Repetition-lag training to improve recollection memory in older people with amnestic mild cognitive impairment. A randomized controlled trial

Abstract

The results of a randomized controlled trial of repetition-lag training in older adults with amnestic mild cognitive impairment (aMCI) are reported. A modified repetition-lag training procedure with extended encoding time and strategy choice was used. The training required discriminating studied words from non-studied lures that were repeated at varying intervals during the test phase. Participants were assessed pre/post using untrained measures of cognition and self-report questionnaires. Primary outcome measures were recall of unrelated word pairs both immediately following presentation and following a delay. Secondary outcomes were a measure of attention, cognitive flexibility, and visual working memory. Participants were also asked to report on the frequency of cognitive failures and mood before and after training. Participants (N = 31) were randomized into either the treatment or a no-contact control group and attended the clinic twice per week over a four week period. Twenty-four participants completed the study (twelve in each group). Results indicated that the training group improved at recalling unrelated word pairs after a delay. There were no significant effects of training on other outcomes, self-reported cognitive failures or mood. The results are discussed along with suggestions for future research.

The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures

“… Fiatarone Singh et al ( 2014 ) RCT, double-blind, active control n = 100 Tx n = 24 Cntl = 27 Age: = 70.1 s = 6.7 • 4–45 min exercises (initial/ group setting); then 45 min sessions, 2 days per week for 24 weeks • CT computer-based multicomponent and multi-domain compensatory training in memory, executive functions, attention, and speed of information processing (COGPACK) ADAS-Cog; MMSE; GP-Cog; CDR; Matrices, Similarities, TMT A & B, LM Iⅈ BVMT-R; SDMT; Semantic Fluency, COWAT, MARS-MF • ADAS-Cog scores: No differences between CT and sham cognitive training • CT group demonstrated modest non-significant changes as compared to controls across cognitive domains • CT group maintained memory ability, no significant improvement or decline • CT reported to attenuate decline in memory • There was no significant change in cognitive outcomes between CT and sham training in global cognition, executive functions, memory, or speed 2.035 7. Finn and McDonald ( 2011 ) RCT, single-blind, inactive control n = 16 (MCI-SD/MD) Tx = 8 Cntl = 8 Age: Tx: = 69.00 s = 7.69 Cntl; = 76.38 s = 6.47 • 30 sessions, 11.43 weeks/ completion • Computer-based restorative training program involving attention, processing speed, visual memory, cognitive control (LUMOSITY) 1° - CANTAB, RVP A, PAL, IED 2° - MFQ, DASS-21 • Significant CANTAB tests: main effect of group - attentional set shifting, visual learning, visual working memory F (2, 14) = 0.35, 1.17, and 3.55, respectively • ↑ in visual sustained attention treatment (pre/ post difference RVPA’ = .03) compared with waitlist ctrl (pre/ post difference RVPA’ = − .06) • No significant data on self-reported memory functioning and perceptions of control over memory • ↑ in performance on visual sustained attention compared to waitlist controls • No significant changes on other primary outcome measures • MCI patients can ↑ performance significantly when given repeated practice on computerized cognitive exercises but study did not translate to secondary measures −1.401 8. Finn and McDonald ( 2015 ) RCT, inactive control n = 24 (aMCI) Tx = 12 Cntl = 12 Age: Tx: = 72.83 s = 5.7 Cntl; = 75.08 s = 7.5 • 6 sessions over several weeks (plus one practice session).…”

Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

“…Hours of contact could be calculated in 12 of the 14 studies (excludes Finn and McDonald 2015; Rojas et al 2013), ranging from 4.5 (Jean et al 2010b) to 156 h (Lam et al 2015). Excluding Lam et al as an outlier, studies averaged 15.5 h of intervention (SD = 10.1).…”

“…The majority of the therapist-based intervention studies (11/14) utilized a group setting for their intervention, only three studies (Finn and McDonald 2015; Greenaway et al 2013; Jean et al 2010b) had solely individual sessions. Nakatsuka et al (2015) had both group and in-home individual sessions.…”

“…Nakatsuka et al (2015) had both group and in-home individual sessions. In terms of the therapy content, two studies focused exclusively on one specific type of learning strategy: repetition lag training (Finn and McDonald 2015) or errorless learning (Jean et al 2010b). One study focused exclusively on training of an external memory (calendar) aid (Greenaway et al 2013).…”

State of the science on mild cognitive impairment (MCI)

“…107,108 Likewise, trials of memory recollection training have shown limited generalization. 109,110 These latter efforts indicate that restorative approaches, attempting to retrain specific cognitive processes, may be less effective cognitive rehabilitation approaches than compensatory approaches such as memory strategy training.…”