Showing papers on "Cognitive training published in 2007"

Cognitive Training for Supported Employment: 2-3 Year Outcomes of a Randomized Controlled Trial

Abstract: Objective: To address cognitive impairments that limit the effectiveness of supported employment services for patients with schizophrenia, a cognitive training program, the Thinking Skills for Work Program, was developed and integrated into supported employment services. Method: Patients with severe mental illness (N=44) and prior histories of job failures who were enrolled in supported employment programs at two sites in New York City were randomly assigned to receive either supported employment alone or supported employment with cognitive training. Measures at baseline and 3 months included a brief cognitive and symptom assessment. Work outcomes were tracked for 2–3 years. Results: Patients in the supported employment with cognitive training program demonstrated significantly greater improvements at 3 months in cognitive functioning, depression, and autistic preoccupation. Over 2–3 years, patients in the supported employment with cognitive training program were more likely to work, held more jobs, worke...

Nonpharmacological Cognitive Interventions in Aging and Dementia

Abstract: There have been increasing efforts to develop cognitive interventions to ameliorate cognitive problems experienced by older adults. In healthy elderly populations, cognitive training has centered on the enhancement of memory and speed of processing, with the goal of maximizing current function and reducing the risk of cognitive decline. Among elderly persons with nonprogressive neurological conditions such as traumatic brain injury (TBI) and stroke, there has been an emphasis on rehabilitation to help restore function. Most recently, there has been increased attention on the development of new cognitive techniques to treat persons with progressive neurodegenerative conditions such as Alzheimer disease. The literature is reviewed on current approaches to cognitive interventions in elderly healthy populations, and a particular emphasis is placed on the most recent strides in progressive neurocognitive conditions, particularly Alzheimer disease. Important issues such as study design, the use of ecologically and functionally valid outcome measures, the need to examine heterogeneous populations and cross-cultural variables, and the incorporation of technologically based systems are examined. It is concluded that cognitive interventions in the elderly show considerable promise and deserve further study.

Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings

Abstract: Background: Anorexia nervosa (AN) is a severe mental illness. Drug treatments are not effective and there is no established first choice psychological treatment for adults with AN. Neuropsychological studies have shown that patients with AN have difficulties in cognitive flexibility: these laboratory based findings have been used to develop a clinical intervention based on Cognitive Remediation Therapy (CRT) which aims to use cognitive exercises to strengthen thinking skills. Aims: 1) To conduct a preliminary investigation of CRT in patients with AN 2) to explore whether cognitive training improves performance in set shifting tasks 3) to explore whether CRT exercises are appropriate and acceptable to AN patients 4) to use the data to improve a CRT module for AN patients. Methods: Intervention was comprised of ten 45 minute sessions of CRT. Four patients with AN were assessed before and after the ten sessions using five set shifting tests and clinical assessments. At the end, each patient wrote a letter providing feedback on the intervention. Results: Post intervention, three of the five set shifting assessments showed a moderate to large effect size in performance and two showed a large effect size in performance, both indicative of improved flexibility. Patients were aware of an improvement in their cognitive flexibility qualitative feedback was generally positive towards CRT. Discussion: This preliminary study suggests that CRT changed performance on flexibility tasks and may be beneficial for acute, treatment resistant patients with AN. Feedback gathered from this small case series has enabled modification of the intervention for a future larger study, for example, by linking exercises with real life behavioural tasks and including exercises that encourage global thinking. Conclusion: This exploratory study has produced encouraging data supporting the use of CRT in patients with AN: it has also provided insight into how the module should be tailored to maximise its effectiveness for people with acute AN.

Successful computer-assisted cognitive remediation therapy in patients with unipolar depression: a proof of principle study

