Targeting alertness to improve cognition in older adults: A preliminary report of benefits in executive function and skill acquisition

Abstract

Efficient self-regulation of alertness declines with age exacerbating normal declines in performance across multiple cognitive domains, including learning and skill acquisition. Previous cognitive intervention studies have shown that it is possible to enhance alertness in patients with acquired brain injury and marked attention impairments, and that this benefit generalizes to improvements in more global cognitive functions. In the current preliminary studies, we sought to test whether this approach, that targets both tonic (over a period of minutes) and phasic (moment-to-moment) alertness, can improve key executive functioning declines in older adults, and enhance the rate of skill acquisition. The results of both experiments 1 and 2 demonstrate that, compared to active control training, alertness training significantly enhanced performance in several validated executive function measures. In experiment 2, alertness training significantly improved skill acquisition compared to active control training in a well-characterized speed of processing task, with the largest benefits shown in the most challenging speed of processing blocks. The results of the current study suggest that targeting intrinsic alertness in cognitive training provides a novel approach to improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments.

Cognitive workload across the spectrum of cognitive impairments: A systematic review of physiological measures

“…The early detection of cognitive deficits may have implications in pharmaceutical and rehabilitation interventions. To date, pharmaceutical and rehabilitation interventions are initiated after significant changes in cognitive functions are observed (Connolly & Lang, 2014;Van Vleet et al, 2016). Previous studies showed that cognitive function could be improved through cognitive rehabilitation interventions (Van Vleet et al, 2016).…”

“…To date, pharmaceutical and rehabilitation interventions are initiated after significant changes in cognitive functions are observed (Connolly & Lang, 2014;Van Vleet et al, 2016). Previous studies showed that cognitive function could be improved through cognitive rehabilitation interventions (Van Vleet et al, 2016). Although the benefits of these interventions have been proven in older adults (Van Vleet et al, 2016), their effectiveness may vary among individuals depending on their mental state at the moment of the training.…”

Construction and evaluation of multidomain attention training to improve alertness attention, sustained attention, and visual‐spatial attention in older adults with mild cognitive impairment: A randomized controlled trial

“…Previous studies have shown that sustained attention seems to be impaired in most patients with MCI . In addition, sustained attention is affected by alertness, which is critical for effective executive function . Both attention and executive function are multidimensional and highly complex cognitive constructs, and they are considered as being intimately related .…”

“…However, the feasibility of attention training in clinical practice/implication may be an issue. Because the attentional deficits appear quite early on in cognitive disease and underlie many difficulties in activities of daily living, the maintenance of attention is effortful, variable, and prone to decline . However, the multidomain attention training, as compared with single attention training, may adapt to different stimuli in daily life and decrease relevant risks, such as during driving and falling.…”

“…20,43,44 In addition, sustained attention is affected by alertness, which is critical for effective executive function. 45 Both attention and executive function are multidimensional and highly complex cognitive constructs, and they are considered as being intimately related. 46,47 Furthermore, both processes are considered to be mediated by the SAS, which plays an important role in the modulation of behavior when tasks are novel and difficult and require a degree of planning and forethought.…”