Memory training interventions for older adults: A meta-analysis

Gross, Alden L.; Parisi, Jeanine M.; Spira, Adam P.; Kueider‐Paisley, Alexandra; Ko, Jean Y.; Saczynski, Jane S.; Samus, Quincy M.; Rebok, George W.

doi:10.1080/13607863.2012.667783

Cited by 168 publications

(145 citation statements)

References 103 publications

(155 reference statements)

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“…CT improved cognition (13, 17, 18) for up to 5 years (19) which suggested CT delayed cognitive and functional decline (20). However, only two out of four studies on memory strategy training reported significant improvements (21,22). The other two studies concluded that improvements in memory were not attributable to CT because the improvements were not larger than those in an active control group (6,23).…”

Section: Introductionmentioning

confidence: 99%

Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature

Coyle

Traynor

Solowij

2015

The American Journal of Geriatric Psychiatry

205

138

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The aim of this study was to assess the efficacy of cognitive training, specifically computerized cognitive training (CCT) and virtual reality cognitive training (VRCT), programs for individuals living with mild cognitive impairment (MCI) or dementia and therefore at high risk of cognitive decline. After searching a range of academic databases (CINHAL, PSYCinfo, and Web of Science), the studies evaluated (N = 16) were categorized as CCT (N = 10), VRCT (N = 3), and multimodal interventions (N = 3). Effect sizes were calculated, but a meta-analysis was not possible because of the large variability of study design and outcome measures adopted. The cognitive domains of attention, executive function, and memory (visual and verbal) showed the most consistent improvements. The positive effects on psychological outcomes (N = 6) were significant reductions on depressive symptoms (N = 3) and anxiety (N = 2) and improved perceived use of memory strategy (N = 1). Assessments of activities of daily living demonstrated no significant improvements (N = 8). Follow-up studies (N = 5) demonstrated long-term improvements in cognitive and psychological outcomes (N = 3), and the intervention groups showed a plateau effect of cognitive functioning compared with the cognitive decline experienced by control groups (N = 2). CCT and VRCT were moderately effective in long-term improvement of cognition for those at high risk of cognitive decline. Total intervention time did not mediate efficacy. Future research needs to improve study design by including larger samples, longitudinal designs, and a greater range of outcome measures, including functional and quality of life measures, to assess the wider effect of cognitive training on individuals at high risk of cognitive decline.

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Section: Introductionmentioning

confidence: 99%

Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature

Coyle

Traynor

Solowij

2015

The American Journal of Geriatric Psychiatry

205

138

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“…Ten reviews including 7-35 studies assessed memory training strategies, [100][101][102][103][104][105][106][107][108][109] but two of these were updated in a later review. The research was largely laboratory based and contained mixed evidence of varying quality.…”

Section: Memorymentioning

confidence: 99%

“…Reviews suggested that for healthy persons and persons with mild cognitive impairment, memory training can improve the type of memory being trained but that this may not transfer to other types of memory, everyday activities or functioning. [100][101][102][103][104][105][106][107] Strategies to compensate for mild memory loss and targeting learning-specific information were therefore recommended.…”

Section: Memorymentioning

confidence: 99%

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Background Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. Objectives (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). Design Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. Intervention development Two systematic reviews (including systematic searches of 14 databases and registries, 1990–2016 and 1980–2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65–94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the ‘HomeHealth’ intervention in collaboration with older people and multidisciplinary stakeholders. ‘HomeHealth’ comprised 3–6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. Feasibility RCT Single-blind RCT, individually randomised to ‘HomeHealth’ or treatment as usual (TAU). Setting Community settings in London and Hertfordshire, UK. Participants A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. Main outcome measures Feasibility – recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. Results We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire –3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. Conclusions Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. Future work A large, definitive RCT of the HomeHealth service is warranted. Study registration This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.

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“…Meta-analyses summarizing this research have shown that these interventions induce small to medium performance gains in the trained tasks (Gross et al, 2012;Verhaeghen, Marcoen, & Goossens, 1992). However, often only subgroups of the trained older adults apply the practiced strategies after training (e.g., Brehmer et al, 2008;Gross et al, 2014;Nyberg et al, 2003).…”

Section: Transfer After Process-based Object-location Memory Trainingmentioning

confidence: 99%

Transfer after process-based object-location memory training in healthy older adults.

Zimmermann¹,

Bastian²,

Röcke³

et al. 2016

Psychology and Aging

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A substantial part of age-related episodic memory decline has been attributed to the decreasing ability of older adults to encode and retrieve associations among simultaneously processed information units from long-term memory. In addition, this ability seems to share unique variance with reasoning. In this study, we therefore examined whether process-based training of the ability to learn and remember associations has the potential to induce transfer effects to untrained episodic memory and reasoning tasks in healthy older adults (60–75 years). For this purpose, the experimental group (n = 36) completed 30 sessions of process-based object-location memory training, while the active control group (n = 31) practiced visual perception on the same material. Near (spatial episodic memory), intermediate (verbal episodic memory), and far transfer effects (reasoning) were each assessed with multiple tasks at four measurements (before, midway through, immediately after, and 4 months after training). Linear mixed-effects models revealed transfer effects on spatial episodic memory and reasoning that were still observed 4 months after training. These results provide first empirical evidence that process-based training can enhance healthy older adults’ associative memory performance and positively affect untrained episodic memory and reasoning abilities.

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Memory training interventions for older adults: A meta-analysis

Cited by 168 publications

References 103 publications

Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature

Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Transfer after process-based object-location memory training in healthy older adults.

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