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The Impact of Sustained Engagement on Cognitive Function in Older Adults: The Synapse Project
Abstract and Figures
In the research reported here, we tested the hypothesis that sustained engagement in learning new skills that activated working memory, episodic memory, and reasoning over a period of 3 months would enhance cognitive function in older adults. In three conditions with high cognitive demands, participants learned to quilt, learned digital photography, or engaged in both activities for an average of 16.51 hr a week for 3 months. Results at posttest indicated that episodic memory was enhanced in these productive-engagement conditions relative to receptive-engagement conditions, in which participants either engaged in nonintellectual activities with a social group or performed low-demand cognitive tasks with no social contact. The findings suggest that sustained engagement in cognitively demanding, novel activities enhances memory function in older adulthood, but, somewhat surprisingly, we found limited cognitive benefits of sustained engagement in social activities.
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... On the one hand, some major areas that can receive gains after cognitive training include processing speed (Ball et al., 2002), working memory (Ball et al., 2002;Basak et al., 2008;Dahlin et al., 2008), and reasoning (Park et al., 2014;Willis et al., 2006). On the other hand, the bilingual advantage literature suggests that bilinguals a,d,e Education: 0 = no schooling; 1 = primary school; 2 = secondary school; 3 = high school; 4 = university; 5 = post-graduate and above b Previous occupation: 0 = unemployed (including housewife); 1 = farm laborer, menial service worker; 2 = unskilled worker; 3 = machine operator, semiskilled worker; 4 = small business owner, skilled manual worker; 5 = clerical and sales worker, small business owner; 6 = technician, semi-professional; 7 = manager, minor professional; 8 = administrator, professional, proprietor. ...
... The digit span tests (both forward and backward) of the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008) were used to assess working memory capacities ( Nijmeijer et al., 2021), which are responsible for temporary storage and manipulation of information for complex cognitive tasks. Raven's colored progressive matrices were used to measure reasoning abilities (Keijzer & Schmid, 2017;Park et al., 2014). This version is typically used with children from 5 through 11 years, elderly persons, and mentally and physically impaired persons. ...
... Raven et al., 1991, p. G1). Processing speed was assessed using the speeded digit-comparison tasks with three, six, and nine items (Park et al., 2014;Salthouse & Babcock, 1991). A modified version of the flanker test (Sullivan et al., 2016) was used to assess conflict monitoring. ...
This paper presents the results of a retrospective study that investigates the cognitive effects of learning a foreign language in late adulthood. The learner group, consisting of 21 L1 Chinese speakers who have been learning to read Arabic for 2 years and 4 months, were compared to the matched group on their performance on a series of cognitive tasks that tap into working memory, processing speed, reasoning, conflict monitoring, and attention. The results showed that the learning group’s performance was significantly better in attention (measured by the Posner cueing attention task). Their working memory capacities (measured by the digit span tests) were also better, but the difference only reached marginal significance. The findings suggest that language learning may lead to improvement in attention abilities, which is in line with the converging evidence in the field of bilingualism showing that executive attention may underlie the mechanism of how bilingual experience can alter brain and the cognitive system.
... Changes in our cognitive abilities as we age are influenced by our lifestyles. An active and engaged lifestyle is supported as being beneficial for brain health [1][2][3][4]. Engaging in activities in mid-or later life may be associated with lower risk of dementia [5,6]. Having a more open disposition may be related to increased engagement in mentally challenging activities and better cognition [7]. ...
... Real-world activities varying in their levels and combinations of physical, mental and social demands, are gaining increasing support as potential multimodal cognitive interventions. For example, Park and colleagues [3] studied the effects of engagement in novel activities (where participants reported no or limited prior exposure) on the cognitive abilities of older adults. Participants engaging in productive activities (requiring new learning) for 12 weeks showed improvements in episodic memory, with limited cognitive benefits observed in the receptive condition (not requiring new learning). ...
