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Early intervention for cognitive decline: can cognitive training be used as a selective prevention technique?

Published online by Cambridge University Press:  22 February 2010

Loren Mowszowski ,
Jennifer Batchelor  and
Sharon L. Naismith
Loren Mowszowski
Affiliation:
Department of Psychology, Macquarie University, Sydney, NSW, Australia Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
Jennifer Batchelor
Affiliation:
Department of Psychology, Macquarie University, Sydney, NSW, Australia
Sharon L. Naismith*
Affiliation:
Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
*
Correspondence should be addressed to: Associate Professor Sharon L. Naismith, Director, Clinical Research Unit and Aging Brain Centre, Brain and Mind Research Institute, 94 Mallett Street, Camperdown, NSW, Australia. Phone: +61 2 9351 0781; Fax: +61 2 9351 0855. Email: [email protected].
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Abstract

Background: Cognitive training (CT) may be effective as a therapeutic strategy to prevent cognitive decline in older adults. This review evaluates CT as a preventive tool at various stages of a prevention hierarchy with specific reference to healthy older adults, “at risk” and clinical populations. It also considers the underlying mechanism of CT, namely that which suggests that CT acts via promoting neuroplasticity.

Methods: Evidence for CT in healthy, “at risk” and clinical populations has been systematically reviewed elsewhere. This review re-examines several studies in each group to clarify the potential of CT as a preventive technique, with a key focus on the secondary level of prevention.

Results: Studies in healthy older adults and those with mild cognitive impairment are largely positive and suggest that CT has the potential to improve cognition. However, findings in relation to Alzheimer's disease are mixed. Limitations of existing research include diverse methodologies and CT programs, small samples, insufficient focus on functional outcomes, sustainability and generalization of effects and the need for imaging data to delineate mechanisms of change. Additionally, there is limited data on those with late-life depression, despite this being an independent risk factor for dementia.

Conclusions: CT offers promise as a preventive therapeutic technique in healthy older adults and particularly as a secondary prevention method for “at risk” groups. Future investigations need to focus on methodological constraints and delineating possible neuroplastic mechanisms of action. Nonetheless, CT programs may represent a viable, non-pharmacological early intervention strategy, as they are easily-implemented, engaging and promote social interaction in group settings.

