Early-life participation in cognitively stimulating activities and risk of depression and anxiety in late life.

BACKGROUND: Early-life stressful experiences are associated with increased risk of adverse psychological outcomes in later life. However, much less is known about associations between early-life positive experiences, such as participation in cognitively stimulating activities, and late-life mental health. We investigated whether greater engagement in cognitively stimulating activities in early life is associated with lower risk of depression and anxiety in late life. METHODS: We surveyed former participants of the St. Louis Baby Tooth study, between 22 June 2021 and 25 March 2022 to collect information on participants' current depression/anxiety symptoms and their early-life activities (N = 2187 responded). A composite activity score was created to represent the early-life activity level by averaging the frequency of self-reported participation in common cognitively stimulating activities in participants' early life (age 6, 12, 18), each rated on a 1 (least frequent) to 5 (most frequent) point scale. Depression/anxiety symptoms were measured by Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Screener (GAD-7). We used logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) of outcome risk associated with frequency of early-life activity. RESULTS: Each one-point increase in the early-life composite cognitive activity score was associated with an OR of 0.54 (95% CI 0.38-0.77) for late-life depression and an OR of 0.94 (95% CI 0.61-1.43) for late-life anxiety, adjusting for age, sex, race, parental education, childhood family structure, and socioeconomic status. CONCLUSIONS: More frequent participation in cognitively stimulating activities during early life was associated with reduced risk of late-life depression.

Effectiveness of Roy Adaptation Model-Based Cognitive Stimulation Therapy in Elderly Patients with Non-Small Cell Lung Cancer Undergoing Curative Resection.

This study aimed to investigate the effects of a Roy adaptation model (RAM)-based cognitive stimulation therapy (CST) intervention on elderly patients diagnosed with primary non-small cell lung cancer (NSCLC) undergoing curative resection. A total of 280 patients diagnosed with primary NSCLC were randomized into RAM-based CST group and control group. Outcomes were assessed at three intervals: pre-surgery, discharge, and one-month post-discharge. Cognitive function was evaluated using Mini-Cognitive test. Postoperative delirium prevalence was determined within 48 hours post-surgery using Nursing Delirium Screening Scale. The Hospital Anxiety and Depression Scale evaluated anxiety and depression symptoms, while Quality of Life (QoL) was assessed via Short Form-36 (SF36) Health Survey. The RAM-based CST group demonstrated significantly higher Mini-Cog test scores than the control group upon discharge and post-intervention. Patients with RAM-based CST exhibited a decrease in postoperative delirium compared to the control group. The RAM-based CST intervention yielded an improvement in anxiety and depression at discharge and 1-month post-discharge compared to preoperative levels. Additionally, the RAM-based CST group exhibited substantial enhancements in SF36 subcategory scores at 1-month post-discharge compared to pre-surgery. At post-intervention, the RAM-based CST group demonstrated significantly higher scores than the control group across various health-related domains, including role limitations due to emotional problems, mental health, general health perception, bodily pain, and role limitations due to physical problems. The RAM-based CST intervention in elderly NSCLC patients undergoing curative resection yielded significant enhancements in cognitive function, reduced delirium incidence, improved emotional well-being, and better QoL postoperatively.

Preventing cognitive decline via digital inclusion and virtual game management: an intervention study with older adults in the community.

OBJECTIVE: To evaluate the impact of cognitive stimulation via digital inclusion and the practice of video games on the cognition of the older population. METHOD: This is a randomized controlled intervention study, nested in a population cohort study. Based on the application of the Clinical Dementia Rating (CDR) test, individuals aged 60 years or older with scores 0 and 0.5 were included and randomly allocated in the Intervention Group (IG) or Control Group (CG). Initially, 160 participants met the selection criteria and underwent neuropsychological evaluation via the Montreal Cognitive Assessment (MoCA), applied before and after intervention. The IG (n = 62) participated in computer-based intervention once a week for one-and-a-half hours, for 4 months. The CG (n = 47) participated in the mindfulness workshops held in the same period. RESULTS: The digital literacy intervention group averaged 2.6 points more in the MoCA after 4 months. The change in the final MoCA decreased in 0.46 points at each unit in the basal MoCA. Individuals with average schooling had an increase of 0.93 points in the change of the MoCA in relation to individuals with low or high schooling. CONCLUSION: Digital inclusion combined with the practice of video games has the potential to improve the cognition of the older population.

