Effects of Computerized Updating and Inhibition Training in Older Adults: The ACTOP Three-Arm Randomized Double-Blind Controlled Trial

Abstract

Background: Working memory (WM) capacity declines with advancing age, which impacts the ability to carry out complex cognitive activities in everyday life. Updating and inhibition processes have been identified as some of the most critical attentional control processes of WM and are linked to age-related WM decline. The general aim of the Attentional Control Training in Older People (ACTOP) study was to perform a side-by-side comparison of updating and inhibition training to examine their respective efficacy and transfer in cognitively healthy older adults.Method: The study was a three-arm, double-blind, randomized controlled trial registered with the US National Institutes of Health clinical trials registry. Ninety older adults were randomly assigned to 12 half-hour sessions of updating (N-back type exercises), inhibition (Stroop-like exercises) computerized training or active control (general knowledge quiz game). A group of thirty younger adults completed all proximal and WM transfer tasks without training to assess age-related deficits prior to training and whether training reduces these deficits.Results: Piecewise mixed models show quick improvement of performance during training for both updating and inhibition training. During updating training, the progression was more pronounced for the most difficult (3-back) than for the least (1-back) difficult level until the ninth session. Updating and inhibition training groups improved performance on all proximal and WM transfer measures but these improvements did not differ from the active control group. Younger adults outperformed older ones on all transfer tasks prior to training. However, this was no longer the case following training for two transfer tasks regardless of the training group.Conclusion: The overall results from this study suggest that attentional control training is effective in improving updating and inhibition performance on training tasks. The optimal dose to achieve efficacy is ~9 half-hour sessions and the dose effect was related to difficulty level for updating training. Despite an overall improvement of older adults on all transfer tasks, neither updating nor inhibition training provided additional improvements in comparison with the active control condition. This suggests that the efficacy of process-based training does not directly affect transfer tasks.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03532113

Molecular and Brain Volume Changes Following Aerobic Exercise, Cognitive and Combined Training in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial

“…These findings suggest that engaging in a multimodal CCT for 45 min a day, 5 days a week for 12 weeks might increase the volume of the precuneus which has a fundamental role in cognition: it is highly involved in the integration of tasks, visuo-spatial imagery, episodic memory retrieval as well as self-referential processing ( Cavanna and Trimble, 2006 ). This result highlights current research challenges in this field since participants in the CCT group did not show significant changes in the cognitive assessments compared to the control group ( Roig-Coll et al, 2020 ) in accordance with other trials of cognitive training ( Boujut et al, 2020 ). The possible neuroprotective effects of a cognitive training program should be addressed by examining molecular, brain and cognitive markers given the challenge of detecting far transfer effects.…”

COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial

“…For the computerized cognitive training sessions, the following three tasks will be available: (1) dual-task training that requires participants to maintain and prepare for many response alternatives and to share attention between two concurrent tasks (i.e., Dual-task [ 32 ]), (2) inhibition training, which requires the participants to refrain from giving an automatic response (i.e., Stroop task [ 33 ]), and (3) working memory training, which asks participants to maintain and update information in working memory to recall items presented earlier (i.e., N-Back task [ 34 ]). Each cognitive task lasts approximately 15 min possesses its respective sets of visual stimuli (e.g., letters, numbers, symbols) and matching button symbols.…”

“…Participants will also complete a computerized assessment on their tablet or computer [ 32 ]. The computerized tasks include a dual-task [ 32 ], Stroop task [ 33 ], and N-back [ 34 ], all in trained and transfer versions (same tasks but with different stimuli) presented in a counterbalanced order between the participants via a Latin square procedure. Subcomponents of each task allow the dissociation of attentional control mechanisms from mere cognitive speed.…”

A Perspective on Implementation of Technology-Driven Exergames for Adults as Telerehabilitation Services

“…Exergames that train various cognitive domains are numerous, albeit under variable mobile circumstances. For example, while sitting with a tablet cognition can be trained, and a test battery can assess cognitive control ( Boujut et al, 2020 ). On the other hand cognitive impairment causes variation in the magnitude of cognitive-motor integration, which in turn causes variation in posture and spatial aspects of gait ( Mahoney and Verghese, 2020 ).…”