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

Abstract

ACKGROUND: Cognitive interventions have the potential to enhance cognition among healthy older adults. However, little attention has been paid to the effect of cognitive training (CT) on mood and activities of daily living (ADL). OBJECTIVES: To assess the effectiveness of a multicomponent CT using a training program of executive functions, attention, memory and visuospatial functions (TEAM-V Program) on cognition, mood and instrumental ADL. DESIGN: A randomized, single-blinded, treatment-as-usual controlled trial. SETTING: Geriatric clinic in Bangkok, Thailand. PARTICIPANTS: 77 nondemented community-dwelling older adults (mean age 65.7±4.3 years). INTERVENTION: The CT (TEAM-V) program or the treatment-as-usual controlled group. The TEAM-V intervention was conducted over 5 sessions, with a 2-week interval between each session. Of 77 participants randomized (n=40 the TEAM-V program; n=37 the control group). MEASUREMENTS: The Thai version of Montreal Cognitive Assessment (MoCA), The Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Thai version of Hospital Anxiety and Depression Scale (HADS) and The Chula ADL were used to assess at baseline, 6 months and 1 year. RESULTS: Compared with the control arm, the TEAM-V Program was associated with reducing anxiety (P = 0.004). Compared with the baseline, participants receiving the TEAM-V Program were associated with significantly improved general cognition (MoCA, P < 0.001), immediate recall (word recall task, P = 0.01), retrieval and retention of memory process (word recognition task, P = 0.01), attention (number cancellation part A, P < 0.001) and executive function (maze test, P = 0.02) at 1 year. No training effects on depression (P = 0.097) and IADL (P = 0.27) were detected. CONCLUSIONS: The TEAM-V Program was effective in reducing anxiety. Even though, the program did not significantly improve cognition, depression and ADL compared with the control group, global cognition, memory, attention and executive function improved in the intervention group compared with baseline. Further studies incorporating a larger sample size, longitudinal follow-up and higher-intensity CT should be conducted.

The Effectiveness of Multicomponent Intervention on Daily Functioning among the Community-Dwelling Elderly: A Systematic Review

“…Table 1 outlines the sample characteristics and methods of the six included studies [ 18 , 19 , 20 , 21 , 22 , 23 ]. Among the six articles, one was published in 2006, one in 2011, three in 2018, and one in 2020.…”

“…As a result of the methodological quality evaluation, only one article met all criteria in seven areas [ 21 ]. The details of the randomization of subjects were not mentioned in three articles, and they could not be determined [ 19 , 20 , 23 ]. The concealment of the assignment order was evaluated as a high risk of bias in one article, as participants were informed of the group assigned to them [ 22 ].…”

“…Blinding of outcome assessment was evaluated as high risk of bias, as the intervention staff adjusted the components according to the characteristics of the participants in one article [ 19 ]. In terms of incomplete outcome data, one article was evaluated to have a high risk of bias, as it did not mention the reasons of the participants for dropping out [ 23 ]. Selective reporting was evaluated as low risk of bias in all articles [ 18 , 19 , 20 , 21 , 22 , 23 ].…”

“…In terms of incomplete outcome data, one article was evaluated to have a high risk of bias, as it did not mention the reasons of the participants for dropping out [ 23 ]. Selective reporting was evaluated as low risk of bias in all articles [ 18 , 19 , 20 , 21 , 22 , 23 ]. As for other biases, two articles did not mention whether or not the protocol was registered, so it was not possible to judge their appropriateness [ 18 , 20 ].…”

The SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER): Study Design and Protocol

“…By contrast, the approach of combining multiple intervention components may have synergistic effects. However, multi-domain intervention studies have demonstrated mixed outcomes ( 8 – 12 ). The 3-year French Multidomain Alzheimer Preventive Trial (MAPT) compared the effect of 3 interventions on cognitive decline ( 9 ).…”