Experiences of cognitive stimulation therapy (CST) in Brazil: a qualitative study of people with dementia and their caregivers.

OBJECTIVES: There is a lack of investment in psychosocial treatments for people with dementia in Brazil. Cognitive Stimulation Therapy (CST) is a group-based intervention that has shown to have benefits on activities of daily living and mood for people with dementia in Brazil. This study aims to explore the experiences and perceived changes following CST groups. METHODS: Individual interviews were conducted with the participants of the group (n = 12) and their caregivers (n = 11). Framework analysis was used to inspect the data. RESULTS: Two main themes have emerged: 'Personal benefits of being part of the group', containing two subthemes: 'Benefits for caregivers' and 'Benefits for person with dementia' and 'Day-to-day changes', containing seven subthemes; 'Memory', Sociability', 'Language', 'Mood', 'Orientation', 'Everyday activities' and 'Behavioural and psychological symptoms'. CONCLUSION: Results suggest that CST groups led to perceived personal benefits for the people with dementia and caregivers and that there are perceived changes for the participants of the groups.

Pilot testing cognitive stimulation intervention on older adults' cognitive function, cognitive self-efficacy, and sense of happiness.

BACKGROUND: With the ageing population increasing worldwide, identifying effective approaches to counteract cognitive decline becomes significant for maintaining cognitive health and quality of life in older adults. The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation interventions can maintain older adults' cognitive reserve, enhance their feelings of happiness, and potentially improve their psychosocial wellbeing. AIM: This study aimed to determine the impact of Cognitive Stimulation Intervention on older adults' cognitive function, cognitive self-efficacy, and sense of happiness. METHOD: A quasi-experimental methodological approach was applied. Two seniors' clubs were the sites for recruitment in this study as part of the Alexandria Governorate's Ministry of Social Solidarity, Egypt. Eighty older adults (aged 60 and above), randomly assigned into two equal groups. The study group received the study intervention, and the control group received regular seniors' club services. RESULTS: Cognitive function, cognitive self-efficacy, and sense of happiness scores among the study group, were significantly increased from (22.40 ± 0.67, 54.51 ± 8.63 and 27.68 ± 14.0 respectively) to (24.30 ± 1.07, 87.84 ± 4.96 and 65.98 ± 8.90 respectively) (P < 0.001) following the interventions, and were significantly higher than the control group's post-test percent scores (22.08 ± 0.98, 54.35 ± 6.97, and 28.75 ± 9.60 respectively) (P < 0.001). CONCLUSIONS: Cognitive Stimulation Intervention effectively fostered the older adults' cognitive function, cognitive self-efficacy, and sense of happiness. Consequently, seniors' clubs, care homes, and other contexts seeking to apply Cognitive Stimulation Intervention to improve older adults' cognitive function, and general wellbeing must embed this intervention as part of their routine care and social activities programs.

From functional neuroimaging to neurostimulation: fNIRS devices as cognitive enhancers.

Functional near-infrared spectroscopy (fNIRS) relies on near-infrared (NIR) light for changes in tissue oxygenation. For decades, this technique has been used in neuroscience to measure cortical activity. However, recent research suggests that NIR light directed to neural populations can modulate their activity through "photobiomodulation" (PBM). Yet, fNIRS is being used exclusively as a measurement tool. By adopting cognitive tests sensitive to prefrontal functioning, we show that a 'classical' fNIRS device, placed in correspondence of the prefrontal cortices of healthy participants, induces faster RTs and better accuracy in some of the indexes considered. A well-matched control group, wearing the same but inactive device, did not show any improvement. Hence, our findings indicate that the 'standard' use of fNIRS devices generates PBM impacting cognition. The neuromodulatory power intrinsic in that technique has been so far completely overlooked, and future studies will need to take this into account.