Keywords

older adultsneurodegenerativemild cognitive impairmentdepressionneuroplasticityneuropsychologicalsecondary prevention
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Issue 4 , June 2010 , pp. 537 - 548
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Acevedo, A. and Loewenstein, D. A. (2007). Nonpharmacological cognitive interventions in aging and dementia. Journal of Geriatric Psychiatry and Neurology, 20, 239–249.CrossRefGoogle ScholarPubMed
Alvarez, L. M., Cortes Sotres, J. F., Ortiz Leon, S., Estrella, J. and Sanchez Sosa, J. J. (2008). Computer program in the treatment for major depression and cognitive impairment in university students. Computers in Human Behavior, 24, 816–826.CrossRefGoogle Scholar
Ball, K. et al. (2002). Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA, 288, 2271–2281.CrossRefGoogle ScholarPubMed
Barnes, D. E., Alexopoulos, G. S., Lopez, O. L., Williamson, J. D. and Yaffe, K. (2006). Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study [see comment]. Archives of General Psychiatry, 63, 273–279.CrossRefGoogle ScholarPubMed
Belleville, S. (2008). Cognitive training for persons with mild cognitive impairment. International Psychogeriatrics, 20, 57–66.CrossRefGoogle ScholarPubMed
Belleville, S., Chertkow, H. and Gauthier, S. (2007). Working memory and control of attention in persons with Alzheimer's disease and mild cognitive impairment. Neuropsychology, 21, 458–469.CrossRefGoogle ScholarPubMed
Belleville, S., Gilbert, B., Fontaine, F., Gagnon, L., Menard, E. and Gauthier, S. (2006). Improvement of episodic memory in persons with mild cognitive impairment and healthy older adults: evidence from a cognitive intervention program. Dementia and Geriatric Cognitive Disorders, 22, 486–499.CrossRefGoogle ScholarPubMed
Butters, M. A. et al. (2000). Changes in cognitive functioning following treatment of late-life depression. American Journal of Psychiatry, 157, 1949–1954.CrossRefGoogle ScholarPubMed
Cipriani, G., Bianchetti, A. and Trabucchi, M. (2006). Outcomes of a computer-based cognitive rehabilitation program on Alzheimer's disease patients compared with those on patients affected by mild cognitive impairment. Archives of Gerontology and Geriatrics, 43, 327–335.CrossRefGoogle ScholarPubMed
Clare, L. and Woods, B. (2008). Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, CD003260.Google Scholar
de Vreese, L. P., Neri, M., Fioravanti, M., Belloi, L. and Zanetti, O. (2001). Memory rehabilitation in Alzheimer's disease: a review of progress. International Journal of Geriatric Psychiatry, 16, 794–809.CrossRefGoogle ScholarPubMed
Duman, R. S. and Monteggia, L. M. (2006). A neurotrophic model for stress-related mood disorders. Biological Psychiatry, 59, 1116–1127.CrossRefGoogle ScholarPubMed
Edwards, J. D., Wadley, V. G., Myers, R. S., Roenker, D. L., Cissell, G. M. and Ball, K. K. (2002). Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology, 48, 329–340.CrossRefGoogle ScholarPubMed
Elgamal, S., McKinnon, M. C., Ramakrishnan, K., Joffe, R. T. and MacQueen, G. (2007). Successful computer-assisted cognitive remediation therapy in patients with unipolar depression: a proof of principle study. Psychological Medicine, 37, 1229–1238.CrossRefGoogle ScholarPubMed
Fuchs, E., Czeh, B., Kole, M. H. P., Michaelis, T. and Lucassen, P. J. (2004). Alterations of neuroplasticity in depression: the hippocampus and beyond. European Neuropsychopharmacology, 14 (Suppl. 5), S481–490.CrossRefGoogle ScholarPubMed
Gauthier, S. et al. (2006). Mild cognitive impairment. Lancet, 367, 1262–1270.CrossRefGoogle ScholarPubMed
Gunther, V. K., Schafer, P., Holzner, B. J. and Kemmler, G. W. (2003). Long-term improvements in cognitive performance through computer-assisted training: a pilot study in a residential home for older people. Aging and Mental Health, 7, 200–206.CrossRefGoogle Scholar
Hickie, I. et al. (2005). Reduced hippocampal volumes and memory loss in patients with early- and late-onset depression. British Journal of Psychiatry, 186, 197–202.CrossRefGoogle ScholarPubMed
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. (1997). “Mental Health Literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182–186.CrossRefGoogle ScholarPubMed
