80% studies in the systematic review excluded these conditions. PROMPT patients also performed worse on global cognition measures than did research participants. Conclusion Stringent eligibility criteria in Canadian research studies excluded a considerable subset of MCI patients with comorbid medical or psychiatric conditions. This exclusion may contribute to differences in cognitive performance and outcomes compared to real-world clinical samples.
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Affiliation(s)
- Vivian Huang
- Department of Psychology, Ryerson University, Toronto, ON
| | - David B Hogan
- Cumming School of Medicine, University of Calgary, Calgary, AB.,Hotchkiss Brain Institute, Calgary, AB
| | - Zahinoor Ismail
- Cumming School of Medicine, University of Calgary, Calgary, AB.,Hotchkiss Brain Institute, Calgary, AB.,Mathison Centre for Mental Health Research & Education, Calgary, AB.,Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Colleen J Maxwell
- Hotchkiss Brain Institute, Calgary, AB.,Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Waterloo, ON
| | - Eric E Smith
- Cumming School of Medicine, University of Calgary, Calgary, AB.,Hotchkiss Brain Institute, Calgary, AB
| | - Brandy L Callahan
- Hotchkiss Brain Institute, Calgary, AB.,Mathison Centre for Mental Health Research & Education, Calgary, AB.,Department of Psychology, University of Calgary, Calgary, AB
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Basak C, Qin S, O'Connell MA. Differential effects of cognitive training modules in healthy aging and mild cognitive impairment: A comprehensive meta-analysis of randomized controlled trials. Psychol Aging 2020; 35:220-249. [PMID: 32011155 DOI: 10.1037/pag0000442] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis was designed to compare the effectiveness of 2 cognitive training modules, single-component training, which targets 1 specific cognitive ability, versus multicomponent training, which trains multiple cognitive abilities, on both trained abilities (near transfer) and untrained abilities (far transfer) in older adults. The meta-analysis also assessed whether individual differences in mental status interacted with the extent of transfer. Eligible randomized controlled trials (215 training studies) examined the immediate effects of cognitive training in either healthy aging (HA) or mild cognitive impairment (MCI). Results yielded an overall net-gain effect size (g) for the cognitive training of 0.28 (p < .001). These effects were similar across mental status and training modules, and were significant for both near (g = 0.37) and far (g = 0.22) transfer. Although all training modules yielded significant near transfer, only a few yielded significant far transfer. Single-component training of executive functions was most effective on near and far transfer, with processing speed training improving everyday functioning. All modules of multicomponent training (specific and nonspecific) yielded significant near and far transfer, including everyday functioning. Training effects on cognition were moderated by educational attainment and number of cognitive outcomes, but only in HA. These findings suggest that, in older adults, all modules of multicomponent training are more effective in engendering near and far transfer, including everyday functioning, when compared with single-component training modules. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Memory-focused interventions for people with cognitive disorders: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Stud 2018; 78:44-51. [DOI: 10.1016/j.ijnurstu.2017.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 08/01/2017] [Accepted: 08/10/2017] [Indexed: 11/22/2022]
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Chandler MJ, Parks AC, Marsiske M, Rotblatt LJ, Smith GE. Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:225-251. [PMID: 27632385 PMCID: PMC5048589 DOI: 10.1007/s11065-016-9330-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 08/22/2016] [Indexed: 01/13/2023]
Abstract
Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.
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Affiliation(s)
- M J Chandler
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - A C Parks
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - M Marsiske
- University of Florida, Gainesville, FL, USA
| | | | - G E Smith
- University of Florida, Gainesville, FL, USA
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Rahe J, Liesk J, Rosen JB, Petrelli A, Kaesberg S, Onur OA, Kessler J, Fink GR, Kalbe E. Sex differences in cognitive training effects of patients with amnestic mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 22:620-38. [DOI: 10.1080/13825585.2015.1028883] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Scheller E, Minkova L, Leitner M, Klöppel S. Attempted and successful compensation in preclinical and early manifest neurodegeneration - a review of task FMRI studies. Front Psychiatry 2014; 5:132. [PMID: 25324786 PMCID: PMC4179340 DOI: 10.3389/fpsyt.2014.00132] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/08/2014] [Indexed: 01/20/2023] Open
Abstract
Several models of neural compensation in healthy aging have been suggested to explain brain activity that aids to sustain cognitive function. Applying recently suggested criteria of "attempted" and "successful" compensation, we reviewed existing literature on compensatory mechanisms in preclinical Huntington's disease (HD) and amnestic mild cognitive impairment (aMCI). Both disorders constitute early stages of neurodegeneration ideal for examining compensatory mechanisms and developing targeted interventions. We strived to clarify whether compensation criteria derived from healthy aging populations can be applied to early neurodegeneration. To concentrate on the close coupling of cognitive performance and brain activity, we exclusively addressed task fMRI studies. First, we found evidence for parallels in compensatory mechanisms between healthy aging and neurodegenerative disease. Several studies fulfilled criteria of attempted compensation, while reports of successful compensation were largely absent, which made it difficult to conclude on. Second, comparing working memory studies in preclinical HD and aMCI, we identified similar compensatory patterns across neurodegenerative disorders in lateral and medial prefrontal cortex. Such patterns included an inverted U-shaped relationship of neurodegeneration and compensatory activity spanning from preclinical to manifest disease. Due to the lack of studies systematically targeting all criteria of compensation, we propose an exemplary study design, including the manipulation of compensating brain areas by brain stimulation. Furthermore, we delineate the benefits of targeted interventions by non-invasive brain stimulation, as well as of unspecific interventions such as physical activity or cognitive training. Unambiguously detecting compensation in early neurodegenerative disease will help tailor interventions aiming at sustained overall functioning and delayed clinical disease onset.
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Affiliation(s)
- Elisa Scheller
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Lora Minkova
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Mathias Leitner
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
| | - Stefan Klöppel
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
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