Computerized cognitive training with older adults: a systematic review.

Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
PLoS ONE (Impact Factor: 3.53). 07/2012; 7(7):e40588. DOI: 10.1371/journal.pone.0040588
Source: PubMed

ABSTRACT A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.

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    ABSTRACT: There is growing evidence that cognitive training (CT) can improve the cognitive functioning of the elderly. CT may be influenced by cultural and linguistic factors, but research examining CT programs has mostly been conducted on Western populations. We have developed an innovative electroencephalography (EEG)-based brain-computer interface (BCI) CT program that has shown preliminary efficacy in improving cognition in 32 healthy English-speaking elderly adults in Singapore. In this second pilot trial, we examine the acceptability, safety, and preliminary efficacy of our BCI CT program in healthy Chinese-speaking Singaporean elderly. Thirty-nine elderly participants were randomized into intervention (n=21) and wait-list control (n=18) arms. Intervention consisted of 24 half-hour sessions with our BCI-based CT training system to be completed in 8 weeks; the control arm received the same intervention after an initial 8-week waiting period. At the end of the training, a usability and acceptability questionnaire was administered. Efficacy was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), which was translated and culturally adapted for the Chinese-speaking local population. Users were asked about any adverse events experienced after each session as a safety measure. The training was deemed easily usable and acceptable by senior users. The median difference in the change scores pre- and post-training of the modified RBANS total score was 8.0 (95% confidence interval [CI]: 0.0-16.0, P=0.042) higher in the intervention arm than waitlist control, while the mean difference was 9.0 (95% CI: 1.7-16.2, P=0.017). Ten (30.3%) participants reported a total of 16 adverse events - all of which were graded "mild" except for one graded "moderate". Our BCI training system shows potential in improving cognition in both English- and Chinese-speaking elderly, and deserves further evaluation in a Phase III trial. Overall, participants responded positively on the usability and acceptability questionnaire.
    Clinical Interventions in Aging 01/2015; 10:217-27. DOI:10.2147/CIA.S73955 · 2.65 Impact Factor
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    ABSTRACT: Background: A number of computerised treatments have been developed for aphasia, but few have remediated typing, an important functional task, and/or been implemented over the Internet via teletherapy, which can increase access to therapeutic services. The current study created a computerised version of Verb Network Strengthening Treatment (VNeST) and administered it via telerehabilitation over the Internet. VNeST is a semantic treatment which seeks to improve lexical retrieval of words through the conceptual connection between verbs and thematic roles. Previous iterations of VNeST have shown improvement in both spoken and written lexical retrieval for people with moderate and moderate-to-severe aphasia.Aims: This study investigates changes to lexical retrieval with four hierarchical outcome measures. The research questions were: Does treatment using Computerised VNeST (VNeST-C) result in pre- to post-treatment increases in: (1) spoken and typed lexical retrieval of trained (e.g., The farmer is weighing the apples.) and untrained words (e.g., The carpenter is measuring the lumber.) in a picture description task, (2) untreated single-word naming accuracy of nouns and verbs in spoken and typed modalities, (3) spoken and typed lexical retrieval as measured by informative words, efficiency of production and complete utterances within discourse, and (4) standardised measures of cognitive and language abilities?Methods & Procedures: Two people with aphasia were treated three times per week for 8 weeks using the VNeST-C program. A single-subject experimental design was used to evaluate changes in trained and untrained stimuli and tasks. Additional pre-treatment and post-treatment testing was also conducted.Outcomes & Results: Results indicate improvements on lexical retrieval during sentence production of trained and untrained stimuli. Additional improvement was observed for single-word naming of untrained nouns and verbs in spoken and typed modalities and standardised measures of aphasia and writing-by-hand. Limited generalisation to discourse was also observed, including a general increase in word output and decrease in typed neologisms.Conclusions: The results of this study suggest that the VNeST-C program and protocol have promise as a broadly generalising treatment for people with aphasia. With refinement of duration and intensity of the protocol, it may be a viable option for treating aphasia.
    Aphasiology 01/2014; 28(4):401-420. DOI:10.1080/02687038.2013.869304 · 1.73 Impact Factor
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    ABSTRACT: Cognitive training has recently become a primary topic of interest in cognitive psychology. The discovery of a strong relationship between WM and Gf gave rise to new cognitive training methods (like dual n-back task), which challenged traditional views of intelligence as a fixed trait in healthy adults. Previous research has shown mixed results in the ability of cognitive training to improve fluid intelligence. Presented dissertation aims to first replicate such effects in a study with (N=142) participants, and then to explore the mediating role of personality systems interaction (PSI) personality factors. In addition, univariate and bivariate analyses of two n-back related, self-report questionnaires (N=258 and N=97) are presented. Experimental results showed improvements in one out of two IQ test scores, which reflects the ambivalent nature of previous research in this field. After examining the results in context of PSI theory, it was found that different training methods yielded different IQ gains in participants, depending on their personality styles. In addition, these correlations suggested a meaningful pattern, indicating that PSI theory may be able to account for the different outcomes of cognitive training studies. Analysis of self-report questionnaires suggests, among other things, that the use of mental strategies during n-back training does not influence prospective IQ gains, and neither does the motivation to participate in n-back study. Qualitative reports complement these findings by offering unique insights into the subjective experiences of people who trained n-back. The presented findings may facilitate tailor-made cognitive training interventions in the future, and can contribute to explaining the mechanisms underlying the far-transfer of working memory training to fluid intelligence.
    01/2015, Degree: Ph.D., Supervisor: prof. PhDr. Tomáš Urbánek, Ph.D.

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