Kelly, C., Foxe, J. J. and Garavan, H. (2006). Patterns of normal human brain plasticity after practice and their implications for neurorehabilitation. Archives of Physical Medicine and Rehabilitation, 87, S20–S29.CrossRefGoogle ScholarPubMed
Kinsella, G. J. et al. (2009). Early intervention for mild cognitive impairment: a randomised controlled trial. Journal of Neurology, Neurosurgery and Psychiatry, 80, 730–736.CrossRefGoogle ScholarPubMed
Kurz, A., Pohl, C., Ramsenthaler, M. and Sorg, C. (2009). Cognitive rehabilitation in patients with mild cognitive impairment. International Journal of Geriatric Psychiatry, 24, 163–168.CrossRefGoogle ScholarPubMed
Levine, B. et al. (2007). Cognitive rehabilitation in the elderly: effects on strategic behavior in relation to goal management. Journal of the International Neuropsychological Society, 13, 143–152.CrossRefGoogle ScholarPubMed
Mahncke, H. W., Bronstone, A. and Merzenich, M. M. (2006a). Brain plasticity and functional losses in the aged: scientific bases for a novel intervention. Progress in Brain Research, 157, 81–109.CrossRefGoogle ScholarPubMed
Mahncke, H. W. et al. (2006b). Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. Proceedings of the National Academy of Sciences of the United States of America, 103, 12523–12528.CrossRefGoogle ScholarPubMed
Manly, T., Hawkins, K., Evans, J., Woldt, K. and Robertson, I. H. (2002). Rehabilitation of executive function: facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia, 40, 271–281.CrossRefGoogle ScholarPubMed
McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J. and Mueser, K. T. (2007). A meta-analysis of cognitive remediation in schizophrenia. American Journal of Psychiatry, 164, 1791–1802.CrossRefGoogle ScholarPubMed
Medalia, A. and Freilich, B. (2008). The Neuropsychological Educational Approach to Cognitive Remediation (NEAR) model: practice, principles and outcome studies. American Journal of Psychiatric Rehabilitation, 11, 123–143.CrossRefGoogle Scholar
Medalia, A. and Richardson, R. (2005). What predicts a good response to cognitive remediation interventions? Schizophrenia Bulletin, 31, 942–953.CrossRefGoogle ScholarPubMed
Modrego, P. J. and Ferrandez, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: a prospective cohort study. Archives of Neurology, 61, 1290–1293.CrossRefGoogle ScholarPubMed
Mueller, S. G. et al. (2005). The Alzheimer's disease neuroimaging initiative. Neuroimaging Clinics of North America, 15, 869–877.CrossRefGoogle ScholarPubMed
Naismith, S. L. et al. (2003). Neuropsychological performance in patients with depression is associated with clinical, etiological and genetic risk factors. Journal of Clinical and Experimental Neuropsychology, 25, 866–877.CrossRefGoogle ScholarPubMed
Naismith, S. L., Hickie, I. B., Ward, P. B., Scott, E. and Little, C. (2006). Impaired implicit sequence learning in depression: a probe for frontostriatal dysfunction? Psychological Medicine, 36, 313–323.CrossRefGoogle ScholarPubMed
Naismith, S. L. et al. (2009a). Enhancing memory in late-life depression: effects of a combined psychoeducation and cognitive training program. American Journal of Geriatric Psychiatry. In press.Google Scholar
Naismith, S. L., Glozier, N., Burke, D., Carter, P., Scott, E. and Hickie, I. (2009b). Early intervention for cognitive decline and dementia: the potential benefits of targeting multiple interventions. Early Intervention in Psychiatry, 3, 19–27.CrossRefGoogle Scholar
Naismith, S. L., Redoblado-Hodge, M. A., Lewis, S. J., Scott, E. M. and Hickie, I. B. (2009c). Cognitive training in affective disorders improves memory: a preliminary study using the NEAR approach. Journal of Affective Disorders. Epublished ahead of print, doi:10.1016/j.jad.2009.06.028.CrossRefGoogle Scholar
Olazaran, J. et al. (2004). Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. Neurology, 63, 2348–2353.CrossRefGoogle ScholarPubMed
Oswald, W., Gunzelmann, T., Rupprecht, R. and Hagen, B. (2006). Differential effects of single versus combined cognitive and physical training with older adults: the SimA study in a 5-year perspective. European Journal of Ageing, 3, 179–192.CrossRefGoogle Scholar