Abstract: Background Despite increasing awareness of the extent and severity of cognitive deficits in major depressive disorder (MDD), trials of cognitive remediation have not been conducted. We conducted a 10-week course of cognitive remediation in patients with long-term MDD to probe whether deficits in four targeted cognitive domains, (i) memory, (ii) attention, (iii) executive functioning and (iv) psychomotor speed, could be improved by this intervention. Method We administered a computerized cognitive retraining package (PSSCogReHab) with demonstrated efficacy to 12 stable patients with recurrent MDD. Twelve matched patients with MDD and a group of healthy control participants were included for comparison; neither comparator group received the intervention that involved stimulation of cognitive functions through targeted, repetitive exercises in each domain. Results Patients who received cognitive training improved on a range of neuropsychological tests targeting attention, verbal learning and memory, psychomotor speed and executive function. This improvement exceeded that observed over the same time period in a group of matched comparisons. There was no change in depressive symptom scores over the course of the trial, thus improvement in cognitive performance occurred independent of other illness variables. Conclusions These results provide preliminary evidence that improvement of cognitive functions through targeted, repetitive exercises is a viable method of cognitive remediation in patients with recurrent MDD.

Effect of memory impairment on training outcomes in ACTIVE

Abstract: Cognitive training improves mental abilities in older adults, but the trainability of persons with memory impairment is unclear. We conducted a subgroup analysis of subjects in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial to examine this issue. ACTIVE enrolled 2802 non-demented, community-dwelling adults aged 65 years and older and randomly assigned them to one of four groups: Memory training, reasoning training, speed-of-processing training, or no-contact control. For this study, participants were defined as memory-impaired if baseline Rey Auditory Verbal Learning Test (AVLT) sum recall score was 1.5 SD or more below predicted AVLT sum recall score from a regression-derived formula using age, education, ethnicity, and vocabulary from all subjects at baseline. Assessments were taken at baseline (BL), post-test, first annual (A1), and second annual (A2) follow-up. One hundred and ninety-three subjects were defined as memory-impaired and 2580 were memory-normal. Training gain as a function memory status (impaired vs. normal) was compared in a mixed effects model. Results indicated that memory-impaired participants failed to benefit from Memory training but did show normal training gains after reasoning and speed training. Memory function appears to mediate response to structured cognitive interventions in older adults.

Who Benefits From Memory Training

Abstract: Cognitive training programs can have significant benefits. However, their efficacy is often reduced for individuals of advanced age or lower cognitive ability. Using older adult subjects, we examined the role of self-initiation of cognitive control in a training program that targets recollection memory. Relative time spent on an open-ended, intentional encoding task that requires the self-initiation of cognitive control was highly predictive of improvement in the training task, and fully accounted for individual differences related to age and crystallized intelligence. Analyzing training programs from the perspective of cognitive theory may help clarify how these programs have their effects and suggest ways to optimize such programs for the individuals who need them most.

Changes in everyday function in individuals with psychometrically defined mild cognitive impairment in the Advanced Cognitive Training for Independent and Vital Elderly Study.

Abstract: OBJECTIVES: To examine trajectories of change in everyday function for individuals with cognitive deficits suggestive of mild cognitive impairment (MCI) DESIGN: Using data from the longitudinal, multisite Advanced Cognitive Training for Independent and Vital Elderly Study allowed for post hoc classification of MCI status at baseline using psychometric definitions for amnestic MCI, nonamnestic MCI, multidomain MCI, and no MCI SETTING: Six US cities PARTICIPANTS: Two thousand eight hundred thirty-two volunteers (mean age 74; 26% African American) living independently, recruited from senior housing, community centers, hospitals, and clinics MEASUREMENTS: Mixed-effect models examined changes in self-reported activities of daily living and instrumental activities of daily living (IADLs) from the Minimum Data Set Home Care Interview in 2,358 participants over a 3-year period RESULTS: In models for IADL performance, IADL difficulty, and a daily functioning composite, there was a significant time by MCI classification interaction for each MCI subtype, indicating that all MCI groups showed faster rates of decline in everyday function than cognitively normal participants with no MCI CONCLUSION: Results demonstrate the importance of MCI as a clinical entity that not only predicts progression to dementia, but also predicts functional declines in activities that are key to autonomy and quality of life MCI classification guidelines should allow for functional changes in MCI, and clinicians should monitor for such changes Preservation of function may serve as a meaningful outcome for intervention efforts

Computer-based cognitive intervention for dementia: preliminary results of a randomized clinical trial.

