Exploring cognitive impairments and the efficacy of phosphatidylcholine and computer-assisted cognitive training in post-acute COVID-19 and post-acute COVID-19 Vaccination Syndrome.

Purpose: The COVID-19 pandemic has led to millions of confirmed cases worldwide, resulting in numerous deaths and hospitalizations. Long-term symptoms after infection or vaccination, known as Post-acute COVID-19 Syndrome (PACS) or Post-acute COVID-19 Vaccination Syndrome (PACVS), present a challenge for the healthcare system. Among the various neurological symptoms, cognitive impairments are frequently observed in PACS/PACVS patients. This study aimed to understand cognitive deficits in PACS/PACVS patients and evaluated potential treatment options, including phosphatidylcholine and computer-assisted cognitive training (CCT). Methods: The Neuro-COVID Outpatient Clinic at Evangelic Hospital Vienna evaluated n = 29 PACS/PACVS patients from May 2023 to October 2023. Enrolled patients were divided into three therapy schemes: Group A received phosphatidylcholine, B received phosphatidylcholine plus access to a computer-assisted cognitive training program, and C (divided into two subgroups) served as a control group. Cognitive impairments were evaluated in multiple assessments (initial and during therapy) using the COGBAT test. Simultaneously, an assessment of the quality of life was conducted using the WHOQOL-BREF. Results: Primary cognitive impairments, especially attentional deficits were notably evident compared to the general population. While all treatment groups showed cognitive improvement (significant or with a positive trend, but without reaching the level of statistical significance) after therapy, no significant interaction was found between assessment time points and treatment schemes for overall cognitive performance, attention, memory, and executive functions, suggesting consistency across the groups. The WHOQOL-BREF primarily demonstrated deficits in the domains of physical health and psychological well-being. Conclusion: This study examined the impact of PACS/PACVS on cognitive performance and evaluated phosphatidylcholine and CCT as potential treatment options. Patients with PACS/PACVS showed notable cognitive deficits, especially in the domain attention. While the effectiveness of phosphatidylcholine and CCT in treating cognitive deficits was inconclusive, the study indicated the possibility of spontaneous remission of cognitive deficits in PACS/PACVS.

Effects of Virtual Reality Motor-Cognitive Training for Older People With Cognitive Frailty: Multicentered Randomized Controlled Trial.

BACKGROUND: Cognitive frailty refers to a clinical syndrome in which physical frailty and mild cognitive impairment coexist. Motor-cognitive training and virtual reality (VR) have been used to launch various therapeutic modalities to promote health in older people. The literature advocates that motor-cognitive training and VR are effective in promoting the cognitive and physical function of older people. However, the effects on older people with cognitive frailty are unclear. OBJECTIVE: This study examined the effects of VR motor-cognitive training (VRMCT) on global cognitive function, physical frailty, walking speed, visual short-term memory, inhibition of cognitive interference, and executive function in older people with cognitive frailty. METHODS: This study used a multicentered, assessor-blinded, 2-parallel-group randomized controlled trial design. Participants were recruited face-to-face in 8 older adult community centers. Eligible participants were aged ≥60 years, were community dwelling, lived with cognitive frailty, had no dementia, and were not mobility restricted. In the intervention group, participants received VRMCT led by interventionists with 16 one-hour training sessions delivered twice per week for 8 weeks. In the control group, participants received the usual care provided by the older adult community centers that the investigators did not interfere with. The primary outcome was global cognitive function. The secondary outcomes included physical frailty, walking speed, verbal short-term memory, inhibition of cognitive interference, and executive function. Data were collected at baseline (T0) and the week after the intervention (T1). Generalized estimating equations were used to examine the group, time, and interaction (time × group) effects on the outcomes. RESULTS: In total, 293 eligible participants enrolled in the study. The mean age of the participants was 74.5 (SD 6.8) years. Most participants were female (229/293, 78.2%), had completed primary education (152/293, 52.1%), were married (167/293, 57.2%), lived with friends (127/293, 43.3%), and had no VR experience (232/293, 79.5%). In the intervention group, 81.6% (119/146) of participants attended >80% (13/16, 81%) of the total number of sessions. A negligible number of participants experienced VR sickness symptoms (1/146, 0.7% to 5/146, 3%). VRMCT was effective in promoting global cognitive function (interaction effect: P=.03), marginally promoting executive function (interaction effect: P=.07), and reducing frailty (interaction effect: P=.03). The effects were not statistically significant on other outcomes. CONCLUSIONS: VRMCT is effective in promoting cognitive functions and reducing physical frailty and is well tolerated and accepted by older people with cognitive frailty, as evidenced by its high attendance rate and negligible VR sickness symptoms. Further studies should examine the efficacy of the intervention components (eg, VR vs non-VR or dual task vs single task) on health outcomes, the effect of using technology on intervention adherence, and the long-term effects of the intervention on older people with cognitive frailty at the level of daily living. TRIAL REGISTRATION: ClinicalTrials.gov NCT04730817; https://clinicaltrials.gov/study/NCT04730817.

