A Study To Explore The Efficacy Of Graded Cognitive Training Among Elderly Individuals With Mild Cognitive Impairment -A Randomized Controlled Trial
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Abstract
Study Design-Experimental Design
Aim- To find the efficacy of graded cognitive training among elderly individuals with mild cognitive impairment.
Objective- To Improve the cognitive impairment, ADL and quality of life.
Participants-113 subjects aged ≧60 years in the baseline survey, and 102 subjects with MCI who participated in the baseline survey.
Methods- A randomized control trial was conducted on 102 patients with mild cognitive impairment (MCI) from Apna ghar Ashram and Apni Sanskriti Charitable Foundation, Noida and shelter home in Ghaziabad. The total sample was randomly divided into two equal groups. Experimental group (N = 51) male=37, female=14 and a control group (N = 51) male=35, female=16. The control group was provided cognitive training, and the experimental group was administered graded cognitive training.
Results-After the intervention, the Experiment group shows a significantly higher mean cognitive score (25.59) compared to the Control group (21.37) (p
= 0.001). The Experiment group shows a significant decrease in basic daily living activity scores post-intervention (29.57) compared to the Control group (37.73) (p = 0.001). Bristol activity of daily living (BADL) shows higher the score lowers the performance. Therefore, the activity of daily living improves after the 2 months of intervention. Post-intervention, the Experiment group shows a significantly higher mean quality of life score (63.02) compared to the Control group (49.44) (p = 0.001). Statistical test revealed a significant effect of the interaction between time and cognitive training on the total MOCA score.
Conclusion- Fifty-one participants in the experimental group improved to normal levels, and no participants progressed to dementia after two months of graded cognitive training. Thus, the efficacy of the intervention was statistically significant. The graded cognitive training intervention is effective and may help to decrease the deterioration of cognitive function, improve ADL and quality of life in patients with MCI, and the interaction between intervention time and graded cognitive training significantly improves cognitive function, ADL and quality of life.
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References
Petersen, R. C. (2011). Mild cognitive impairment. New England Journal of Medicine, 364(23), 2227- 2234.
Ward, A., Tardiff, S., Dye, C., & Arrighi, H. M. (2013). Rate of conversion from prodromal Alzheimer's disease to Alzheimer's dementia: a systematic review of the literature. Dementia and Geriatric Cognitive Disorders Extra, 3(1), 320-332.
Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., Marsiske, M., ... & Willis, S. L. (2002). Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA, 288(18), 2271-2281.
Tardif, S., & Simard, M. (2011). Cognitive stimulation programs in healthy elderly: A review. International Journal of Alzheimer's Disease, 2011, 378934.
Gates, N. J., & Valenzuela, M. (2010). Cognitive exercise and its role in cognitive function in older adults. Current Psychiatry Reports, 12(1), 20-27.
Reijnders, J., van Heugten, C., & van Boxtel, M. (2013). Cognitive interventions in healthy older adults
and people with mild cognitive impairment: a systematic review. Ageing Research Reviews, 12(1), 263- 275.
Peng Z, Jiang H, Wang X, Huang K, Zuo Y, Wu X, Abdullah AS, Yang L. The Efficacy of Cognitive Training for Elderly Chinese Individuals with Mild Cognitive Impairment. Biomed Res Int. 2019 Nov 30;2019:4347281.
Giuli C, Papa R, Lattanzio F, Postacchini D. The Effects of Cognitive Training for Elderly: Results from My Mind Project. Rejuvenation Res. 2016 Dec;19(6):485-494.
Murman DL. The Impact of Age on Cognition. Semin Hear. 2015 Aug;36(3):111-21.
Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92
Logsdon RG, McCurry SM, Teri L. Evidence-Based Interventions to Improve Quality of Life for Individuals with Dementia. Alzheimer’s care today. 2007;8(4):309-318.
Rosenberg PB, Lyketsos C. Mild cognitive impairment: searching for the prodrome of Alzheimer's disease. World Psychiatry. 2008;7(2):72-8.
Dunlay SM, Chamberlain AM. Multimorbidity in Older Patients with Cardiovascular Disease. Curr Cardiovasc Risk Rep. 2016 Jan;10:3.