Abstract: Dementia is a highly invalidating condition and, given the progressive aging of the population, one of the major issues that health systems will have to face in future years. Recently there has been an increase in the potential of diagnostic tools and pharmacological treatments for dementia; moreover, considerable interest has been expressed regarding non pharmacological interventions. However, the current evidence in support of non pharmacological treatments in patients affected by dementia still does not allow to draw definitive conclusions on what is the most effective treatment to apply, largely because of methodological difficulties and limitations of the studies so far carried out due to the complex nature of the disease. To address this need, we carried out a single blind randomized controlled study on the efficacy of computer cognitive rehabilitation in patients with mild cognitive decline. We here present preliminary data on 11 patients with diagnosis of Alzheimer's Disease (AD) and mild cognitive decline randomly assigned to treatment (a) or control (b) condition (i.e. specific vs. aspecific treatment). The specific treatment (a) consisted in a cycle of 12 individual sessions of computer exercises, while the control condition (b) consisted in sessions of semi-structured interviews with patients, conducted with the same frequency and time period as (a). Cognitive, behavioural and functional assessment was performed by an expert evaluator, blinded to the patients' group allocation. Preliminary results show a significant performance decline only in the control group at the 9-month follow-up compared to both baseline and the 3-month follow-up. Our results suggest that computer based cognitive training in patients with AD and mild cognitive decline is effective at least in delaying the continuous progression of cognitive impairment in AD.

Language-enriched exercise plus socialization slows cognitive decline in Alzheimer's disease.

Abstract: This article reports the effects of language-enriched physical fitness interventions provided by University of Arizona undergraduate students to 24 mild- to moderate-stage Alzheimer's disease patients (AD Rehab group). Socialization experiences consisted of supervised volunteer work and cultural/recreational activities. Changes in global functioning and neuropsychological test performance were tracked and compared to those of a similar group of untreated patients from the Consortium for the Establishment of a Registry for Alzheimer's Disease (CERAD). Cohorts completing 4 semesters or longer showed no significant between-year changes after their first year on the Clinical Dementia Rating, a measure of global functioning, and on 5 or 6 of the cognitive and language measures. Comparisons with the CERAD sample suggested a slower rate of decline for the AD Rehab group. The stabilization of global and cognitive performance was not apparent among participants who completed only 2 semesters. Significant physical fitness and mood outcomes were previously reported in this journal.

Sustained favorable effects of cognitive training in children with acquired brain injuries.

Abstract: The overall aim of the present study was to assess in greater detail the sustained effects of a broad-based cognitive training programme on the neuropsychological performance of children with acquired brain injury. In particular, the long term (6 months) effects on cognitive functions, as well as how various moderators (gender, age at the time of injury/diagnosis, time since injury/diagnosis, age at the training) might influence outcome were investigated. A group of 38 children, 9-16 years of age, with various types of acquired brain injury had earlier been randomly assigned into treatment and control groups. These two groups had first been assessed directly after completion of the training and were now reassessed 6 months later. The treatment group exhibited significantly more persistent improvements with respect to complex tasks of attention and memory in comparison to the control group. In contrast there were no differences on simple reaction time tests. We conclude that the long term effects on cognitive functions of this broad-based neuro-cognitive training is encouraging. These positive results should be further investigated in larger more specific diagnostic groups and in different settings.

Cognitive training in MS: Effects and relation to brain atrophy

Abstract: Purpose Cognitive disorders are common in MS patients without any generally recommended treatment. Recent brain imaging studies show considerable neuroplasticity for cognitive tasks in MS patients, but also brain atrophy already early in the disease progression. We explored the benefits of a home-based cognitive training program for memory and working memory functions in relapsing-remitting MS patients controlling for whole brain and central brain atrophy as covariates. Methods Using a single-blinded controlled study design, 42 patients were randomised into a treatment group and a control group. Home based computer training focusing on memory and working memory was started at least 4 weeks after the discontinuation of methylprednisolone treatment and lasted for 6 weeks. Two weeks later the patients were re-investigated for their clinical and cognitive performance. We assessed also quality of life (QoL), depression and fatigue using self-rating scales. Results Training had no effect on the neurological status and on QoL or fatigue. However, the treatment group showed better verbal learning, long-delay verbal memory performance, and working memory performance. The impact of treatment on long-delay verbal memory performance was independent from the extent of brain atrophy, whereas for the other findings brain atrophy played a significant role. Conclusions An intensive home-based cognitive training program is suitable to improve the cognitive performance of MS patients. The impact of brain atrophy on rehabilitation outcome may differ for cognitive functions.

