Exercising the Brain to Avoid Cognitive Decline

Examining the Evidence

William E Reichman; Alexandra J Fiocco; Nathan S Rose

Disclosures

Aging Health. 2010;6(5):565-584. 

In This Article

Cognitive Training Interventions in MCI

Kurz and colleagues explored the benefits of a multicomponent cognitive rehabilitation program in patients with MCI.[53] Their study included two active intervention groups composed of 18 patients with MCI and ten patients meeting clinical criteria for mild AD, and 12 MCI patients allocated to a waiting list control condition. Both intervention groups participated in a 4-week group format cognitive training regimen that included activity planning, training in self-assertiveness, stress management, relaxation techniques and the use of external memory aids, memory training and physical exercise. The investigators reported that after four weeks, MCI participants demonstrated significant improvements on IADL, verbal and nonverbal episodic recall and mood. However, participants with mild AD seemed to gain no measurable benefits from the program other than an improvement in verbal memory, which failed to reach statistical significance. The MCI control participants demonstrated a significant retest effect on verbal episodic memory, but no other significant changes. It is promising that individuals with MCI showed some response to the training program, but owing to the multiple factors that were trained, it is difficult to differentiate between types of training that were beneficial and those that were not.

Troyer and colleagues conducted a randomized controlled trial to evaluate the effectiveness of a multidisciplinary group-based intervention program designed to change everyday 'memory behavior' in participants with a MCI.[54] The active intervention consisted of evidence-based memory training techniques and lifestyle education consisting of ten 2-h small group sessions conducted over 6 months. The investigators reported that the active intervention group demonstrated an increase in memory-strategy knowledge and use from pretest to immediate post-test, and these gains were maintained at 3-months post-test, relative to wait-list controls. Notably, there were no group differences in memory beliefs or on neuropsychological test measures of objective memory performance. The authors concluded that individuals with MCI can acquire and maintain knowledge about memory strategies and can alter their daily memory behavior by applying this knowledge into everyday functioning.

Belleville and collaborators reported on the efficacy of cognitive training in participants with MCI and individuals with 'normal cognitive aging'.[55] The intervention consisted of teaching the participants strategies to improve episodic memory. Three tasks of episodic memory (list recall, face–name association and text memory) were used as primary outcome measures. The authors reported that, relative to a wait-list control condition, the intervention effect (pre- and post-intervention difference) was significant on two of the three primary outcome memory performance measures (delayed list recall and face-name association). A significant pre-post effect was also found on measures of subjective memory and well-being. There was no improvement in the performance of either individuals with MCI or normal elderly people who were randomized to the wait-list condition. The investigators concluded that the results of this study suggest that individuals with MCI can improve their performance on episodic memory when provided with structured cognitive training.

In summary, in all three studies that enlisted individuals with MCI into a cognitive training intervention, participants benefited from the treatment in some way, including improvements in near transfer tasks (e.g., recall of lists or face–name associations) to domains as far reaching as activities of daily living and subjective measures of memory, mood and overall well-being. Although these studies suggest enhancement effects, longitudinal studies are required to determine whether interventions prevent or slow the progression to AD.

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