Marino FR, Jiang K, Smith JR, Chen D, Tzuang M, Reed NS, Swenor BK, Deal JA, Rebok GW, Huang A. Inclusion of hearing and vision impairments in cognitive training interventions. Alzheimers Dement (N Y). 2023 Feb 20;9(1):e12374.
Cardona M, Andrés P. Are social isolation and loneliness associated with cognitive decline in ageing? Front Aging Neurosci. 2023 Feb 23;15:1075563.
Mandolesi L, Polverino A, Montuori S, Foti F, Ferraioli G, Sorrentino P, Sorrentino G. Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits. Front Psychol. 2018 Apr 27;9:509.
Sue S, Zane N, Nagayama Hall GC, Berger LK. The case for cultural competency in psychotherapeutic interventions. Annu Rev Psychol. 2009;60:525-48.
Barman A, Chatterjee A, Bhide R. Cognitive Impairment and Rehabilitation Strategies After Traumatic Brain Injury. Indian J Psychol Med. 2016 May-Jun;38(3):172-81.
Gomez-Soria I, Peralta-Marrupe P, Plo F. Cognitive stimulation program in mild cognitive impairment A randomized controlled trial. Dement Neuropsychol. 2020 Apr- Jun;14(2):110-117.
Al-Qazzaz NK, Ali SH, Ahmad SA, Islam S, Mohamad K. Cognitive impairment and memory dysfunction after a stroke diagnosis: a post-stroke memory assessment. Neuropsychiatr Dis Treat. 2014 Sep 9;10:1677-91.
Gates NJ, Rutjes AW, Di Nisio M, Karim S, Chong LY, March E, Martínez G, Vernooij RW. Computerised cognitive training for maintaining cognitive function in cognitively healthy people in late life. Cochrane Database Syst Rev. 2019 Mar 13;3(3):CD012277.
Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E; ACTIVE Study Group. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006 Dec 20;296(23):2805-14.
Ruthirakuhan M, Luedke AC, Tam A, Goel A, Kurji A, Garcia A. Use of physical and intellectual activities and socialization in the management of cognitive decline of aging and in dementia: a review. J Aging Res. 2012;2012:384875
Liebzeit D, Kuo WC, Carlson B, Mueller K, Koscik RL, Smith M, Johnson S, Bratzke L. Relationship of Cognitive and Social Engagement to Health and Psychological Outcomes in Community-Dwelling Older Adults. Nurs Res. 2022 Jul-Aug 01;71(4):295-302.
Irazoki E, Contreras-Somoza LM, Toribio-Guzmán JM, Jenaro-Río C, van der Roest H, Franco-Martín MA. Technologies for Cognitive Training and Cognitive Rehabilitation for People With Mild Cognitive Impairment and Dementia. A Systematic Review. Front Psychol. 2020 Apr 9;11:648.
Gillis C, Mirzaei F, Potashman M, Ikram MA, Maserejian N. The incidence of mild cognitive impairment: A systematic review and data synthesis. Alzheimers Dement (Amst). 2019 Mar 8;11:248- 256.
Hwang HR, Choi SH, Yoon DH, Yoon BN, Suh YJ, Lee D, Han IT, Hong CG. The effect of cognitive training in patients with mild cognitive impairment and early Alzheimer's disease: a preliminary study. J Clin Neurol. 2012 Sep;8(3):190-7.
Iype T, Babu V, Sreelakshmi PR, Alapatt PJ, Rajan R, Soman B. The Prevalence of Mild Cognitive Impairment (Mci) among Older Population of Rural Kerala: A Cross-Sectional Study. Neurol India. 2023 Mar-Apr;71(2):296-300.
Ziegler DA, Anguera JA, Gallen CL, Hsu WY, Wais PE, Gazzaley A. Leveraging technology to personalize cognitive enhancement methods in aging. Nat Aging. 2022 Jun;2(6):475-483
Xue G, Chen C, Lu ZL, Dong Q. Brain Imaging Techniques and Their Applications in Decision-Making Research. Xin Li Xue Bao. 2010 Feb 3;42(1):120-137.
Javvaji CK, Reddy H, Vagha JD, Taksande A, Kommareddy A, Reddy NS. Immersive Innovations: Exploring the Diverse Applications of Virtual Reality (VR) in Healthcare. Cureus. 2024 Mar 14;16(3):e56137.