Cognitive stimulation intervention for elders with mild cognitive impairment compared with normal aged subjects: preliminary results.

Abstract: Background and aims: Cognitive training programs have been developed for Alzheimer’s disease patients and the health]; elderly) population. Collective cognitive stimulation programs have been shown to be efficient for subjects with memory complaint. The aim of this study was to evaluate the benefit of such cognitive programs in populations with Mild Cognitive Impairment (MCI). Methods: Twelve patients with MCI and twelve cognitively normal elders were administered a cognitive stimulation program. Cognitive performance (Logical Memory, Word paired associative learning task, Trail Making Test, verbal fluency test) were collected before and after the intervention. A gain score [(post-score — pre-score)/pre-score] was calculated for each variable and compared between groups. Results: The analysis revealed a larger intervention size effect in MCI than in normal elders’ performances on the associative learning task (immediate recall: p<0.05, delayed recall: p<0.01). The intervention was more beneficial in improving associative memory abilities in MCI than in normal subjects. At the end of the intervention, the MCI group had lower results than the normal group only for the delayed recall of Logical Memory. Conclusions: Although further studies are needed for more details on the impact of cognitive stimulation programs on MCI patients, this intervention is effective in compensating associative memory difficulties of these patients. Among non-pharmacological interventions, cognitive stimulation therapy is a repeatable and inexpensive collective method that can easily be provided to various populations with the aim of slowing down the rate of decline in elderly persons with cognitive impairment.

Cognitive impairment in multiple sclerosis.

Abstract: Cognitive dysfunctions are frequent symptoms of multiple sclerosis (MS) and occur in up to 65% of patients. Especially memory, attention, executive and visual constructive functions are impaired. These problems strongly affect patients' ability to work, social relationships, and quality of life. Symptoms of physical disabilities can arise independently. Cognitive dysfunctions are clear indicators of MS progression, because they represent highly complex functions that depend on the integrity of the neuronal networks. Once manifested after a relapse, they remain stable . Given a differentiating diagnosis, it is possible to treat these dysfunctions by cognitive training and with pharmaceutical drugs, for example by immunomodulating drugs. However, treatment options are limited at present. This report provides a detailed description of cognitive functions and performance in MS patients, their comorbidities such as fatigue and depression and therapeutic options.

Cognitive rehabilitation and cognitive training for mild dementia

Abstract: Cognitive deficits caused by dementing illnesses are chronic and progressive problems, which should be tackled both by biological and non-biological approaches. Among the various techniques of non-biological approaches (cognitive rehabilitation), centered is cognitive training intervention for individuals with dementia. Cognitive training is further divided into two different types of setting: group and individualized. Among group training techniques, the reality orientation training and day care/day services are known to have evidence-based efficacy. Individually tailored cognitive training aims to directly and explicitly improve cognitive functioning of people with dementia specifically in the early stages. Increasing evidence demonstrates the efficacy of various individualized training programs for dementia, including Alzheimer's disease (AD). Specifically, three techniques, known as spaced retrieval, dual cognitive support and procedural memory training, have shown promise in their ability to enhance learning in people with dementia. In addition, recent studies have suggested that a combination of pharmacotherapy and cognitive training may benefit individuals with AD. Cognitive training appears to be particularly effective for people with mild memory impairment who are on cholinergic treatment. It is now widely accepted that the theoretical framework of ‘errorless learning’ is also a guiding principle in the realm of cognitive training for people with dementia. Although the effect of factors, namely effort (effortful vs effortless) and stimulus features (perceptual vs conceptual), has not been fully determined, error elimination during learning sessions is essential for favorable outcomes.

Effects of Cognitive Training on Change in Accuracy in Inductive Reasoning Ability

Abstract: We investigated cognitive training effects on accuracy and number of items attempted in inductive reasoning performance in a sample of 335 older participants (M = 72.78 years) from the Seattle Longitudinal Study. We assessed the impact of individual characteristics, including chronic disease. The reasoning training group showed significantly greater gain in accuracy and number of attempted items than did the comparison group; gain was primarily due to enhanced accuracy. Reasoning training effects involved a complex interaction of gender, prior cognitive status, and chronic disease. Women with prior decline on reasoning but no heart disease showed the greatest accuracy increase. In addition, stable reasoning-trained women with heart disease demonstrated significant accuracy gain. Comorbidity was associated with less change in accuracy. The results support the effectiveness of cognitive training on improving the accuracy of reasoning performance.

