Posts Tagged Mild Cognitive Impairment

[ARTICLE] Technology-based cognitive training and rehabilitation interventions for individuals with mild cognitive impairment: a systematic review

Abstract

Background

Individuals with mild cognitive impairment (MCI) are at heightened risk of developing dementia. Rapid advances in computing technology have enabled researchers to conduct cognitive training and rehabilitation interventions with the assistance of technology. This systematic review aims to evaluate the effects of technology-based cognitive training or rehabilitation interventions to improve cognitive function among individuals with MCI.

Methods

We conducted a systematic review using the following criteria: individuals with MCI, empirical studies, and evaluated a technology-based cognitive training or rehabilitation intervention. Twenty-six articles met the criteria.

Results

Studies were characterized by considerable variation in study design, intervention content, and technologies applied. The major types of technologies applied included computerized software, tablets, gaming consoles, and virtual reality. Use of technology to adjust the difficulties of tasks based on participants’ performance was an important feature. Technology-based cognitive training and rehabilitation interventions had significant effect on global cognitive function in 8 out of 22 studies; 8 out of 18 studies found positive effects on attention, 9 out of 16 studies on executive function, and 16 out of 19 studies on memory. Some cognitive interventions improved non-cognitive symptoms such as anxiety, depression, and ADLs.

Conclusion

Technology-based cognitive training and rehabilitation interventions show promise, but the findings were inconsistent due to the variations in study design. Future studies should consider using more consistent methodologies. Appropriate control groups should be designed to understand the additional benefits of cognitive training and rehabilitation delivered with the assistance of technology.

Background

Due to the aging of the world’s population, the number of people who live with dementia is projected to triple to 131 million by the year 2050 []. Development of preventative strategies for individuals at higher risk of developing dementia is an international priority []. Mild cognitive impairment (MCI) is regarded as an intermediate stage between normal cognition and dementia []. Individuals with MCI usually suffer with significant cognitive complaints, yet do not exhibit the functional impairments required for a diagnosis of dementia. These people typically have a faster rate of progression to dementia than those without MCI [], but the cognitive decline among MCI subjects has the potential of being improved []. Previous systematic reviews of cognitive intervention studies, both cognitive training and cognitive rehabilitation, have demonstrated promising effects on improving cognitive function among subjects with MCI [].

Recently, rapid advances in computing technology have enabled researchers to conduct cognitive training and rehabilitation interventions with the assistance of technology. A variety of technologies, including virtual reality (VR), interactive video gaming, and mobile technology, have been used to implement cognitive training and rehabilitation programs. Potential advantages to using technology-based interventions include enhanced accessibility and cost-effectiveness, providing a user experience that is immersive and comprehensive, as well as providing adaptive responses based on individual performance. Many computerized cognitive intervention programs are easily accessed through a computer or tablet, and the technology can objectively collect data during the intervention to provide real-time feedback to participants or therapists. Importantly, interventions delivered using technology have shown better effects compared to traditional cognitive training and rehabilitation programs in improving cognitive function and quality of life []. The reasons for this superiority are not well-understood but could be related to the usability and motivational factors related to the real-time interaction and feedback received from the training system [].

Three recent reviews of cognitive training and rehabilitation for use with individuals with MCI and dementia suggest that technology holds promise to improve both cognitive and non-cognitive outcomes []. The reviews conducted by Coyle, et al. [] and Chandler, et al. [] were limited by accessing articles from only two databases, and did not comprehensively cover available technologies. Hill, et al. [] limited their review to papers published until July 2016 and included only older adults aged 60 and above. More technology-based intervention studies have been conducted since then, and only including studies with older adults 60 and above could limit the scope of the review given that adults can develop early-onset MCI in their 40s []. Therefore, the purpose of this review is to 1) capture more studies using technology-based cognitive interventions by conducting a more comprehensive search using additional databases 2) understand the effect of technology-based cognitive interventions on improving abilities among individuals with MCI; and 3) examine the effects of multimodal technology-based interventions and their potential superiority compared to single component interventions.[…]

 

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[Abstract] The Beneficial Effects of Mind-body Exercises for People with Mild Cognitive Impairment: A Systematic Review with Meta-Analysis

Highlights

  • A meta-analysis on 1298 adults with MCI was conducted.
  • The effects of mind-body exercises (MBE) on various cognitions was assessed.
  • Various MBEs, such as Tai Chi, were effective in enhancing numerous cognitive outcomes.

