Previous studies of letter recognition have not found priming for abstract letter identities. We used a task that required participants to decide whether a target is the same or different from a reference letter presented in opposite case, which avoids the shortcomings of tasks used in previous studies. We found robust priming effects in this task, which were the same size for letter pairs that have similar visual features across case (e.g., c/C, x/X) and dissimilar features (e.g., a/A, b/B). Also, the pattern of priming was the same whether the prime was in the same or different case as the reference. We take these findings as evidence that abstract letter identities support priming in this task. We suggest that the same-different match task is a useful tool for studying representations used to support masked priming in letter recognition and with other stimuli with limited set size.

Background and objectivesIn the absence of a cure for dementia, investigation of novel strategies aimed at delaying or preventing the onset of dementia are gaining momentum. In this regard, using the RE-AIM framework, we outline steps taken to adapt and implement an evidence-based cognitive training program for older adults ‘at risk’ of developing dementia within a clinical setting of a major metropolitan hospital. The primary aim was to explore feasibility (or ‘reach’), tolerability (or ‘implementation’), and acceptability (or ‘adoption’). The secondary aim was to explore the most sensitive clinical outcomes and measurement tools (i.e. ‘efficacy’) to inform a subsequent formal feasibility randomised controlled trial. MethodThis was an exploratory feasibility pilot study, using a pre-post single-arm study design. We conducted this study within the Older People’s Mental Health Service at St Vincent’s Hospital, Sydney, Australia. Seventy-nine participants, with a mean age of 78 years (SD=5.8, range=67-94) were enrolled. All enrolled participants engaged in ‘Club Connect’ an adaptation of a 10-week, group-based multifaceted program, comprised of psychoeducation and computer-based cognitive training. At baseline and follow-up, all participants completed a battery of neuropsychological tests and several questionnaires related to mood and psychosocial functioning. ResultsImplementing cognitive training within a clinical setting was feasible, well tolerated and accepted by participants. Further, cognitive training was associated with large to very large effect size improvements in verbal learning, memory for verbal and visual information, and semantic fluency, as well as quality of life, and reductions in anxiety and stress. We also found small to medium effect size improvements for other cognitive and psychosocial outcomes. ConclusionsOur preliminary findings support the feasibility of translating a group-based cognitive training program into the clinical setting, and provide key data to facilitate the next phase of implementation.

Background:Current treatments for Major Depression are only moderately effective. In fact, 20-30% do not achieve full recovery despite multiple interventions. Interestingly, while it is well recognised that cognitive impairment is associated with Major Depression, available treatments do not address cognitive impairment. In this regard, cognitive training (CT) represents a promising intervention, however CT is not typically offered in public health settings.Aim:To evaluate the feasibility of a blinded, randomised controlled trial of group-based CT in a hospital sample of older adults with clinically significant depressive symptoms or history of a major depressive episode within the last five years, and in doing so, to adapt and translate research findings to the clinical setting.Methods:40 older adults, aged at least 65 years, with depression or a history of depression, and without dementia were randomly allocated to Club Connect, a 10-week group-based healthy brain ageing CT program, or a waitlist, treatment-as-usual control group. Baseline assessment including review by a psychogeriatrician and a brief neuropsychological assessment was completed within a fortnight of the intervention starting, and follow-up assessment was completed within a fortnight of the intervention ceasing. Primary outcomes included feasibility of trial design, tolerability of the intervention, and acceptability of random allocation and data collection procedures (as perceived by both participants and clinicians). We also examined the most sensitive clinical outcomes and measurement tools to inform larger scale trials.Significance:The current health, social and economic costs of late-life depression, especially in those with concomitant cognitive impairment, renders the holistic treatment of depression in older adults a public health priority. CT represents an efficacious therapeutic intervention in this regard, however, there appears to be a paucity of CT programs being offered in public health settings. This trial represents the first step in addressing the ‘implementation gap’ that exists between care that is known to be effective and care that is delivered. We must recognise the need to evaluate not only health outcomes, but also to perform formative evaluations that assess the extent to which implementation is effective in order to optimise intervention benefits, to prolong sustainability, and to promote dissemination of findings.

No abstract