Computerized Games versus Crosswords Training in Mild Cognitive Impairment

Devanand, Davangere P.; Goldberg, Terry E.; Qian, Min; Rushia, Sara N.; Sneed, Joel R.; Andrews, Howard; Niño, Izael; Phillips, Julia; Pence, Sierra T.; Linares, Alexandra R.; Hellegers, Caroline; Michael, Andrew M.; Kerner, Nancy Allison; Petrella, Jeffrey R.; Doraiswamy, P. Murali

doi:10.1056/evidoa2200121

Cited by 14 publications

(12 citation statements)

References 35 publications

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“…Because the primary outcome of this trial was within-network DMN FC, we did not adjust p -values for multiple comparisons; therefore, these secondary findings should be viewed as preliminary. Though no direct correlation between change in DMN FC and cognitive outcomes was demonstrated, these exploratory findings nevertheless support the overall trial findings in which the primary cognitive outcome measure, Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) 11, showed a small, but significant, decline for games compared to improvement for crosswords within the LMCI group as well as across all subjects [ 12 ]. However, within the EMCI group, there was no difference between crosswords and games in any cognitive or functional outcomes [ 12 ].…”

Section: Discussionmentioning

confidence: 52%

“…Among LMCI participants, dropout rate was marginally greater for games (6/30 = 20%) than crosswords (5/33 = 15.2%). Cognitive and functional outcomes in the trial have been reported elsewhere [ 12 ]. Among the 107 subjects who were randomized, 20 additional subjects were excluded based on failed fMRI QC and preprocessing criteria (12/51 for games, 8/56 for crosswords), leaving a total of 87 subjects (39 for games and 48 for crosswords) with both baseline and 78 week fMRI data.…”

Section: Resultsmentioning

confidence: 99%

“…A detailed description of trial design features and study intervention of this two-site study has been published elsewhere [ 12–14 ]. The prior articles dealt with the primary and secondary neuropsychological testing outcomes as a result of CCT, whereas we report on the within- and between-network connectivity of the DMN and other functional networks influenced by the CCT intervention.…”

Section: Methodsmentioning

confidence: 99%

“…Here we report the first randomized controlled trial in subjects with EMCI and LMCI examining the effects of home-based CCT on resting-state connectivity within the DMN as well as within and between other functional networks modulated by CCT effects. The primary outcome cognitive findings from this trial are being reported separately [ 12 ]. Our hypothesis was that CCT would normalize changes in the DMN from MCI, compared to a crossword puzzle control condition, and that the resulting network changes would correlate with a slowing of cognitive decline or with cognitive improvement.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer’s Disease: A 78-week Randomized Controlled Trial

Petrella

Michael

Qian

et al. 2023

JAD

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Background: Mild cognitive impairment (MCI) represents a high risk group for Alzheimer’s disease (AD). Computerized Cognitive Games Training (CCT) is an investigational strategy to improve targeted functions in MCI through the modulation of cognitive networks. Objective: The goal of this study was to examine the effect of CCT versus a non-targeted active brain exercise on functional cognitive networks. Methods: 107 patients with MCI were randomized to CCT or web-based crossword puzzles. Resting-state functional MRI (fMRI) was obtained at baseline and 18 months to evaluate differences in fMRI measured within- and between-network functional connectivity (FC) of the default mode network (DMN) and other large-scale brain networks: the executive control, salience, and sensorimotor networks. Results: There were no differences between crosswords and games in the primary FC outcome. However, secondary analyses suggest differential effects on between-network connectivity involving the DMN and SLN, and within-network connectivity of the DMN in subjects with late MCI. Paradoxically, in both cases, there was a decrease in FC for games and an increase for the crosswords control (p < 0.05), accompanied by lesser cognitive decline in the crosswords group. Conclusion: Results do not support a differential impact on within-network DMN FC between games and crossword puzzle interventions. However, crossword puzzles might nonspecifically engage multiple specialized cognitive networks at a low level, resulting in cognitively beneficial remodeling between the DMN and other networks, and within the DMN in subjects at higher risk of dementia.