Learning by parenting: How do mothers respond to their children's developmental declines?

Children's developmental processes are not always linear. During the childhood period, children usually experience ups and downs in their skills, and how parents respond to these changes can crucially condition the subsequent process of child development. This paper examines (1) how children's developmental declines impact the level of cognitive stimulation implemented by the mothers, and (2) whether these effects vary by socioeconomic groups. Using longitudinal NLSY79-CYA data from the US, I implement a series of two-way fixed effects and fixed effects counterfactual models. Findings show that mothers respond negatively to the declines in their children's mathematical skills by decreasing their levels of cognitive stimulation, although the effects are relatively small, approximately one-tenth of a standard deviation. This effect is concentrated among mothers with low levels of education or those at the bottom part of the income distribution. Additionally, it's observed that mothers in the sample do not modify their behaviours in response to declines in their children's reading skills. All in all, this evidence suggests that mothers might be reinforcing existing disadvantages by decreasing their cognitive stimulation when their children show developmental declines and that this mechanism could be responsible for broadening the developmental gap between children from low- and high-socioeconomic backgrounds.

Incorporating Spirituality into Cognitive Stimulation Therapy Groups for Persons with Dementia: An Exploratory Study.

Cognitive Stimulation Therapy (CST) is an evidence-based, non-pharmacological intervention for older adults with mild to moderate dementia. While CST has been adapted in various ways, this study explored the impact of adding a spiritual dimension to CST. Participants (N = 34) were divided into spiritual and traditional CST groups based on their residence. After a 14-session intervention involving interactive conversations, the spiritual CST group showed significantly lower depression scores (M = 2.7) compared to traditional CST (M = 6.5). With the global increase in dementia-related disorders, non-pharmacological interventions like CST offer crucial support for addressing memory loss. Social workers are uniquely positioned to deliver CST to diverse populations who value spirituality or faith in their daily lives.

Effects of a Taiwanese Adaptation of the Group Cognitive Stimulation Therapy Program on Mild-To-Moderate Dementia: A Quasi-Experimental Trial.

Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up.

[Samii: a robotic mediation application to improve geriatric care]. / Samii : une application de médiation robotique pour améliorer les soins gériatriques.

The emergence of social robots in gerontology has introduced new playful and reassuring media into nursing homes and geriatric wards. Despite promising results, their complexity hinders their widespread adoption. The Intelligent Interactive Care System aims to remedy these limitations by offering interactive therapeutic workshops. This study evaluates residents' involvement in these workshops within an adapted activity and care center, revealing a high level of involvement and satisfaction.

Comparison of Cognitive Intervention Strategies for Individuals With Alzheimer's Disease: A Systematic Review and Network Meta-analysis.

Accumulating evidence has shown the effectiveness of cognitive interventions, which can be divided into cognitive training (CT), cognitive stimulation (CS), cognitive rehabilitation (CR), and combined interventions (i.e., cognitive interventions combined with other non-pharmacological interventions such as physical exercise), in individuals with Alzheimer's disease (AD). However, the effectiveness of cognitive interventions varies greatly among studies and more comprehensive studies are required. We aimed to evaluate whether the current evidence shows that cognitive interventions are effective at improving cognition, neuropsychiatric symptoms, depression, quality of life, and basic activities of daily living among individuals with possible or probable AD. Randomized controlled trials of all types of cognitive intervention were identified for inclusion in pairwise and network meta-analyses. There was a moderate and statistically significant post-intervention improvement in global cognition among individuals with AD for all types of cognitive intervention compared to control interventions (39 studies, g = 0.43, 95% CI: 0.28 to 0.58, p < 0.01; Q = 102.27, df = 38, p < 0.01; I2 = 61.97%, τ2 = 0.13). Regarding the specific types of cognitive intervention, combined interventions had the highest surface under the cumulative ranking curve (SUCRA) value (90.7%), followed by CT (67.8%), CS (53.4%), and lastly CR (28.9%). Significant effects of cognitive interventions were also found for working memory, verbal memory, verbal fluency, confrontation naming, attention, neuropsychiatric symptoms, basic activities of daily living, and quality of life.