... Our results also provide some support for studies exploring the benefits of an engaged lifestyle and similar cognitive interventions designed in-house [3,8,9]. Some of our participants reported cognitive and health and wellbeing benefits, although others did not perceive any changes. ...
Introduction:
An active and engaged lifestyle is supported as being beneficial for brain health. Activities comprising physical, mental and social demands, or combinations of those, are of particular interest, and have been the focus of specific interventions. Exploring how older people engage with such community-based activities, including facilitators and barriers to participation, may help improve the success of future translational activities. The purpose of this study was therefore to identify factors that enabled or hindered activity engagement by conducting focus groups with people who had been supported to take up a new activity as part of an intervention study.
Materials and methods:
Twenty-seven older adults aged 65-86 (56% female) who had completed an activity-based intervention study participated in three focus groups. Discussions explored their experiences of taking up a new activity, including facilitators and barriers to their engagement, and their perceptions of any benefits.
Results:
Thematic analysis grouped participants' responses into five themes: positive aspects and facilitators of engagement in a new activity; challenges and barriers to engagement; ageing being a facilitator and a barrier to engagement; differential effects of activities on participants' health and wellbeing; and general project feedback (including opinions on study design).
Discussion and conclusions:
Participants' experiences and expectations included positive (e.g., enjoyment, socialisation) and negative factors (e.g., lack of confidence, other commitments, class costs and poor structure), consistent with previous research on social participation and engaging with new learning opportunities. Future studies should also consider those who do not readily participate in leisure activities to address earlier barriers. It is important that older adults have access to potentially beneficial activities and local authorities should prioritise increasing their provision.
... To date, one way to prevent cognitive decline is through intellectual activity and novel learning, which is based on the cognitive reserve hypothesis [3]. Intellectual activities, such as taking pictures, playing Go, and reading aloud picture books, can help maintain and improve cognitive function [4][5][6][7]. Furthermore, even in mild cognitive impairment (MCI), such activities can improve cognitive function, [8] and a certain number of patients return to normal cognitive status [9]. Thus, the development of methods for early detection of cognitive decline is an important issue. ...
Background
As the older population increases, the need for early detection of cognitive decline is also increasing. In this study, we examined whether our paper–pencil type group examination for cognitive assessment (PAPLICA) could detect the effects of years of education and aging.
Methods
PAPLICA was conducted on 829 older people. The inclusion criteria were age 60 years or older and the ability to come to the event site alone. The exclusion criteria were participants with a medical or psychiatric disorder or dementia.One examiner conducted the test on a group of approximately 10–20 people in approximately 25 min. Participants were instructed on tackling the issues projected on the projector, and their answers were recorded in a response booklet.
Results
An independent sample t-test was performed for years of education, and ANCOVA was performed for aging. Among the test items included in PAPLICA, the Speed I and Letter fluency tests were unable to detect the effects of aging. Furthermore, the age at which the effect of aging manifests varies depending on the test item. For instance, a decline in scores in the Speed I and Picture ECR Free recall tests was observed in the 70–74 age group; for that of Word DRT, Picture ECR cued recall, and Similarity, in the 75–79 age group; for CFT, in the 80–84 age group, and for CLOX, the decline was observed in the 85 ≤ age group.
Conclusions
PAPLICA, similar to other neuropsychological tests, was able to detect the effects of years of education and aging. Future testing should be conducted on different demographics to identify the differences in patterns of cognitive decline.
Society within the Brain provides insightful accounts of scientific research linking social connection with brain and cognitive aging through state-of-the-art research. This involves comprehensive social network analysis, social neuroscience, neuropsychology, psychoneuroimmunology, and sociogenomics. This book provides a scientific discourse on how a society, community, or friends and family interact with individuals' cognitive aging. Issues concerning social isolation, rapidly increasing in modern societies, and the controversy in origins of individual difference in social brain and behaviour are discussed. An integrative framework is introduced to explicate how social networks and support alleviate the effects of aging in brain health and reduce dementia risks. This book is of interest and useful to a wide readership: from gerontologists, psychologists, clinical neuroscientists and sociologists, to those involved in developing community-based interventions or public health policy for brain health, to people interested in how social life influences brain aging or in the prevention of dementia.