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Section: Discussionmentioning

confidence: 52%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer’s Disease: A 78-week Randomized Controlled Trial

Petrella

Michael

Qian

et al. 2023

JAD

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“…In the 2020 Lancet report, Livingston et al (2020) list additional risk factors that include education. While education is often set earlier in life, older adults who engage in stimulating activities such as reading, crossword puzzles, and discussion of local/national issues were reported to experience better cognitive outcomes ( Chang, et al, 2021 ; Devanand et al, 2022 ; Parisi et al, 2015). The degree to which the cognitive activity has a social aspect is also important to consider.…”

Section: Introductionmentioning

confidence: 99%

How an Intergenerational Book Club Can Prevent Cognitive Decline in Older Adults: A Pilot Study

Plummer

Nguyen

Everly

et al. 2023

Gerontology and Geriatric Medicine

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Older adults are at higher risk for social isolation because of widowhood, loss of friends, retirement, physical limitations, geographic relocation, and caregiving demands. Behavioral interventions aimed at increasing social contact may help to maintain cognition and prevent cognitive decline. The purpose of this pilot study was to examine a novel intervention for social isolation with an intergenerational book club that had weekly in-person and virtual meetings of college students and older adults. We wanted to know whether the study was feasible and if our methods would be likely to generate meaningful results should it be expanded to a larger number of participants. We predicted that wellbeing and cognition would improve following participation in the book club. Results found that while measures of quality of life and affect were not statistically different before and after participation in a book club, scores on a measure of cognition (the Montreal Cognitive Assessment) were statistically significant between groups (intervention and control) showing greater improvement among book club participants.

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Effects of computerized cognitive training on biomarker responses in older adults with mild cognitive impairment: A scoping review

Hayashi,

Sone,

Iokawa

et al. 2024

Health Science Reports

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Background and AimsMild cognitive impairment (MCI) is a widespread condition in older individuals, posing significant risk of dementia. However, limited research has been conducted to explore effective interventions and clarify their impact at the neural level. Therefore, this study aimed to investigate the effects of computerized cognitive training (CCT) and explore the associated neural mechanisms in preventing dementia in older individuals with MCI, with a view to inform future intervention efforts.MethodsWe reviewed the effects of CCT on biomarker outcomes in older adults with MCI. The search was conducted for studies published between 2010 and May 10, 2023, using three search engines: PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature. The inclusion criteria were as follows: studies that involved participants diagnosed with MCI, included CCT, included quantitative assessment of biomarker results, and conducted randomized controlled trials.ResultsSixteen studies that used biomarkers, including magnetic resonance imaging, electroencephalography (EEG), functional near‐infrared spectroscopy (fNIRS), and blood or salivary biomarkers, were extracted. The results showed that CCT caused changes in structure and function within the main brain network, including the default mode network, and decreased both theta rhythm activity on EEG and prefrontal activity on fNIRS, with improvement in cognitive function. Furthermore, CCT combined with physical exercise showed more significant structural and functional changes in extensive brain regions compared with CCT alone. Virtual reality‐based cognitive training improved not only executive function but also instrumental activities of daily living.ConclusionCCT causes functional and structural changes in extensive brain regions and improves cognitive function in older adults with MCI. Our findings highlight the potential of individualized intervention methods and biomarker assessment according to the specific causes of MCI. Future research should aim to optimize these personalized therapeutic strategies to maximize the benefits of CCT in older adults with MCI.

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Computerized Games versus Crosswords Training in Mild Cognitive Impairment

Cited by 14 publications

References 35 publications

Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer’s Disease: A 78-week Randomized Controlled Trial

Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer’s Disease: A 78-week Randomized Controlled Trial

How an Intergenerational Book Club Can Prevent Cognitive Decline in Older Adults: A Pilot Study

Effects of computerized cognitive training on biomarker responses in older adults with mild cognitive impairment: A scoping review

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