The effects of multi-domain versus single-domain cognitive training in non-demented older people: a randomized controlled trial

Abstract

BackgroundWhether healthy older people can benefit from cognitive training (CogTr) remains controversial. This study explored the benefits of CogTr in community dwelling, healthy, older adults and compared the effects of single-domain with multi-domain CogTr interventions.MethodsA randomized, controlled, 3-month trial of CogTr with double-blind assessments at baseline and immediate, 6-month and 12-month follow-up after training completion was conducted. A total of 270 healthy Chinese older people, 65 to 75 years old, were recruited from the Ganquan-area community in Shanghai. Participants were randomly assigned to three groups: multi-domain CogTr, single-domain CogTr, and a wait-list control group. Twenty-four sessions of CogTr were administrated to the intervention groups over a three-month period. Six months later, three booster training sessions were offered to 60% of the initial training participants. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Form A), the Color Word Stroop test (CWST), the Visual Reasoning test and the Trail Making test (TMT) were used to assess cognitive function.ResultsMulti-domain CogTr produced statistically significant training effects on RBANS, visual reasoning, and immediate and delayed memory, while single-domain CogTr showed training effects on RBANS, visual reasoning, word interference, and visuospatial/constructional score (all P < 0.05). At the 12-month posttest, the multi-domain CogTr showed training effects on RBANS, delayed memory and visual reasoning, while single-domain CogTr only showed effects on word interference. Booster training resulted in effects on RBANS, visual reasoning, time of trail making test, and visuospatial/constructional index score.ConclusionsCognitive training can improve memory, visual reasoning, visuospatial construction, attention and neuropsychological status in community-living older people and can help maintain their functioning over time. Multi-domain CogTr enhanced memory proficiency, while single-domain CogTr augmented visuospatial/constructional and attention abilities. Multi-domain CogTr had more advantages in training effect maintenance.Clinical Trial RegistrationChinese Clinical Trial Registry. Registration number: ChiCTR-TRC-09000732.

Maintaining older brain functionality: A targeted review

“…Cognitive studies have shown that even in advanced age, the brain displays certain plasticity (Berry et al, 2010;Cheng et al, 2012;Edwards et al, 2002Edwards et al, , 2005Jones et al, 2006;Smith et al, 2009). Structural imaging has shown substantial age-related gray and white matter shrinkage, especially in anterior brain regions (lateral prefrontal cortex), the hippocampus, and basal ganglia while neural loss is minimal in the occipital brain areas (Raz et al, 2005).…”

“…Some clinical trials, however, have shown transfer to other domains different than that of the trained exercises (Cheng et al, 2012;Mahncke et al, 2006;Oswald et al, 2006;Richmond et al, 2011;Willis et al, 2006).…”

“…Training on more than one strategy was associated with memory improvement but was not significant after adjustment for multiple comparisons . Cheng et al (2012) conducted a randomized cognitive training study including control waiting-list group, single domain and multi-domain cognitive trained groups. The multi-domain cognitive intervention trained memory, reasoning, problem solving, visual-spatial map reading, handcraft making and health lessons.…”

“…Most video games, however, are action games that were not developed considering the interests or needs of the older adults. Accumulated evidence suggests that playing action video games improves aspects of cognition in young adults, including visual-spatial attention, executive control, and peripheral vision (e.g., Boot et al, 2008;Chisholm and Kingstone, 2012;Green and Bavelier, 2003Green et al, 2010). Video game training also enhances visual short-term memory, task switching, object mental rotation and executive control in young and older individuals (Basak et al, 2008;Boot et al, 2008;Cain et al, 2012;Colzato et al, 2010;Lee et al, 2012); for reviews, see (Bavelier et al, 2012).…”

Memory and Cognitive Prevention Training for Typically Aging Seniors in a University Clinic Setting: A Feasibility Study

“…Generally these findings suggest that the implementation of CT with aging adults with MCI is effective in improving various aspects of memory performance, executive functioning, processing speed, attention, fluid intelligence and subjects' perception of memory functioning, as measured by formal and task specific measures, as well as particular MRI measures of brain connectivity. In seven out of 26 randomized control trials where follow-up data was provided, positive effects on memory, recall, speed of processing and fluid intelligence were preserved anywhere from one week to two years following training [12][13][14].…”