Long-term beneficial impact of the randomised trial 'Train the Brain', a motor/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up.

No treatment options are currently available to counteract cognitive deficits and/or delay progression towards dementia in older people with mild cognitive impairment (MCI). The 'Train the Brain' programme is a combined motor and cognitive intervention previously shown to markedly improve cognitive functions in MCI individuals compared to non-trained MCI controls, as assessed at the end of the 7-month intervention. Here, we extended the previous analyses to include the long-term effects of the intervention and performed a data disaggregation by gender, education and age of the enrolled participants. We report that the beneficial impact on cognitive functions was preserved at the 14-month follow-up, with greater effects in low-educated compared to high-educated individuals, and in women than in men.

Cognitive stimulation of executive functions through computational thinking.

The healthy development of cognitive functions, including executive functions, has been shown to depend mainly on the experiences and learning opportunities of people, especially during childhood. Over the past few years, researchers have been studying the impacts of diverse types of interventions on children's cognitive development in which computational thinking programs are a recent field. This pilot study evaluated the effect of computational thinking training based on the "Programming for Children" program on the executive functions of children aged 10 and 11 years: working memory, inhibition, and planning (N = 30). The results showed that children in the experimental group improved on tests of visuospatial working memory, cognitive inhibition, and sequential planning compared with the control group. However, tests of verbal working memory, memory strategy, and visual spatial planning did not show any observed changes. Although this was an exploratory study, and its findings should be interpreted cautiously due to the small sample size, the findings support the relevance and feasibility of conducting similar larger studies with larger samples.

Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol.

BACKGROUND: Delirium is a clinical condition characterised by acute and fluctuating deterioration of the cognitive state, generally secondary to an acute pathology. Delirium is associated with negative outcomes in older adults, such as longer hospitalisations, higher mortality, and short and medium-term institutionalisation. Randomised clinical trials have shown that delirium is preventable through non-pharmacological prevention measures, decreasing its incidence by 30-50%. These interventions include promoting physical activity, facilitating the use of glasses and hearing aids, cognitive stimulation, and providing frequent reorientation of time and space, among others. These measures are currently seldom applied in hospitals in Chile and around the world for reasons including the heavy workload of clinical staff, the lack of trained personnel, and in general the absence of a systematic implementation processes. We developed a software called PREVEDEL, which includes non-pharmacological strategies such as cognitive stimulation, early mobilisation, orientation, and pain assessment. We propose a randomised clinical trial to evaluate whether cognitive stimulation guided by PREVEDEL software prevents delirium status (full/subsyndromal delirium) in hospitalised older adults. METHOD: A randomised controlled trial, with parallel, multicentre groups. We will recruite patients 65 years or older who have been hospitalised for less than 48 h in the general ward or the intermediate care units of four hospitals in Santiago, Chile. The participants in the intervention group will use a tablet with cognitive stimulation software for delirium prevention for five continuous days versus the control group who will use the tablet without the software. We will evaluate the incidence, duration, density of delirium, subsyndromal delirium with the Confusion Assessment Method, cognitive with the Montreal Cognitive Assessment, and functional status with the Functional Independence Measure at discharge. Moreover, we will evaluate the adherence to prevention measures, as well as demographic variables of interest. DISCUSSION: The use of cognitive PREVEDEL software could increase and improve the implementation of non-pharmacological prevention measures for delirium in hospitalised older adults, thus reducing its incidence and contributing to patients and health professionals. TRIAL REGISTRATION: NCT05108207 ClinicalTrials.gov. Registered 4 November 2021.

Big Five personality factors predict self-rated cognitive reserve: a two-wave online study in a Mexican sample.

