Cognitive Training in the Elderly: Bottlenecks and New Avenues

Development of measures to preserve cognitive function or even reverse cognitive decline in the ever-growing elderly population is the focus of many research and commercial efforts. One such measure gaining in popularity is the development of computer-based interventions that “exercise” cognitive functions. Computer-based cognitive training has the potential to be specific and flexible, accommodates feedback, and is highly accessible. As in most budding fields, there are still considerable inconsistencies across methodologies and results, as well as a lack of consensus on a comprehensive assessment protocol. We propose that the success of training-based therapeutics will rely on targeting specific cognitive functions, informed by comprehensive and sensitive batteries that can provide a “fingerprint” of an individual's abilities. Instead of expecting a panacea from training regimens, focused and personalized training interventions that accommodate individual differences should be developed to redress specific patterns of deficits in cognitive rehabilitation, both in healthy aging and in disease.

[1]  L. Jacoby,et al.  Cognitive and neural effects of semantic encoding strategy training in older adults. , 2012, Cerebral cortex.

[2]  Nir Giladi,et al.  Sensitivity of Neuropsychological Tests to Identify Cognitive Decline in Highly Educated Elderly Individuals: 12 Months Follow up. , 2015, Journal of Alzheimer's disease : JAD.

[3]  D L Roenker,et al.  The impact of speed of processing training on cognitive and everyday performance , 2005, Aging & mental health.

[4]  Etsuro Mori,et al.  Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial , 2016, Dementia and Geriatric Cognitive Disorders Extra.

[5]  M. Merzenich,et al.  Adaptive Training Diminishes Distractibility in Aging across Species , 2014, Neuron.

[6]  George W Rebok,et al.  Effects of cognitive training interventions with older adults: a randomized controlled trial. , 2002, JAMA.

[7]  Catherine Willmott,et al.  Cognitive training approaches to remediate attention and executive dysfunction after traumatic brain injury: A single-case series , 2016, Neuropsychological rehabilitation.

[8]  Lee Bowman,et al.  Impact of cognitive impairment on mild dementia patients and mild cognitive impairment patients and their informants , 2006, International Psychogeriatrics.

[9]  Alan Hartley,et al.  Effects of interactive physical-activity video-game training on physical and cognitive function in older adults. , 2012, Psychology and aging.

[10]  Daniel Gopher,et al.  Space Fortress game training and executive control in older adults: A pilot intervention , 2011, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[11]  João Maroco,et al.  Quality of life in patients with mild cognitive impairment , 2013, Aging & mental health.

[12]  Gereon R Fink,et al.  Effects of cognitive training with additional physical activity compared to pure cognitive training in healthy older adults , 2015, Clinical interventions in aging.

[13]  Paul M. Bays,et al.  Age-Related Decline of Precision and Binding in Visual Working Memory , 2013, Psychology and aging.

[14]  Brian E Maki,et al.  Attitudes of older adults toward shooter video games: An initial study to select an acceptable game for training visual processing. , 2010, Gerontechnology : international journal on the fundamental aspects of technology to serve the ageing society.

[15]  R. Rupprecht,et al.  Differential effects of single versus combined cognitive and physical training with older adults: the SimA study in a 5-year perspective , 2006, European journal of ageing.

[16]  Adam Gazzaley,et al.  Age-Related Changes in Orienting Attention in Time , 2011, The Journal of Neuroscience.

[17]  Jessica A. Grahn,et al.  Putting brain training to the test , 2010, Nature.

[18]  Adam Gazzaley,et al.  Age-Related Changes in Expectation-Based Modulation of Motion Detectability , 2013, PloS one.

[19]  Judith Waters,et al.  Video games: Utilization of a novel strategy to improve perceptual motor skills and cognitive functioning in the non-institutionalized elderly. , 1986 .

[20]  Monica Melby-Lervåg,et al.  Is working memory training effective? A meta-analytic review. , 2013, Developmental psychology.