Petersen, R. C. and Morris, J. C. (2005). Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 1160–1163.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Rapp, S., Brenes, G. and Marsh, A. P. (2002). Memory enhancement training for older adults with mild cognitive impairment: a preliminary study. Aging and Mental Health, 6, 5–11.CrossRefGoogle ScholarPubMed
Rozzini, L., Costardi, D., Chilovi, B. V., Franzoni, S., Trabucchi, M. and Padovani, A. (2007). Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors. International Journal of Geriatric Psychiatry, 22, 356–360.CrossRefGoogle ScholarPubMed
Sartory, G., Zorn, C., Groetzinger, G. and Windgassen, K. (2005). Computerized cognitive remediation improves verbal learning and processing speed in schizophrenia. Schizophrenia Research, 75, 219–223.CrossRefGoogle ScholarPubMed
Shimizu, E. et al. (2003). Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biological Psychiatry, 54, 70–75.CrossRefGoogle ScholarPubMed
Sitzer, D. I., Twamley, E. W. and Jeste, D. V. (2006). Cognitive training in Alzheimer's disease: a meta-analysis of the literature. Acta Psychiatrica Scandinavica, 114, 75–90.CrossRefGoogle ScholarPubMed
Smith, G. E. et al. (2009). A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) Study. Journal of the American Geriatrics Society, 57, 594–603.CrossRefGoogle ScholarPubMed
Steffens, D. C. et al. (2007). Longitudinal magnetic resonance imaging vascular changes, apolipoprotein E genotype, and development of dementia in the neurocognitive outcomes of depression in the elderly study. American Journal of Geriatric Psychiatry, 15, 839–849.CrossRefGoogle ScholarPubMed
Strangman, G. et al. (2005). Functional neuroimaging and cognitive rehabilitation for people with traumatic brain injury. American Journal of Physical Medicine and Rehabilitation, 84, 62–75.CrossRefGoogle ScholarPubMed
Stuss, D. T. et al. (2007). Cognitive rehabilitation in the elderly: a randomized trial to evaluate a new protocol. Journal of the International Neuropsychological Society, 13, 120–131.CrossRefGoogle ScholarPubMed
Talassi, E., Guerreschi, M., Feriani, M., Fedi, V., Bianchetti, A. and Trabucchi, M. (2007). Effectiveness of a cognitive rehabilitation program in mild dementia (MD) and mild cognitive impairment (MCI): a case control study. Archives of Gerontology and Geriatrics, 44, 391–399.CrossRefGoogle ScholarPubMed
Thal, L. J. (2006). Prevention of Alzheimer disease. Alzheimer Disease and Associated Disorders, 20, S97–S99.CrossRefGoogle ScholarPubMed
Turkstra, L. S., Holland, A. L. and Bays, G. A. (2003). The neuroscience of recovery and rehabilitation: what have we learned from animal research? Archives of Physical Medicine and Rehabilitation, 84, 604–612.CrossRefGoogle ScholarPubMed
Valenzuela, M. (2008). Brain reserve and the prevention of dementia. Current Opinion in Psychiatry, 21, 296–302.CrossRefGoogle ScholarPubMed
Valenzuela, M. and Sachdev, P. (2006). Complex mental activity and risk for dementia. Acta Neuropsychiatrica, 18, (16):272.CrossRefGoogle ScholarPubMed
Valenzuela, M. and Sachdev, P. (2009). Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. American Journal of Geriatric Psychiatry, 17, 179–187.CrossRefGoogle ScholarPubMed
Valenzuela, M. J. et al. (2003). Memory training alters hippocampal neurochemistry in healthy elderly. Neuroreport, 14, 1333–1337.Google ScholarPubMed
Valenzuela, M., Breakspear, M. and Sachdev, P. (2007). Complex mental activity and the aging brain: molecular, cellular and cortical network mechanisms. Brain Research Reviews, 56, 198–213.CrossRefGoogle ScholarPubMed
Valenzuela, M., Sachdev, P., Wen, W., Chen, X. and Brodaty, H. (2008). Lifespan mental activity predicts diminished rate of hippocampal atrophy. PLoS ONE, 3, e2598.CrossRefGoogle ScholarPubMed
Willis, S. L. et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 296, 2805–2814.CrossRefGoogle ScholarPubMed
Winocur, G. et al. (2007). Cognitive rehabilitation in the elderly: overview and future directions. Journal of the International Neuropsychological Society, 13, 166–171CrossRefGoogle ScholarPubMed
Zanetti, O., Binetti, G., Magni, E., Rozzini, L., Bianchetti, A. and Trabucchi, M. (1997). Procedural memory stimulation in Alzheimer's disease: impact of a training programme. Acta Neurologica Scandinavica, 95, 152–157.CrossRefGoogle ScholarPubMed