Abstract

Objective

To objectively evaluate the most common forms of mind body exercise (MBE) (Tai Chi, Yoga, and Qigong) on cognitive function among people with MCI.

Data sources

We searched six electronic databases (Scopus, PubMed, PsycINFO, WanFang, Web of Science, and CNKI) from inception until September, 2018.

Study Selection

Nine randomized controlled trials and three non-randomized controlled trials were included for meta-analysis.

Data Extraction

Two researchers independently performed the literature searches, study selection, data extraction, and methodological quality assessment using the revised Physiotherapy Evidence Database (PEDro) scale.

Data Synthesis

The pooled effect size (standardized mean difference, SMD) was calculated while random-effect model was selected. Overall results of the meta-analysis (N = 1298 people with MCI) indicated that MBE significantly improved attention (SMD = 0.39, 95% CI 0.07 to 0.71, p = 0.02, I2 = 31.6%, N = 245), short-term memory (SMD= 0.74, 95% CI 0.57 to 0.90, p < 0.001, I2 = 0%, N = 861), executive function (SMD = -0.42, 95% CI -0.63 to -0.21, p < 0.001, I2 = 38.54%, N = 701), visual-spatial/executive function (SMD = 0.35, 95% CI 0.07 to 0.64, p < 0.05, I2 = 0%, N = 285), and global cognitive function (SMD = 0.36, 95% CI 0.2 to 0.52, p < 0.001, I2 = 15.12%, N = 902). However, the significant positive effect on cognitive processing speed was not observed following MBE interventions (SMD = 0.31, 95% CI -0.01 to 0.63, p = 0.054, I2 = 28.66%, N = 233).

Conclusions

Study findings of this meta-analysis suggest that MBE have the potential to improve various cognitive functions in people with MCI.

via The Beneficial Effects of Mind-body Exercises for People with Mild Cognitive Impairment: A Systematic Review with Meta-Analysis – Archives of Physical Medicine and Rehabilitation

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[ARTICLE] A Brief Overview and Assessment of the Role and Benefits of Cognitive Rehabilitation

Abstract

Cognition is one of our most important attributes. Arresting its decline whether in association with normal aging, a diagnosis of mild cognitive impairment, acquired brain injury or dementia concerns everyone-regardless of whether their role is that of spouse, child, or clinician. This paper provides a brief, and by necessity, somewhat superficial appraisal of the status of our knowledge of the benefits of cognitive rehabilitation in these conditions and the authors’ assessment of it strengths and weaknesses. In summary, there is support for the belief that participation in exercise as well as socially and cognitively stimulating activities (whether or not rehabilitative in nature) is beneficial for all but perhaps the most demented. Focused efforts at cognitive training/rehabilitation also appear potentially helpful but are best established for those with acquired brain injury. There are, however, caveats to this assessment. For example, cognitive retraining is resource and time intensive while, even for those most likely to benefit, its impact on their daily activities and quality of life remain unclear. In addition, responses to training may vary from person to person and are likely to be influenced by factors such as an individual’s acceptance of the need for assistance. Future research may benefit from continued efforts to treat the patient holistically, fit the treatment to those most likely to benefit, and encouraging the translation of training effects to functioning in the real world.

via A Brief Overview and Assessment of the Role and Benefits of Cognitive Rehabilitation – Archives of Physical Medicine and Rehabilitation.

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