[21]  Craig Stark Virtual environmental enrichment through video games , 2015 .

[22]  Cheng Luo,et al.  Effects of Cognitive Training on Resting-State Functional Connectivity of Default Mode, Salience, and Central Executive Networks , 2016, Front. Aging Neurosci..

[23]  Maxine Weinstein,et al.  Participating in social activities helps preserve cognitive function: an analysis of a longitudinal, population-based study of the elderly. , 2005, International journal of epidemiology.

[24]  Charles Calderwood,et al.  Use it or lose it? Wii brain exercise practice and reading for domain knowledge. , 2010, Psychology and aging.

[25]  E. William Noland Hawthorne Revisited. By Henry A. Landsberger. Ithaca, New York: The New York State School of Industrial and Labor Relations, 1958, 132 pp. $3.50 , 1959 .

[26]  D. Jeste,et al.  Cognitive training in Alzheimer's disease: a meta‐analysis of the literature , 2006, Acta psychiatrica Scandinavica.

[27]  D. Klahr,et al.  Finding One’s Place in Transfer Space , 2011 .

[28]  Kristin A. Lowry,et al.  Exercise, Fitness, and Neurocognitive Function in Older Adults: The “Selective Improvement” and “Cardiovascular Fitness” Hypotheses , 2008, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[29]  Yasuyuki Taki,et al.  Brain Training Game Improves Executive Functions and Processing Speed in the Elderly: A Randomized Controlled Trial , 2012, PloS one.

[30]  Elizabeth M Zelinski,et al.  Far transfer in cognitive training of older adults. , 2009, Restorative neurology and neuroscience.

[31]  Pedro Gamito,et al.  Cognitive training on stroke patients via virtual reality-based serious games , 2017, Disability and rehabilitation.

[32]  M. Butters,et al.  Physical activity and brain plasticity in late adulthood , 2013, Dialogues in clinical neuroscience.

[33]  Martin Paczynski,et al.  Placebo effects in cognitive training , 2016, Proceedings of the National Academy of Sciences.

[34]  Todd W. Thompson,et al.  Failure of Working Memory Training to Enhance Cognition or Intelligence , 2013, PloS one.

[35]  K. Krishnan,et al.  A Brain-Computer Interface Based Cognitive Training System for Healthy Elderly: A Randomized Control Pilot Study for Usability and Preliminary Efficacy , 2013, PloS one.

[36]  Rui Li,et al.  Combined Cognitive-Psychological-Physical Intervention Induces Reorganization of Intrinsic Functional Brain Architecture in Older Adults , 2015, Neural plasticity.

[37]  O. Okonkwo,et al.  Mild cognitive impairment and everyday function: evidence of reduced speed in performing instrumental activities of daily living. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[38]  J. Karbach,et al.  Making Working Memory Work , 2014, Psychological science.

[39]  J. G. Jenkins Management and the worker: An account of a research program conducted by the Western Electric Company, Hawthorne Works, Chicago. , 1940 .

[40]  D. Beck,et al.  Participating in social enquiry and action , 1993 .

[41]  Theodore Wasserman,et al.  The Sensitivity and Specificity of Neuropsychological Tests in the Diagnosis of Attention Deficit Hyperactivity Disorder , 2012, Applied neuropsychology. Child.

[42]  G. Band,et al.  The effects of an 8-week computer-based brain training programme on cognitive functioning, QoL and self-efficacy after stroke , 2016, Neuropsychological rehabilitation.

[43]  Soledad Ballesteros,et al.  Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial , 2014, Front. Aging Neurosci..

[44]  Vered Aharonson,et al.  Computer-Based, Personalized Cognitive Training versus Classical Computer Games: A Randomized Double-Blind Prospective Trial of Cognitive Stimulation , 2011, Neuroepidemiology.

[45]  Kenji Hachisuka,et al.  The impact of subjective memory complaints on quality of life in community‐dwelling older adults , 2014, Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society.