Introduction: One of the main contributors to cognitive reserve (CR) is the involvement in cognitively stimulating activities (CSAs), including education, work, leisure, social and physical activities. Personality traits are plausible determinants of CR, influencing the tendency to engage in CSAs. The goal of this study was to evaluate the association between personality and CR, operationalised as self-rated involvement in CSAs, in a sample of individuals aged 18-50 or more. Method: We collected two-wave non-probabilistic online data throughout Mexico. The instruments were the Big Five Inventory-2 for the baseline, its extra-short form for the follow-up and the Self-Rating of Cognitive Reserve (SRCR). Confirmatory factor analyses (CFAs) were performed to test the unifactorial structure of the SRCR, and multiple regressions were conducted with personality factors as predictors of CR. Results: For the baseline, 2025 participants were recruited, and 610 for the follow-up, most of them female and aged 18-40. CFAs showed excellent goodness-of-fit, and the regression analyses proved Negative Emotionality and Extraversion to be the main predictors of CR. Conclusions: Our study highlights the need to identify personality profiles at high risk of underdevelopment of CR in ages where it is still feasible to promote engagement in CSAs.

The experiences of carers in supporting a person living with dementia to participate in virtual cognitive stimulation therapy during the COVID-19 pandemic.

OBJECTIVES: Cognitive stimulation therapy (CST) is an evidence-based group intervention for people with dementia. In response to the COVID-19 pandemic, many existing CST groups moved virtually and this required carers of people living with dementia to assist with setting up the appropriate technology. This study aimed to explore the roles and experiences of carers in accessing virtual CST (vCST). METHODS: This qualitative study used semi-structured individual interviews, via telephone or videoconference, to explore the roles and experiences of carers. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS: Twelve family carers (age: 51-75 years) reported a range of experiences, from novice to expert knowledge in terms of accessing digital devices (mainly laptops and iPads) and connecting to Zoom. Accessing vCST provided carers an immediate application of new knowledge. Carers reported positive responses to vCST that provided their family member living with dementia with social contact and cognitive stimulation during lockdown. CONCLUSION: Accessing vCST required carers to have an existing adequate level of technological competence in order to learn and use the Zoom platform. Adult learning principles can be used to improve carers' digital literacy required for vCST and other telehealth initiatives.

Digital Therapeutics for Insomnia: Assessing the Effectiveness of a Computerized Home-Based Cognitive Stimulation Program.

BACKGROUND: Sleep disturbances represent a major health burden today, affecting up to one-third of the population worldwide. Computerized cognitive stimulation has been proven as an effective approach in diminishing negative symptomatology and improving the quality of life in a range of medical conditions. Given its nature in enhancing neural networks, such as those involved in stimulus monitoring and inhibitory processes, computerized cognitive stimulation is arising as a potential tool to overcome underlying cognitive deficits found among patients suffering from insomnia. In the current study, we report the results of Phase 1 and Phase 2 clinical trials of a home-based computerized cognitive stimulation program. METHODS: The cognitive stimulation intervention followed a home-based approach with online supervision by a psychologist. The training activities were gamified cognitive tasks that had been designed to improve executive functions, with a focus on inhibition skills. The Insomnia Severity Index and the Pittsburgh Sleep Quality Index scales were used as the main assessment measures. Data from the Behavior Rating Inventory of Executive Function, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Penn State Worry Questionnaire were also recorded before and after the intervention. During 15 consecutive days, participants performed on alternate days a total of 7 training sessions (each lasting 45 minutes). RESULTS: Twelve patients with clinical insomnia were administered the home-based online cognitive stimulation program. After seven training sessions, mean changes in sleep quality, depressive and anxiety symptoms, worry thoughts, and everyday function were found, with significant improvements in these domains in the full absence of safety issues. CONCLUSIONS: In patients with insomnia, cognitive stimulation demonstrated improvements in sleep quality, mood, and cognitive performance over a 15-day protocol. No relevant side effects were reported. The long-term effectiveness of the intervention is still unknown. CLINICAL TRIAL REGISTRATION: The study protocol has been reviewed and published in ClinicalTrials.gov, assigning it the code NCT05050292 https://clinicaltrials.gov/ct2/show/NCT05050292?term=NCT05050292&draw=2&rank=1.

Caregiver training: Evidence of its effectiveness for cognitive and functional improvement in older adults.

