Digital Device Use, Risk of Cognitive Impairment, and Cognition in Healthy Older Adults: The Role of Cognitive Reserve

Distinguishing between normal and pathological cognitive aging is challenging because there is no typical older person. Some people in their eighties have cognitive abilities similar to many 30-year-olds, while others experience significant cognitive decline at a much younger age. The variation in age-related cognitive decline is not arbitrary. Several non-modifiable (e.g. genetic) and potentially modifiable (e.g. high blood pressure, smoking, and hearing loss) risk factors are associated with faster cognitive aging. Beyond these individual-level risk factors, a growing body of evidence has identified associations between cognitive impairment and social, economic, and environmental factors. These associations are even more pronounced in developing countries, notably because of greater disparities in education and socioeconomic status. However, people from these countries are rarely studied in scientific research: a citizen of a high-income country is 37 times more likely to appear in a study in top medical journals than a citizen of a low-income country. Here, we examine the association between sociodemographic factors and cognitive aging trajectories among 715,295 participants in 46 countries. Cognition is assessed using Sea Hero Quest, a spatial navigation video game that predicts spatial ability in the real world. We find that the social, economic, and environmental well-being of older adults, as measured by the Global AgeWatch Index (GAWI), is negatively associated with age-related decline in spatial ability. In particular, the GAWI Health and Environment subscores are strongly correlated with the effect of age on wayfinding performance. We also found that gender differences in spatial navigation skills increase with age, and even more so in countries with greater gender inequality, as estimated by the Gender Inequality Index. Our results show that cognitive aging must be understood as a dynamic, heterogeneous process that is strongly linked to potentially modifiable environmental and social factors.

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Development of a digital multidomain lifestyle intervention for mild cognitive impairment: A pilot study on the feasibility and efficacy of cognitive training

Han,

Ko,

Park

et al. 2024

DIGITAL HEALTH

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Background The heterogeneous etiology of mild cognitive impairment (MCI) presents significant challenges in monitoring its progression and impeding its advancement toward dementia. Digital multidomain lifestyle interventions have shown promise as potential solutions for their ability to treat MCI. Objective This study is the first phase in a series of evaluations aimed at assessing various components of Silvia-Rx, which was originally designed as a digital multidomain lifestyle intervention. Specifically, this study focused on a 60-session core cognitive training program to evaluate its feasibility and efficacy in addressing cognitive decline in individuals with MCI. Methods Individuals aged 60 to 80 years diagnosed with MCI were enrolled to participate in a 60-session tablet-based cognitive regimen of Silvia-Rx. Feasibility was assessed through adherence and retention rates, while the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog) scale was utilized to measure cognitive function as the primary indicator of efficacy. Results The mean age of the participants was 71.11 years, and 13 (68.42%) were women. Only one withdrawal occurred, resulting in a 95% retention rate (19 participants) post-intervention. The completion rate was excellent at 100%, indicating that the 60-session core cognitive program in Silvia-Rx was well tolerated by older participants with MCI. Regarding efficacy, there was a statistically significant improvement in cognitive function among MCI participants after the intervention, as evidenced by changes in total ADAS-cog scores. Conclusions Results demonstrated excellent adherence throughout the program and significant cognitive improvements after the intervention. This pilot study indicates that Silvia-Rx's digital cognitive program is feasible for people diagnosed with MCI, suggests potential for improving cognitive function, though further research with large sample size is needed to confirm these results.

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Digital Device Use, Risk of Cognitive Impairment, and Cognition in Healthy Older Adults: The Role of Cognitive Reserve

Cited by 4 publications

References 44 publications

Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use

Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use

Social determinants of cognitive aging trajectories across 39 countries

Development of a digital multidomain lifestyle intervention for mild cognitive impairment: A pilot study on the feasibility and efficacy of cognitive training

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