Cognitive Training Enhances Auditory Attention Efficiency in Older Adults

Fostering cognitive performance in older adults with a process- and a strategy-based cognitive training

       The present study investigates the impact of process-based and strategy-based cognitive training to boost performance in healthy older adults. Three groups trained with either a dichotic listening training (process-based training, n = 25), an implementation intention strategy training (strategy-based training, n = 23), or served as a non-contact control group (n = 30). Our results demonstrated that training participants improved their performance in the trained tasks (process-based training: d = 3.01, strategy-based training: d = 2.6). For untrained tasks, the process-based training group showed significant working memory (d = .58) as well as episodic memory task improvement (d = 1.19) compared to the strategy-based training and to the non-contact control group (all d < .03). In contrast, in the strategy-based training group there was a tendency towards some performance gain in a fluid intelligence test (d = .92). These results indicate that cognitive training can be tailored to improve specific cognitive abilities.

Auditory outcome following aneurysmal subarachnoid haemorrhage

Auditory deficits are increasingly recognised following aneurysmal subarachnoid haemorrhage (aSAH) and are thought to be of central rather than peripheral origin. Central hearing impairment, also known as auditory processing disorder (APD), often coexists with cognitive deficits and it is thought that APD has both auditory and cognitive elements. The aim of this study was to assess auditory outcome following aSAH and its relationship with cognition. A retrospective case-controlled study design was employed with aSAH cases and matched controls identified from the UK Biobank. Auditory and cognitive outcomes were assessed using the digit triplet test (DTT) and a test of psychomotor reaction time, respectively. Best DTT score was compared between cases and controls using the t-test. A regression-based mediation analysis was performed to assess whether cognition mediated auditory outcome. 270 aSAH patients with auditory outcomes were identified with an average follow-up of 106 months. A matched control cohort of 1080 individuals was also identified. The aSAH cohort had significantly impaired best DTT scores compared to matched controls (p = 0.002). Cognition significantly mediated auditory outcome following aSAH, accounting for 9.8% of the hearing impairment after aSAH. In conclusion significant hearing impairment follows aSAH. The deficit is bilateral and non-progressive. There is a link with cognitive deficit, pointing to a central rather than peripheral source, in keeping with an auditory processing disorder. All aSAH patients should be asked about hearing difficulty at follow-up and when present it should be investigated with peripheral and central auditory assessments, as well as cognitive tests.

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

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.

Cognitive Event-Related Potential Responses Differentiate Older Adults with and without Probable Mild Cognitive Impairment

Background: Older adults rarely seek cognitive assessment, but often visit other healthcare professionals (e.g., audiologists). Noninvasive clinical measures within the scopes of practice of those professions sensitive to cognitive impairment are needed. Purpose: This study examined the differences of probable mild cognitive impairment (MCI) on latency and mean amplitude of the P3b auditory event-related potential. Method: Fifty-four participants comprised two groups according to cognitive status (cognitively normal older adults [CNOA], n = 25; probable MCI, n = 29). P3b was recorded using an oddball paradigm for speech (/ba/, /da/) and non-speech (1000, 2000 Hz) stimuli. Amplitudes and latencies were compared from six electrodes (FPz, Fz, FCz, Cz, CPz, Pz) between groups across stimulus probability and type. Results: CNOA participants had larger P3b mean amplitudes for deviant stimuli than those with probable MCI. Group effects of latency were isolated to deviant stimuli at FCz only when those with unclear P3bs were included. Findings did not covary with age or education. Overall, CNOAs showed a large P3b oddball effect while those with probable MCI did not. Conclusions: P3b can be used to show electrophysiological differences between older adults with and without probable MCI. These results support the development of educational materials targeting professionals using auditory-evoked potentials.

Are auditory processing and cognitive performance assessments overlapping or distinct? Parsing the auditory behaviour of older adults

OBJECTIVE

Auditory processing predicts cognitive decline, including dementia, in older adults. Auditory processing involves the understanding, interpretation, and communication of auditory information. Cognition is linked to auditory processing; however, it is disputed whether auditory processing is a separate construct distinct from cognition. The purpose of this study was to determine if auditory processing is distinct from cognition in older adults.

DESIGN

Participants completed 14 cognitive and auditory processing assessments. Assessments were subjected to exploratory factor analysis with principal components extraction and varimax rotation with Kaiser normalisation. Study sample: 213 community-dwelling older adults (M = 71.39 years, 57% female, 93% Caucasian, M = 16 years education) with and without mild cognitive impairment (MCI) participated.

RESULTS

Four factors were identified, explaining 66.3% of the total variance: (1) executive functions, visual processing speed, and dichotic auditory processing, (2) auditory processing of degraded speech, (3) memory, and (4) auditory temporal processing of nonspeech.

CONCLUSIONS

Two domains of auditory processing (processing degraded speech and temporal processing) account for unique variance to which cognitive measures are not sensitive, while measures of auditory dichotic processing appear to be tapping similar abilities as measures of cognition. Older adults who perform poorly on dichotic measures should be screened for cognitive impairment.

Cognitive and neural plasticity in old age: A systematic review of evidence from executive functions cognitive training

Cognitive training is a popular intervention aimed at attenuating age-related cognitive decline, however, the effects of this intervention on brain structure and function have not been thoroughly explored. Core executive functions (working memory, inhibition, cognitive flexibility) are dependent upon prefrontal brain regions-one of the most vulnerable areas of age-related decline. They are also implicated in numerous cognitive processes and higher-order functions. Training executive functions should therefore promote cognitive and neural enhancements in old age. This systematic review examined the effects of executive functions training on brain and cognition amongst healthy older adults across 20 studies. Behavioral performance consistently improved on trained cognitive tasks, though mixed findings were reported for untrained tasks. Training-related structural changes were reported, evidenced through increases in grey matter and cortical volume. Functional changes were not consistent, though a general pattern of increased subcortical and decreased frontal and parietal activation emerged across studies, indicating that training may potentially reduce reliance on compensatory neural mechanisms. Training executive functions appears to promote cognitive and neural plasticity in old age, though further research is required to develop a more comprehensive framework which connects and elucidates the mechanisms underlying cognitive training, cognitive transfer, and cognitive aging.