ObjectiveTo summarise evidence on the preventive effects of continuing education on mild cognitive impairment and Alzheimer’s-type dementia in adults 45 years or older.DesignSystematic review and overview of systematic reviews.Data sourcesWe systematically searched MEDLINE, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Scopus for published studies and grey literature databases for unpublished studies from January 1990 to April 2018.MethodsTo assess evidence directly addressing our objectives, we conducted a systematic review. Because we were aware of a dearth of direct evidence, we also performed an overview of systematic reviews on leisure activities that mimic formal continuing education. We a priori established the inclusion and exclusion criteria. Two authors independently assessed inclusion and exclusion at the abstract and full-text level, rated the risk of bias, and determined the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation. We resolved all discrepancies by consensus. We synthesised the available evidence narratively.ResultsOur searches identified 4933 citations. For the systematic review, only two publications on the same prospective cohort study (Tasmanian Healthy Brain Project) met the inclusion criteria; for the overview of reviews, we included five systematic reviews. Based on 459 participants, preliminary data of the ongoing cohort study indicated that cognitive reserve statistically significantly increased in persons attending university classes compared with the control group (92.5% vs 55.7%, p<0.01). Likewise, language processing capacities statistically significantly improved (p<0.01). Episodic memory, working memory and executive function did not differ significantly between groups. Systematic reviews consistently reported a positive association between participation in cognitively stimulating leisure activities and reduced incidence of dementia and improved cognitive test performance.ConclusionAvailable results demonstrate that cognitive reserve increases through continuing education and show a positive association of cognitive leisure activities with both improved cognitive function and lower dementia incidence.PROSPERO registration numberCRD42017063944.

BackgroundBecause of the enormous social and economic burden of disease, the prevention of mild cognitive impairment and Alzheimer’s-type dementia has become a major global public health priority. Studies show that cognitively stimulating activities during middle adulthood might have a protective effect on the brain by boosting the cognitive reserve. The aim of this review is to identify evidence investigating the effects of continuing education for the prevention of mild cognitive impairment and Alzheimer’s-type dementia in late life.MethodsOur approach employs a two-stage design: First, we will conduct a systematic review to assess the preventive effects of continuing education on mild cognitive impairment and Alzheimer’s-type dementia. Second, because we expect to find few studies, we will perform a review of systematic reviews on leisure activities that mimic formal continuing education to determine their effects on the prevention of mild cognitive impairment and Alzheimer’s-type dementia. We will search electronic databases (e.g., MEDLINE, PsycINFO, EMBASE, CENTRAL, CINAHL, and Scopus) for published studies and gray literature databases (e.g., trial registries) for unpublished studies.Two authors will independently screen abstracts and full-texts using pre-defined eligibility criteria, select studies, extract data, and assess the quality of included studies or reviews. Outcomes of interest include the incidence of mild cognitive impairment or Alzheimer’s-type dementia, quality of life, functional capacity, and psychological wellbeing. Intermediate outcomes are cognitive (test) performance, cognitive functioning, and social inclusion. The review team is a multidisciplinary group consisting of methodological experts and dementia, geriatrics, and continuing education researchers.DiscussionWe anticipate that our review will highlight serious gaps in the current evidence. Results will build the basis for further research regarding the relation of continuing education and cognitive decline and dementia.Systematic review registrationPROSPERO CRD42017063944 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0553-0) contains supplementary material, which is available to authorized users.

Since the outbreak of the COVID-19 pandemic in 2020, digital technologies for distance learning have been used in educational institutions worldwide, raising issues about social implications, technological development, and teaching and learning strategies. While disparities regarding access to technical equipment and the internet (‘the digital divide’) have been the subject of previous research, the physical learning environment of learners participating in online learning activities has hardly been investigated. In this study, the physical-spatial conditions of learning environments, including technical equipment for distance learning activities and their influence on adult learners in academic continuing education during initial COVID-19 restrictions, were examined. Data were collected with an online survey sent to all students enrolled in an Austrian continuing education university, together with a small number of semi-structured interviews. A total of 257 students participated in the survey during the 2020 summer semester. Our findings provide insights in two infrequently-studied areas in learning environment research: the physical learning environment for online learning and the learning environment in academic continuing education. The study illustrates that students in academic continuing education have spacious living conditions and almost all the equipment necessary for digitally-supported learning. According to gender and household structure, significant differences were found regarding technical equipment, ergonomic furniture and availability of a dedicated learning place. In their learning sessions during the restrictions, students reported low stress levels and positive well-being. The more that they perceived that their physical learning environment was meeting their needs, the higher were their motivation and well-being and the lower was their stress. Their learning experience was further improved by the extent to which they had a separate and fixed learning place that did not need to be coordinated or shared with others. The study contributes to the literature on creating conducive learning environments for digitally-supported online learning for adult learners.

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When the COVID-19 pandemic forced higher education institutions to implement their programs in an online setting, different groups of students were influenced to different extents. In many cases, the main locus of learning moved to students' homes, and their learning experiences were suddenly contextualized in their residential situation and immediate physical learning environment. The present study consequently examines the role of physical learning environments on different factors influencing students’ learning when pursuing their study from at home. It contrasts the situation of traditional students in a higher education institution and non-traditional students in an academic continuing education institution, which address target groups with different living conditions and needs in learning support. Data were collected via an online survey sent to students enrolled in these two institutions, with a total of 353 students participating during a timeframe impacted by COVID-related lockdowns. We found that stress and well-being is strongly linked to the quality of the surrounding environment of the learning place, whereas perceived motivation is more strongly related to the quality of the learning place itself. How strongly students are affected by these factors is moderated by their overall socio-spatial context. Academic continuing education students are more resilient to sub-optimal physical learning environment than traditional students. Altering the design of the immediate learning environment consequently can help to mitigate factors that negatively impact students’ well-being and learning motivation, which is particularly important for traditional students, who primarily dedicate their time to pursuing their studies.

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