The Future of Cognitive Remediation Training in Older Adults

Abstract

With the growing population of older adults, nurses will need to address age-related cognitive declines. Evidence demonstrates that cognitive remediation training is effective in improving neuropsychological abilities in older adults, which can translate into improved functioning in instrumental activities of daily living. The future of cognitive remediation training will incorporate health promoting factors (e.g., sleep hygiene, physical exercise), which supports neuroplasticity and cognitive reserve. By approaching cognitive health holistically, the patient will be primed to receive the maximum benefit from cognitive remediation training. A model emphasizing this approach is provided as a didactic for nurses and other health professionals providing care to their older patients.

Habitual Sleep, Reasoning, and Processing Speed in Older Adults with Sleep Complaints

“…While the present study was quasi-experimental and cannot be used to both draw causal inferences, at least one study found that following behavioral sleep treatment, older poor sleepers who received treatment performed similarly to the good sleepers on reaction time tasks (Altena et al 2008a). Researchers have speculated that a holistic model for cognitive remediation training that takes into account other health promoting factors (e.g., sleep) may be needed for patients to fully benefit from remediation training (Vance et al 2010). Clearly, more research on sleep and cognition in older adults is warranted as is additional research examining the impact of behavioral and cognitive-behavioral treatments for insomnia singly as well as combined with cognitive remediation training on cognitive performance.…”

Relationship of Age to Impulsivity and Decision Making: A Baseline Secondary Analysis of a Behavioral Treatment Study in Stimulant Use Disorders

“…Next, providers may consider adding adjunctive treatments in a patient’s treatment plan to directly remediate the impaired cognitive domains (e.g., decision-making, executive function). Examples of adjunctive cognitively remediating treatments that have shown efficacy in addiction and other populations include pharmacological interventions 4–7 (e.g., cholinesterase inhibitors, nicotinic agonists) and non-pharmacological interventions 82–87 (e.g., computerized software, physical exercise). Finally, by capitalizing on unimpaired cognitive domains, treatment providers may modify their treatment approach to compensate for impaired cognitive domains.…”

Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada

“…These interviews discussed work-in-progress and design considerations for intervention research, an example of which is BTA. BTA, comprised of online and offline games and activities targeted for cognition, shows promise in helping people with cognitive impairment improve their function at specific tasks and activities (eg, remembering sequences, responding quickly) through repeated practise 20. BTA has been predominantly administered as an individual activity, such as software installed on a person’s home computer with clinic follow-up on progress.…”

“…Mindfulness-based stress reduction (MBSR) group therapy has decreased stress and anxiety, and improved coping for people with dementia 19. Computerised brain training activities (BTAs) have had similar benefit in middle-aged and older adults with HAND, but participants have requested emotional support (such as MBSR) to complement BTA 20. In the general population with dementia, a systematic review synthesis found that these group-based, multicomponent strategies improve global cognitive functioning and activities of daily living to a greater extent than a single-component therapy 21.…”