[46]  Heidi Johansen-Berg,et al.  A systematic review of MRI studies examining the relationship between physical fitness and activity and the white matter of the ageing brain , 2016, NeuroImage.

[47]  Linda Heskamp,et al.  Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment , 2016, Brain Imaging and Behavior.

[48]  Shauna M. Stark,et al.  Stability of age-related deficits in the mnemonic similarity task across task variations. , 2015, Behavioral neuroscience.

[49]  James R. Brockmole,et al.  Do binding deficits account for age-related decline in visual working memory? , 2008, Psychonomic bulletin & review.

[50]  Walter R. Boot,et al.  The Pervasive Problem With Placebos in Psychology , 2013, Perspectives on psychological science : a journal of the Association for Psychological Science.

[51]  A. Kramer,et al.  Can training in a real-time strategy video game attenuate cognitive decline in older adults? , 2008, Psychology and aging.

[52]  Susanne M. Jaeggi,et al.  The role of individual differences in cognitive training and transfer , 2014, Memory & cognition.

[53]  Adam Gazzaley,et al.  Closed-loop cognition: the next frontier arrives , 2015, Trends in Cognitive Sciences.

[54]  Shauna M. Stark,et al.  A task to assess behavioral pattern separation (BPS) in humans: Data from healthy aging and mild cognitive impairment , 2013, Neuropsychologia.

[55]  K. Ball,et al.  Long-term effects of cognitive training on everyday functional outcomes in older adults. , 2006, JAMA.

[56]  Anne Collins McLaughlin,et al.  Individual differences in response to cognitive training: Using a multi-modal, attentionally demanding game-based intervention for older adults , 2012, Comput. Hum. Behav..

[57]  James R. Brockmole,et al.  Age-Related Change in Visual Working Memory: A Study of 55,753 Participants Aged 8–75 , 2013, Front. Psychology.

[58]  J. Goldstein,et al.  Video games and the elderly , 1997 .

[59]  Po H. Lu,et al.  Reduced quality-of-life ratings in mild cognitive impairment: analyses of subject and informant responses. , 2012, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[60]  R. Martins,et al.  A combination of physical activity and computerized brain training improves verbal memory and increases cerebral glucose metabolism in the elderly , 2014, Translational Psychiatry.

[61]  C. S. Green,et al.  Learning, Attentional Control, and Action Video Games , 2012, Current Biology.

[62]  Yee Lee Shing,et al.  Neuromodulation of associative and organizational plasticity across the life span: Empirical evidence and neurocomputational modeling , 2006, Neuroscience & Biobehavioral Reviews.

[63]  Sharona M. Atkins,et al.  Memory enhancement in healthy older adults using a brain plasticity-based training program: A randomized, controlled study , 2006, Proceedings of the National Academy of Sciences.

[64]  Kristine Yaffe,et al.  A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity‐based Adaptive Cognitive Training (IMPACT) Study , 2009, Journal of the American Geriatrics Society.

[65]  Jeffrey W. Cooney,et al.  Top-down suppression deficit underlies working memory impairment in normal aging , 2005, Nature Neuroscience.

[66]  Camarin E. Rolle,et al.  Video game training enhances cognitive control in older adults , 2013, Nature.

[67]  N. McNaughton,et al.  Frontal-midline theta from the perspective of hippocampal “theta” , 2008, Progress in Neurobiology.

[68]  Michael Valenzuela,et al.  Cognitive and memory training in adults at risk of dementia: A Systematic Review , 2011, BMC geriatrics.

[69]  Carrie Heeter,et al.  Effects of a computer-based cognitive exercise program on age-related cognitive decline. , 2013, Archives of gerontology and geriatrics.

[70]  Nico Bunzeck,et al.  Dopamine Modulates Episodic Memory Persistence in Old Age , 2012, The Journal of Neuroscience.

[71]  Brigitte Röder,et al.  Beneficial effects of physical exercise on neuroplasticity and cognition , 2013, Neuroscience & Biobehavioral Reviews.