Zhao X, Ji C, Zhang C, Huang C, Zhou Y, Wang L. Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial. BMC Psychiatry. 2023 Jun 12;23(1):418.
Peng Z, Jiang H, Wang X, Huang K, Zuo Y, Wu X, Abdullah AS, Yang L. The Efficacy of Cognitive Training for Elderly Chinese Individuals with Mild Cognitive Impairment. Biomed Res Int. 2019 Nov 30;2019:4347281.
Sridhar S, Khamaj A, Asthana MK. Cognitive neuroscience perspective on memory: overview and summary. Front Hum Neurosci. 2023 Jul 26;17:1217093.
Morris JC, Storandt M, Miller JP, McKeel DW, Price JL, Rubin EH, Berg L. Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol. 2001 Mar;58(3):397-405.
Rieker JA, Reales JM, Muiños M, Ballesteros S. The Effects of Combined Cognitive- Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis. Front Hum Neurosci. 2022 Mar 24;16:838968.
Ottis P, Koppe K, Onisko B, Dynin I, Arzberger T, Kretzschmar H, Requena JR, Silva CJ, Huston JP, Korth C. Human and rat brain lipofuscin proteome. Proteomics. 2012 Aug;12(15-16):2445-54.
Clewett DV, Lee TH, Greening S, Ponzio A, Margalit E, Mather M. Neuromelanin marks the spot: identifying a locus coeruleus biomarker of cognitive reserve in healthy aging. Neurobiology of aging. 2016 Jan 1;37:117-26.
Chen JJ, Rosas HD, Salat DH. Age-associated reductions in cerebral blood flow are independent from regional atrophy. Neuroimage. 2011 Mar 15;55(2):468-78.
Montagne A, Barnes SR, Sweeney MD, Halliday MR, Sagare AP, Zhao Z, Toga AW, Jacobs RE, Liu CY, Amezcua L, Harrington MG. Blood-brain barrier breakdown in the aging human hippocampus. Neuron. 2015 Jan 21;85(2):296-302.
Mather M. The affective neuroscience of aging. Annual review of psychology. 2016 Jan 4;67.
Fenn AM, Norden DM, Godbout JP. Neuroinflammation in Aging. Neuroinflammation. 2015Mar10:87- 105.
Minhas PS, Latif-Hernandez A, McReynolds MR, Durairaj AS, Wang Q, Rubin A, Joshi AU, He JQ, Gauba E, Liu L, Wang C. Restoring metabolism of myeloid cells reverses cognitive decline in ageing. Nature. 2021 Feb;590(7844):122-8.
Mani Abdul Karim, Jonnadula Venkatachalam. (2023). Feasibility and Efficacy of a Newly Adapted Multimodal Cognitive Intervention for the Elderly with Mild Cognitive Impairment. Qeios.
Stypulkowski K, Anquillare E, Twamley EW, Thayer RE. Feasibility of a Telehealth Compensatory Cognitive Training Program for Older Adults with Mild Cognitive Impairment. Clin Gerontol. 2024 Jan-Dec;47(1):17-25.
Jones KT, Ostrand AE, Gazzaley A, Zanto TP. Enhancing cognitive control in amnestic mild cognitive impairment via at-home non-invasive neuromodulation in a randomized trial. Sci Rep. 2023 May 8;13(1):7435.
Tran T, Donnelly C, Nalder E, Trothen T, Finlayson M. Mindfulness-based stress reduction for community-dwelling older adults with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in primary care: a mixed-methods feasibility randomized control trial. BMC Prim Care. 2023 Feb 9;24(1):44.
Sanghuachang W, Hengudomsub P, Chaimongkol N, Kotchabhakdi N. Effectiveness of neurobic exercise program on memory performance in community-dwelling older adults with mild cognitive impairment: A randomized controlled crossover trial. Belitung NursJ. 2023 Apr 18;9(2):100-109.
Granland KA, Thompson CL, Dong Y. "Train Your Brain" Cognitive Intervention Group Program for Singaporean Older Adult Patients With Mild Cognitive Impairment: A Pilot Feasibility Study. J Geriatr Psychiatry Neurol. 2022 May;35(3):442-449.
