Cognitive Exercise and Its Role in Cognitive Function in Older Adults
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Converging lines of research indicate that complex mental activity is associated with reduced dementia risk. Thus, intense interest exists in whether different forms of cognitive exercise can help protect against cognitive decline and dementia. However, there is considerable confusion in terminology that is hindering progress in the field. We therefore introduce a concrete definition of cognitive training (CT) and make this the focus of our article. Clinical research that has evaluated CT in normal aging, mild cognitive impairment, and dementia is then critically reviewed. Despite many methodological shortcomings, the overall findings indicate that multidomain CT has the potential to improve cognitive function in healthy older adults and slow decline in affected individuals. Finally, practical issues, including the strengths and weaknesses of commercial products, are explored, and recommendations for further research and clinical implementation are made.
KeywordsCognitive training Cognitive intervention Cognitive exercise
Dr. Valenzuela is supported by a University of New South Wales Vice Chancellor’s Fellowship.
Miss Gates is a former director of HeadStrong Cognitive Fitness, Australia, a commercial, Internet-based CT enterprise, and maintains a financial interest. No other potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 5.Galante E, Venturini G, Fiaccadori C: Computer-based cognitive intervention for dementia: preliminary results of a randomized clinical trial [in Italian]. G Ital Med Lav Ergon 2007, 29(3 Suppl B):B26–B32.Google Scholar
- 7.• Rozzini L, Costardi D, Chilovi V, et al.: Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors. Int J Geriatr Psychiatry 2007, 22:356–360. This was the first randomized, longitudinal trial of CT in patients with MCI with domain-specific, global cognitive, and psychiatric outcome measures. Significant improvements were found in memory and executive function, as was a reduction in neuropsychiatry symptoms following training intervention.CrossRefPubMedGoogle Scholar
- 12.Martin M, Clare L, Altgassen M, et al.: Cognition-based interventions for older people and people with mild cognitive impairment. Cochrane Database Syst Rev 2006, 4:006220.Google Scholar
- 13.Clare L, Woods B: Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev 2003, 4:CD003260.Google Scholar
- 19.Stigsdotter N, Backman A: Long -term maintenance of gains from memory training in older adults: two 3 1/2-year follow-up studies. J Gerontol Psychol Sci 1993, 48:P233–P237.Google Scholar
- 28.Olazaran J, Muniz R, Reisberg B, et al.: Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. Neurology 2004, 2:2348–2353.Google Scholar
- 29.Kawashima R, Okita K, Yamazaki R, et al.: Reading aloud and arithmetic calculation improve frontal function of people with dementia. J Gerontol Med Sci 2005, 60A:380–384.Google Scholar
- 34.•• Valenzuela MJ, Sachdev P: Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 2009, 17:179–187. This was the first meta-analysis of the effect of CT on longitudinal performance in healthy adults.CrossRefPubMedGoogle Scholar
- 36.Tonetta M: TNP—Training Neuropsiclogico di Mario Tonette [software, in Italian]. Stradella, Italy: BEAC-Biomedical; 1998.Google Scholar
- 37.Beck C, Heacock P, Mercer S, et al.: The impact of cognitive skills remediation training on persons with Alzheimer’s disease or mixed dementia. J Geriatr Psychiatry 1998, 21:73–88.Google Scholar
- 42.Lumos Labs: Ongoing research using Lumosity. Available at http://lumosity.com/knowledge-centre. Accessed September 16, 2009.
- 44.Yesavage JA, Friedman L, Ashford W, et al.: Acetylcholinesterase inhibitor in combination with cognitive training in older adults. J Gerontol 2008, 63:288–294.Google Scholar
- 49.Sinforiani E, Banchieri L, Zucchella C, et al.: Cognitive rehabilitation in Parkinson’s disease. Arch Gerontol Geriatr 2004, 38(Suppl):387–391.Google Scholar