Society within the Brain provides insightful accounts of scientific research linking social connection with brain and cognitive aging through state-of-the-art research. This involves comprehensive social network analysis, social neuroscience, neuropsychology, psychoneuroimmunology, and sociogenomics. This book provides a scientific discourse on how a society, community, or friends and family interact with individuals' cognitive aging. Issues concerning social isolation, rapidly increasing in modern societies, and the controversy in origins of individual difference in social brain and behaviour are discussed. An integrative framework is introduced to explicate how social networks and support alleviate the effects of aging in brain health and reduce dementia risks. This book is of interest and useful to a wide readership: from gerontologists, psychologists, clinical neuroscientists and sociologists, to those involved in developing community-based interventions or public health policy for brain health, to people interested in how social life influences brain aging or in the prevention of dementia.
Purpose of Review
To review recent research regarding cognitive problems during perimenopause, including which menopause-related symptoms, demographic variables, stress exposures, and neural biomarkers are associated with cognitive problems and which interventions demonstrate efficacy at improving cognitive performance.
Recent Findings
Cognitive problems are common during perimenopause and have a significant impact on a substantial proportion of women. Evidence continues to indicate that verbal learning and verbal memory are the cognitive functions that are most negatively affected during perimenopause, and new research suggests that perimenopause may also be associated with deficits in processing speed, attention, and working memory. Recent research suggests that the cognitive profiles of women transitioning through perimenopause are heterogenous – with some showing strengths and others demonstrating weaknesses in particular cognitive domains. Depression, sleep problems, and vasomotor symptoms in perimenopause may be associated with cognitive difficulties. Recent neuroimaging studies are identifying changes in activity patterns within brain regions that correlate with cognitive performance in perimenopause, but future causal studies are needed to understand the neural mechanisms of cognitive problems during this time. Although clinical treatment studies for cognitive concerns have historically focused on postmenopause, some small trials in perimenopausal samples have been conducted recently but are frequently underpowered. Current guidelines from the North American Menopause Society do not support the use of hormone therapy at any age for cognitive problems. Animal research demonstrates that estradiol and levonorgestrel combined may alleviate working memory problems.
Summary
Much progress has been made in understanding how perimenopause impacts cognition, and more research is needed to better identify who is at highest risk and how to meaningfully prevent and alleviate cognitive problems during this reproductive stage. Larger-scale randomized intervention trials specifically during perimenopause are urgently needed to address cognitive concerns in this population of women. More consistent reproductive staging, inclusion of covariates, and analyses examining perimenopause specifically would improve study quality and the ability to draw clear conclusions from this research.
Older adults exposed to enriched environments (EE) maintain relatively higher levels of cognitive function, even in the face of compromised markers of brain health. Response speed (RS) is often used as a simple proxy to measure the preservation of global cognitive function in older adults. However, it is unknown which specific selection, decision, and/or motor processes provide the most specific indices of neurocognitive health. Here, using a simple decision task with electroencephalography (EEG), we found that the efficiency with which an individual accumulates sensory evidence was a critical determinant of the extent to which RS was preserved in older adults (63% female, 37% male). Moreover, the mitigating influence of EE on age-related RS declines was most pronounced when evidence accumulation rates were shallowest. These results suggest that the phenomenon of cognitive reserve, whereby high EE individuals can better tolerate suboptimal brain health to facilitate the preservation of cognitive function, is not just applicable to neuroanatomical indicators of brain ageing, but can be observed in markers of neurophysiology. Our results suggest that EEG metrics of evidence accumulation may index neurocognitive vulnerability of the ageing brain.