AIMS AND OBJECTIVES: The objectives of this study were to assess the benefits of a caregiver training programme on the cognitive and functional status of older adults, and to compare the effects of this programme according to type of caregiver (professional vs. family caregiver). BACKGROUND: Due to demographic changes that have resulted in an aging population, the role of caregiver of an older adult has become very important in recent years. DESIGN AND METHODS: The sample was composed of 160 older adults: (a) 100 received care from caregivers who had taken the three-month training programme (treatment group), of which 60 were professional caregivers and 40 were family caregivers, and (b) 60 received care from caregivers who had not taken the programme (control group). In order to evaluate programme effects on cognitive and functional status, we used both direct measures answered by the older adults (MMSE, CAPE and EuroQol) and caregiver reports (Barthel and RMPBC). We used a quasi-experimental, pre-post design. We followed SQUIRE 2.0 guidelines for reporting. RESULTS: The results showed that older adults who were cared for by caregivers that had participated in the training programme showed gains in quality of life and cognitive ability and maintenance of functional ability. Within the treatment group, although everyone significantly improved their scores, the older adults cared for by family caregivers improved in more of the cognitive sub-items than did their peers in the professional caregiver group. CONCLUSIONS: The data obtained show that a caregiver training programme based on cognitive stimulation produces cognitive, functional and health-related quality-of-life benefits in older adults. Furthermore, the caregivers reported increased satisfaction with their work. RELEVANCE TO CLINICAL PRACTICE: The improvements obtained in the older adults and in caregivers show the relevance of this type of intervention when working in the clinical field of caregiving.

[Testing Effectiveness of Localized Cognitive Stimulation Training With Musical Rhythm Courses Among Older People in Day Care Centers: A Pilot Study].

BACKGROUND: Staff caregivers of day care centers provide many activities for older people. However, there is a lack of a systematic curriculum based on Taiwanese culture to improve cognitive function, self-care ability, and depressive mood status in these individuals. PURPOSE: This study was designed to test the effectiveness of a series of localized cognitive stimulation training courses implemented by direct caregivers and aimed at improving cognitive function, self-care ability, and depressive mood in older people at day care centers. METHODS: This cluster-randomized controlled trial research was conducted over a four-month period. The participants were randomly assigned to the experimental, comparison, or control groups based on their day care center affiliation. The experimental group received a series of localized cognitive stimulation training sessions with musical rhythm courses from day care center direct caregivers. The cognitive function, self-care ability, and depression mood state of the three groups were then tested. RESULTS: The experimental group reported statistically significant changes in average scores for attention, feeding, and depressive mood. After controlling for time and degree of participation in activities, the comparison group reported a lower average score for cognitive function at timepoint 3. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study support caregivers at day care centers implementing a series of localized cognitive stimulation training course interventions to prevent declines in activities of daily living and cognitive function and ameliorate depressive mood in older adults. In the future, a larger sample size should be used to improve the effectiveness of the intervention.

Metacognitive Improvements Following Cognitive Stimulation Therapy for People with Dementia: Evidence from a Pilot Randomized Controlled Trial.

OBJECTIVES: Impaired self-awareness is a common feature of dementia, with considerable clinical impact. Some therapeutic strategies such as cognitive stimulation and psychotherapy have been suggested to mitigate loss of awareness. Nevertheless, evidence of intervention improving awareness of deficits is scarce. The present study aims to explore the impact of a Brazilian adapted version of Cognitive Stimulation Therapy (CST-Brasil), an evidence-based psychosocial intervention for people with dementia (PwD), on the level of awareness, reporting here a secondary outcome of a pilot randomized controlled trial. METHODS: 47 people with mild to moderate dementia attending an out-patient unit were randomly allocated to CST (n = 23) or treatment as usual (TAU) (n = 24) across 7 weeks, in a pilot randomized controlled trial. Awareness was measured before and after the intervention. RESULTS: Results indicated that people in both groups increased in overall awareness of the disease, but only those receiving CST exhibited improvements of awareness of cognitive ability. CONCLUSIONS: These findings suggest that CST may also improve metacognitive abilities in PwD, which could potentially be applied to other settings with beneficial effects. CLINICAL IMPLICATIONS: Considering the negative impacts of anosognosia, CST-led improvements in awareness have the potential to benefit PwD and their caregivers.