A Novel BrainHealth Index Prototype Improved by Telehealth-Delivered Training During COVID-19.

Introduction: Brain health is neglected in public health, receiving attention after something goes wrong. Neuroplasticity research illustrates that preventive steps strengthen the brain's component systems; however, this information is not widely known. Actionable steps are needed to scale proven population-level interventions. Objectives: This pilot tested two main objectives: (1) the feasibility/ease of use of an online platform to measure brain health, deliver training, and offer virtual coaching to healthy adults and (2) to develop a data driven index of brain health. Methods: 180 participants, ages 18-87, enrolled in this 12-week pilot. Participants took a BrainHealth Index™ (BHI), a composite of assessments encompassing cognition, well-being, daily-life and social, pre-post training. Participants engaged in online training with three coaching sessions. We assessed changes in BHI, effects of training utilization and demographics, contributions of sub-domain measures to the BHI and development of a factor analytic structure of latent BrainHealth constructs. Results: The results indicated that 75% of participants showed at least a 5-point gain on their BHI which did not depend on age, education, or gender. The contribution to these gains were from all sub-domains, including stress, anxiety and resilience, even though training focused largely on cognition. Some individuals improved due to increased resilience and decreased anxiety, whereas others improved due to increased innovation and social engagement. Larger gains depended on module utilization, especially strategy training. An exploratory factor analytic solution to the correlation matrix of online assessments identified three latent constructs. Discussion/Conclusion: This pilot study demonstrated the efficacy of an online platform to assess changes on a composite BrainHealth Index and efficacy in delivering training modules and coaching. We found that adults, college age to late life, were motivated to learn about their brain and engage in virtual-training with coaching to improve their brain health. This effort intends to scale up to thousands, thus the pilot data, tested by an impending imaging pilot, will be utilized in ongoing machine learning (ML) algorithms to develop a precision brain health model. This pilot is a first step in scaling evidence-based brain health protocols to reach individuals and positively affect public health globally.

Influential Cognitive Processes on Framing Biases in Aging.

Factors that contribute to overcoming decision-making biases in later life pose an important investigational question given the increasing older adult population. Limited empirical evidence exists and the literature remains equivocal of whether increasing age is associated with elevated susceptibility to decision-making biases such as framing effects. Research into the individual differences contributing to decision-making ability may offer better understanding of the influence of age in decision-making ability. Changes in cognition underlying decision-making have been shown with increased age and may contribute to individual variability in decision-making abilities. This study had three aims; (1) to understand the influence of age on susceptibility to decision-making biases as measured by framing effects across a large, continuous age range; (2) to examine influence of cognitive abilities that change with age; and (3) to understand the influence of individual factors such as gender and education on susceptibility to framing effects. 200 individuals (28-79 years of age) were tested on a large battery of cognitive measures in the domains of executive function, memory and complex attention. Findings from this study demonstrated that cognitive abilities such as strategic control and delayed memory better predicted susceptibility to framing biases than age. The current findings demonstrate that age may not be as influential a factor in decision-making as cognitive ability and cognitive reserve. These findings motivate future studies to better characterize cognitive ability to determine decision-making susceptibilities in aging populations.

Enhancing latent cognitive capacity in mild cognitive impairment with gist reasoning training: a pilot study.

OBJECTIVE: Cognitive training offers a promising way to mitigate cognitive deterioration in individuals with mild cognitive impairment (MCI). This randomized control pilot trial examined the effects of Gist Reasoning Training on cognition as compared with a training involving New Learning in a well-characterized MCI group. METHODS: Fifty participants with amnestic MCI were randomly assigned to the experimental Gist Training group or an active control New Learning group. Both groups received 8 h of training over a 4-week period. We compared pre-training with post-training changes in cognitive functions between the two training groups. RESULTS: The Gist Training group showed higher performance in executive function (strategic control and concept abstraction) and memory span compared with the New Learning group. Conversely, the New Learning group showed gains in memory for details. CONCLUSION: These findings suggest that cognitive training in general yields benefits, and more specifically, training programs that target top-down cognitive functions such as gist reasoning may have a broad impact on improving cognition in MCI. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

Enhancing Executive Function and Neural Health in Bipolar Disorder through Reasoning Training.

Cognitive deficits in executive function and memory among individuals with bipolar disorder (BD) are well-documented; however, only recently have efforts begun to address whether such cognitive deficits can be ameliorated through cognitive training. This pilot study examined the effects of a top-down, cognitive reasoning training program in adults with BD on both brain and cognitive measures. Twenty-seven participants (11 males, 16 females), aged 21-70 years old, completed the study. Participants completed neurocognitive testing and functional magnetic resonance imaging (fMRI) before and after training, consisting of 8 h (2 h/week) of training in small groups. The training delivered information processing strategies that were implemented and applicable to a variety of daily living contexts. Results indicated that participants showed significant gains in the primary outcome measure of complex abstraction, also referred to as gist reasoning, as well as in untrained domains of executive function and memory. We found a significant increase in resting cerebral blood flow (CBF) in left inferior frontal gyrus after cognitive training. We also found that resting CBF in the right frontal middle gyrus correlated positively with performance on the measure of complex abstraction. This feasibility study provides promising evidence that short-term reasoning training can enhance cognitive performance and brain health in adults with BD. These data motivate further efforts to explore adjuvant therapeutics to improve cognitive performance and underlying brain systems in bipolar, as well as other psychiatric disorders. Clinicaltrials.gov Identifier: NCT02843282, http://www.clinicaltrials.gov/ct2/show/NCT02843282.