SIGNIFICANCE STATEMENT:
Response speed in older adults is closely linked with trajectories of cognitive ageing. Here, by recording brain activity while individuals perform a simple computer task, we identify a neural metric which is a critical determinant of response speed. Older adults exposed to greater cognitive and social stimulation throughout a lifetime could maintain faster responding, even when this neural metric was impaired. This work suggests EEG is a useful technique for interrogating how a lifetime of stimulation benefits brain health in ageing.
Background and Objectives
Epidemiological evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study.
Methods
Dementia-free community-dwelling Japanese aged ≥65 years underwent brain MRI scans and a comprehensive health examination. Frequency of contact with non-cohabiting relatives and friends was determined by asking a single question with four categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV) and white matter lesions volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms.
Results
We included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared to that in the group with the highest frequency (67.3% vs 67.8%), with a significant increasing trend across the groups ( p value for trend <0.001). The white matter lesions volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q value of FDR correction <0.05). The relationships appeared to be partly mediated by depressive symptoms, which accounted for 15% to 29% of the observed associations.
Discussion
Lower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.
Facilitating communication between generations has become increasingly important. However, individuals often demonstrate a preference for their own age group, which can impact social interactions, and such bias in young adults even extends to inhibitory control. To assess whether older adults also experience this phenomenon, a group of younger and older adults completed a Go/NoGo task incorporating young and old faces, while undergoing functional magnetic resonance imaging. Within the networks subserving successful and unsuccessful response inhibition, patterns of activity demonstrated distinct neural age bias effects in each age group. During successful inhibition, the older adult group demonstrated significantly increased activity to other-age faces, whereas unsuccessful inhibition in the younger group produced significantly enhanced activity to other-age faces. Consequently, the findings of the study confirm that neural responses to successful and unsuccessful inhibition can be contingent on the stimulus-specific attribute of age in both younger and older adults. These findings have important implications in regard to minimizing the emergence of negative consequences, such as ageism, as a result of related implicit biases.
Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool for cognitive enhancement.
A new test of verbal learning and memory, the Hopkins Verbal Learning Test, was developed. The test consists of three trials of free-recall of a 12-item, semantically categorized list, followed by yes/no recognition. Six parallel forms yielded equivalent results in normals. The performance of patients with Alzheimer's disease and chronic amnesia is described. The test is likely to be useful in patients too impaired for more comprehensive memory assessments and where repeated testing is necessary.
This chapter summarizes the Turkish standardization of the Standard Progressive Matrices (SPM). The only tests of intelligence or general mental ability in Turkey prior to SPM were the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Stanford-Binet Scale of Intelligence. Both have been widely used in Turkey, especially in health institutions and schools. A Turkish adaptation and standardization of WISC-R had been realized in eighties (Savasir and Sahin, 1988). Although no broadly based adaptation of the Stanford-Binet Scale has been undertaken, clinicians rely on their accumulated experience in interpreting the scores and they use it as a signaling apparatus rather than a measurement device. As a result, the absence of national norms does not appear to be a practical disadvantage although the test increasingly fails to meet the needs of the clinicians with regard to ever increasing complexity of multi-channel information and the test itself has not been brought up to date.
Research findings in recent years from both animal models and on human learners converge clearly on the conclusion that there is plasticity in brain and behavior throughout the adult life span. This chapter considers the different types of interventions that vary in the extent to which they involve direct exercise of target outcomes, from retest effects that are highly specific to target outcomes, to ability-specific training of different sorts, to lifestyle interventions that may only be tangentially related to measured outcomes. It also describes challenges for developing evidence-based principles of cognitive optimization that can be authentically translated into programs and social structures with potential to instantiate successful aging as a cultural norm. Thus, it serves both the practical function of informing the creation of evidence-based programs with potential to promote independence, social engagement, and continued participation in work and in civic institutions, as well as the scientific function of testing theories of cognitive aging.