[72]  Ulman Lindenberger,et al.  Cognitive plasticity in adulthood and old age: gauging the generality of cognitive intervention effects. , 2009, Restorative neurology and neuroscience.

[73]  Giovanni W. Sosa The Impact of a Video Game Intervention on the Cognitive Functioning, Self-Efficacy, Self-Esteem, and Video Game Attitudes of Older Adults , 2012 .

[74]  Anna Sikorska,et al.  Training and transfer effects of N-back training for brain-injured and healthy subjects , 2016, Neuropsychological rehabilitation.

[75]  Bing Li,et al.  Cognitive intervention for persons with mild cognitive impairment: A meta-analysis , 2011, Ageing Research Reviews.

[76]  Arthur F Kramer,et al.  Transfer of computer-based training to simulated driving in older adults. , 2009, Applied ergonomics.

[77]  David R Shanks,et al.  Aging and implicit learning: explorations in contextual cuing. , 2010, Psychology and aging.

[78]  A. Nobre,et al.  Long-term memory prepares neural activity for perception , 2011, Proceedings of the National Academy of Sciences.

[79]  Lars Bäckman,et al.  Transfer of Learning After Updating Training Mediated by the Striatum , 2008, Science.

[80]  Susanne M. Jaeggi,et al.  Influence of neuroticism and conscientiousness on working memory training outcome , 2012 .

[81]  Martin van Boxtel,et al.  Cognitive interventions in healthy older adults and people with mild cognitive impairment: A systematic review , 2013, Ageing Research Reviews.

[82]  Raja Parasuraman,et al.  Neurocognitive enhancement in older adults: Comparison of three cognitive training tasks to test a hypothesis of training transfer in brain connectivity , 2014, NeuroImage.

[83]  William C. Mann,et al.  Video game training to improve selective visual attention in older adults , 2013, Comput. Hum. Behav..

[84]  F. Craik,et al.  Cognition through the lifespan: mechanisms of change , 2006, Trends in Cognitive Sciences.

[85]  P. Dayan,et al.  Dopamine restores reward prediction errors in old age , 2013, Nature Neuroscience.

[86]  Anna Christina Nobre,et al.  Behavioral and Neural Markers of Flexible Attention over Working Memory in Aging , 2016, Cerebral cortex.

[87]  Helen D Davies,et al.  The impact of dementia and mild memory impairment (MMI) on intimacy and sexuality in spousal relationships , 2010, International Psychogeriatrics.

[88]  Alexandre Pouget,et al.  Action video game play facilitates the development of better perceptual templates , 2014, Proceedings of the National Academy of Sciences.

[89]  Soledad Ballesteros,et al.  Video game training enhances cognition of older adults: a meta-analytic study. , 2014, Psychology and aging.

[90]  A. Otero,et al.  Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. , 2003, The journals of gerontology. Series B, Psychological sciences and social sciences.

[91]  A. Nobre,et al.  Temporal Expectation Improves the Quality of Sensory Information , 2012, The Journal of Neuroscience.

[92]  A. Kramer,et al.  Fitness Effects on the Cognitive Function of Older Adults , 2003, Psychological science.

[93]  G. Band,et al.  Online games training aging brains: limited transfer to cognitive control functions , 2011, Front. Hum. Neurosci..

[94]  Shu-Chen Li,et al.  Working memory plasticity in old age: practice gain, transfer, and maintenance. , 2008, Psychology and aging.

[95]  L. Pessoa How do emotion and motivation direct executive control? , 2009, Trends in Cognitive Sciences.

[96]  Mark G. Stokes,et al.  Attention Modulates Maintenance of Representations in Visual Short-term Memory , 2012, Journal of Cognitive Neuroscience.

[97]  Damian P. Birney,et al.  The effects of personality and metacognitive beliefs on cognitive training adherence and performance , 2016 .

[98]  Siné McDougall,et al.  Brain training in older adults: Evidence of transfer to memory span performance and pseudo-Matthew effects , 2012, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.