Protocol for Fit Bodies, Fine Minds: a randomized controlled trial on the affect of exercise and cognitive training on cognitive functioning in older adults

Abstract: Background Declines in cognitive functioning are a normal part of aging that can affect daily functioning and quality of life. This study will examine the impact of an exercise training program, and a combined exercise and cognitive training program, on the cognitive and physical functioning of older adults.

Use of computer assisted and interactive cognitive training programmes with moderate to severely demented individuals: a preliminary study.

Abstract: The purpose of this study was to investigate the potential effects of interactive cognitive training and computer-assisted programmes in reducing decline in older adults with dementia. The primary goal of this programme was to maintain participants’ level of cognitive function. This study included six moderately to severely demented older adults living in a secured memory-impairment unit within an assisted living community. The participants were assessed with neuropsychological tests prior to, and immediately following, an intensive six-week cognitive training programme. The results showed that the participants improved significantly on measures of overall cognitive function, including short-term memory and cognitive failures. Caregiver reports also indicated significant improvement in the participants’ behaviour signs and socialization. Additionally, these participants did not demonstrate significant decline on any of the measures from pre-test to post-test levels. This preliminary study indicates that a...

Cognitive Training Gain as a Predictor of Mental Status

Abstract: We examined the association of proximal and distal training gain to subsequent mental status ratings in 302 participants (M = 7662 years) trained on inductive reasoning or spatial orientation in the Seattle Longitudinal Study Only training effects on reasoning ability were predictive of mental status group membership Participants subsequently rated as probably demented did not significantly differ from nondemented participants in magnitude of reasoning training gain 14 years prior to assessment, but they did 7 years prior to status ratings Proximal training gain 1 year prior to assessment was 040 SD for nondemented participants, compared with 025 and 010 SD for at-risk and probably demented participants, respectively The combination of reasoning ability training and increased proximal training gain on reasoning ability was associated with a decreased likelihood of being rated as probably demented

Should One Use Medications in Combination With Cognitive Training? If So, Which Ones?

Abstract: In this article, we review current research regarding diagnosis of cognitive impairment in nondemented adults and discuss why medications and cognitive training together may be more beneficial than either alone. We also review potential cognitive enhancers and future research challenges. There are major reasons for such research: (a) Large numbers of older adults without dementia but with cognitive problems are not treatable with current cognitive training techniques; (b) some medications offer a rationale (i.e., cognitive enhancement) and some evidence that they might be a useful adjunct; and (c) there are unanswered questions about which population to target, which medications to use, how to administer them, and issues regarding tolerance and use of appropriate (active) placebo controls. As the number of cognitively impaired older adults grows, it is likely that there will be pressure to treat more broadly with both medications and cognitive training.

Effects of cognitive training on individual differences in attention

Abstract: Selective attention is responsible for detecting, localizing and identifying a target while neglecting distractors [1],[2]. A superior capacity in selective attention contributes to good performance in tasks that require monitoring the environment and searching for a target [2],[3],[4]. Since it is our goal to optimize work efficiency, understanding individual differences in attentional capacity and whether they are mutable is important. Our first experiment demonstrates the existence of systematic individual differences in selective attention. More remarkably, our second experiment shows that appropriate cognitive training using an action video game can alter selective attentional capacity. Furthermore, individuals with the poorest initial scores gain most from the training. We show that these gains cannot be attributed to regression effects alone. Thus we conclude that individual differences in attentional capacity can be reduced or even eliminated by training.

[The effects of a computer assisted cognitive training on neuropsychological parameters, mood and dysfunctional cognitions in depressive patients].