Christogianni, A., Kartheka Bojan, Elizabeta B. Mukaetova-Ladinska, VT. Sriramm, G. Murth, & Gopukumar Kumarpilla. (2022). Attention and Motor skill improvements in Mild Cognitive Impairment patients using COSMA Application . International Journal of Serious Games, 9(4), 25–42
Eun SJ, Kim EJ, Kim JY. Development and Evaluation of an Artificial Intelligence-Based Cognitive Exercise Game: A Pilot Study. J Environ Public Health. 2022 Sep 27;2022:4403976.
Han C, Sun W, Zhang D, Xi X, Zhang R, Gong W. Effects of different aerobic exercises on the global cognitive function of the elderly with mild cognitive impairment: a meta- analysis. BMJ Open. 2023 Jun 30;13(6):e067293.
Srisuwan P, Nakawiro D, Chansirikarnjana S, Kuha O, Chaikongthong P, SuwannagootT. Effects of a Group-Based 8-Week Multicomponent Cognitive Training on Cognition, Mood and Activities of Daily Living among Healthy Older Adults: A One-Year Follow- Up of a Randomized Controlled Trial. J Prev Alzheimers Dis. 2020;7(2):112-121.
Bajwa RK, Goldberg SE, Van der Wardt V, Burgon C, Di Lorito C, Godfrey M, Dunlop M, Logan P, Masud T, Gladman J, Smith H, Hood-Moore V, Booth V, Das Nair R, Pollock K, Vedhara K, Edwards RT, Jones C, Hoare Z, Brand A, Harwood RH. A randomised controlled trial of an exercise intervention promoting activity, independence and stability in older adults with mild cognitive impairment and early dementia (PrAISED) - A Protocol. Trials. 2019 Dec 30;20(1):815.
Law LLF, Mok VCT, Yau MMK. Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial. Alzheimers Res Ther. 2019 Dec 4;11(1):98.
Kallio EL, Öhman H, Hietanen M, Soini H, Strandberg TE, Kautiainen H, Pitkälä KH. Effects of Cognitive Training on Cognition and Quality of Life of Older Persons with Dementia. J Am Geriatr Soc. 2018 Apr;66(4):664-670
Lipardo DS, Tsang WWN. Falls prevention through physical and cognitive training (falls PACT) in older adults with mild cognitive impairment: a randomized controlled trial protocol. BMC Geriatr. 2018 Aug 24;18(1):193.
Young KW, Ng P, Kwok T, Cheng D. The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial. Clin Interv Aging. 2017 Sep 25;12:1543-1552.
Chang CF, Yang RJ, Chang SF, Chou YH, Huang EW. The Effects of Quality of Life and Ability to Perform Activities of Daily Living on Mild Cognitive Impairment in Older People Living in Publicly Managed Congregate Housing. J Nurs Res. 2017 Jun;25(3):187- 197.
Barban F, Annicchiarico R, Pantelopoulos S, Federici A, Perri R, Fadda L, Carlesimo GA, Ricci C, Giuli S, Scalici F, Turchetta CS, Adriano F, Lombardi MG, Zaccarelli C, Cirillo G, Passuti S, Mattarelli P, Lymperopoulou O, Sakka P, Ntanasi E, Moliner R, Garcia- Palacios A, Caltagirone C. Protecting cognition from aging and Alzheimer's disease: a computerized cognitive training combined with reminiscence therapy. Int J Geriatr Psychiatry. 2016 Apr;31(4):340-8.
Fiatarone Singh MA, Gates N, Saigal N, Wilson GC, Meiklejohn J, Brodaty H, Wen W, Singh N, Baune BT, Suo C, Baker MK, Foroughi N, Wang Y, Sachdev PS, Valenzuela M. The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc. 2014 Dec;15(12):873-80.
Olchik MR, Farina J, Steibel N, Teixeira AR, Yassuda MS. Memory training (MT) in mild cognitive impairment (MCI) generates change in cognitive performance. Arch Gerontol Geriatr. 2013 May- Jun;56(3):442-7
Bucks RS, Haworth J. Bristol Activities of Daily Living Scale: a critical evaluation. Expert Rev Neurother. 2002 Sep;2(5):669-76.
Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998 May;28(3):551-8.