Abstract: Aim In this pilot study a computer-assisted cognitive training programme (CAT) was tested and evaluated in patients with depressive syndromes for its effects on neuropsychological parameters, modd and dysfunctional cognitions. Methods A total of 48 patients were randomized either to the treatment or the control group. The former underwent 20 sessions, 30-45 minutes each, of computer-assisted cognitive training, twice a week. At the beginning and at the end of the training (ten weeks later), both groups were given neuropsychological tests (memory, attention, concentration and information processing speed) and also questionnaires to assess depressive mood, thoughts, negative self communication and locus of control. Results At the start of the study, both the groups information processing speed. All these were absent in the control group. Also the depressive mood, as well as negative self-communication markedly improved in the training group. As expected, these results were not observed in the control group. Conclusion According to these results in depressed patients a computer-assisted cognitive training programme might have a positive influence not only on their neuropsychological functions but also on their dysfunctional beliefs. Thus CAT should be part of the treatment of depressive patients.

Short-term effect of cognitive training intervention in community elders

Abstract: Objective:To explore the short-term effect of cognitive training intervention in community elders.Method:The volunteer elders aged more than 65 in one community were conducted the cognitive training intervention for 12 weeks(totally 24 times).We compared the cognitive function difference between invention group(44 volunteer elders participating in the cognitive intervention training)and control group(51 elders only finishing basement and follow-up evaluation)by neuropsychological tests battery for eladerly(NTBE).Results:In self-comparison of NTBE between before and after cognitive training intervention,there were significant differences in scores of visual matching and reasoning item in intervention group,and in scores of motor testing,proactive inhibition and learning efficacy index item in control group.Cognitive training intervention were positively correlated with the items of NTBE,such as right number for listening and learning words 4,repeating number for listening and learning words 4,sort test,small sign test,visual matching and reasoning,inserting for listening words 8 and hint times for sequence of 1 in connected line test.Conclusion:Cognitive training intervention can improve short-term cognitive function or postpone part of cognitive dysfunction.

Impact of computerized cognitive training on working memory, fluid intelligence, and science achievement

Abstract: Working memory (WM), which includes short-term memory and cognitive control, has been found to be closely related to a wide range of high-level cognitive abilities and academic achievement (Gathercole, Pickering, Knight, & Stegmann, 2004; Kyllonen, 2002). Prior studies showed children with attention-deficit/hyperactivity disorder improved their WM and fluid intelligence (e.g., the ability to understand complex relationships and solve novel problems) through computerized cognitive training (CCT) in a clinical setting (Kingberg, Firssberg, & Westerberg, 2002; Klingberg et al., 2005). This research examined whether regular middle-school students would significantly improve their WM through CCT on WM; and if so, whether increase in WM would lead to improved fluid intelligence and science achievement. Two randomized pretest-posttest control-group experimental studies were conducted to answer these questions. Fifty-two and 37 seventh- and eighth-grader in a summer school and an intermediate middle school in Northern California participated in the pilot and main study, respectively. In both the pilot and main studies, students were randomly assigned into the experimental or control group after being tested on working memory, fluid intelligence, and science achievement. Experimental group students were trained on WM, while control group students took training unrelated to WM. The average number of training days was 13.55 days in the pilot study and 24.65 days in the main study. Students took the same tests at the end of training as at the beginning to examine whether experimental group students improved significantly more than did control group students on measures of working memory, fluid intelligence, and science achievement. Results showed CCT effectively improved regular students' WM in a school setting, with more increase in short-term memory than in cognitive control. No significant improvement was observed right after training in fluid intelligence and science achievement. With more participants, enough time to transfer changes in working memory to fluid intelligence and science achievement, and more training on cognitive control, CCT might significantly improve students' fluid intelligence and science achievement in future studies.

Cognitive Training and Daily Functioning in Older Adults

Abstract: The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study group investigated the long-term effects of cognitive training on everyday functioning and on specific cognitive abilities in nondemented, community-dwelling elders (age 65 or older). The ACTIVE study was a multicenter study with 5-year follow-up. Of 2832 subjects enrolled, two thirds completed the study. Subjects were randomized to either no intervention (unblinded placebo group) or one …

Method And Systems For Improving Human Brain Activity To Confront Aging

Abstract: A method and system for improving human brain activity of individual persons to confront aging comprises evaluating individual existing cognitive skills which identify substantially mentally healthy individuals, referring each substantially healthy individual to an appropriate cognitive skill training program, administering the respective cognitive training program, and, optionally providing additional activities.