Comparative Efficacy of Cognitive Training for Post-Stroke Aphasia: A Systematic Review and Network Meta-Analysis.

BACKGROUND: Although cognitive training has shown potential for treating post-stroke aphasia (PSA), its efficacy varies across studies, and the optimal training approaches remain unclear. OBJECTIVE: To evaluate and compare the effects of distinct cognitive training interventions, either combined with or independent of speech and language therapy (SLT), on language function in individuals with PSA. METHODS: A systematic search encompassing PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Databases was conducted for randomized controlled trials (RCTs). A network meta-analysis evaluated interventions, including computer-assisted cognitive training (CCT), conventional cognitive training (CT), virtual reality (VR)-based cognitive training (vrCT), telerehabilitation computer-assisted cognitive training (tCCT), working memory (WM) training, and attention training (AT). RESULTS: Eleven RCTs comprising 501 participants were included. Individuals with PSA who underwent combined WM training with SLT led to significantly enhanced Western Aphasia Battery (WAB) Aphasia Quotient (AQ), as well as in spontaneous speech, auditory comprehension, repetition, and naming, compared to those receiving SLT alone. This combination was more effective than both CCT with SLT and tCCT with SLT in improving WAB AQ. Similarly, it outperformed both CCT with SLT and vrCT with SLT in enhancing WAB spontaneous speech. Additionally, both AT and CT combined with SLT were more effective than SLT alone in enhancing WAB spontaneous speech. Specifically, AT combined with SLT proved more effective than vrCT with SLT in this area. Moreover, vrCT combined with SLT significantly improved auditory comprehension compared with SLT alone. CONCLUSIONS: Combining WM training and SLT and integrating vrCT with SLT both significantly enhance language function in individuals with PSA, compared with SLT alone. Our findings advocate for the use of these cognitive training approaches as promising strategies for language rehabilitation in this population. PROSPERO registration number: CRD42023462361.

Brain endurance training improves soccer-specific technical skills and cognitive performance in fatigued professional soccer players.

OBJECTIVES: Brain Endurance Training (BET) - the addition of mentally fatiguing cognitive tasks to standard physical training - could improve performance in soccer. We tested whether BET, with cognitive tasks intermixed with physical training activities, improved players' cognitive and soccer-specific technical performance compared to physical training alone when fresh and fatigued. DESIGN: The study employed a pre/training/midtest/training/posttest design. METHODS: 31 professional male soccer players were randomly assigned to BET or control groups and completed 18 physical training sessions over 6 weeks. In between the physical training activities, the BET group completed demanding cognitive tasks, whereas the control group rested. Players completed the Loughborough soccer passing (LSPT) and shooting test (LSST) before and after completing a 30-min Stroop task. A brief psychomotor vigilance test (PVT-B), a visual analog rating of mental fatigue (MF-VAS), and rating of perceived exertion (RPE) were measured during testing and training. RESULTS: During testing, the 30-min Stroop task elicited a state of MF, confirmed by higher subjective ratings (P < .01). Compared to pre-testing, at mid- and post-testing, the BET group improved passing (all P < .01), shooting (all P < .01), and PVT-B performance (all P < .01) when tested after (fatigued) but not before (fresh) the Stroop task, whereas the control group did not change performance either way. During training the BET group reported higher MF (P < .01) and exhibited slower PVT-B responses (P < .01) compared to control. CONCLUSIONS: Intermixed BET was more effective than physical training alone at improving cognitive and soccer-specific technical performance of professional soccer players when fatigued.

A meta-analysis of the consequences of cognitive training on the cognitive function of aged mild cognitive impairment patients.

Cognitive training has gained popularity as a means to aid older adults with mild cognitive impairment (MCI), a transitional phase between normal ageing and Alzheimer's disease (AD). MCI represents a critical and potentially reversible state that can either improve or progress to full-blown dementia. This study aims to evaluate the impact of cognitive training on cognitive function in aged patients with MCI. PubMed, Embase, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were systematically retrieved from inception until May 2024. We rigorously applied the risk-of-bias methodology recommended by the Cochrane Handbook to assess the quality of the included studies. After two rounds of screening and removing duplicates, a total of 2685 articles were initially identified, from which 28 met the inclusion criteria. The meta-analysis included 28 randomised controlled trials with 1960 participants. In this meta-analysis, Review Manager 5.4 was used for statistical analysis. Findings revealed that cognitive training significantly improved the global cognitive function in aged MCI patients, as evidenced by the results of the Montreal Cognitive Assessment (standard mean difference (SMD) = 3.26; 95% CI, 2.69-3.82; P < 0.00001) and Mini-Mental State Examination (SMD = 2.27; 95% CI, 1.52-3.01; P < 0.00001). The beneficial effects of cognitive training interventions were consistent regardless of duration, including periods of 2 months or less (SMD = 1.94; 95% CI, 1.25-2.63; P < 0.00001), 2 to 6 months (SMD = 2.53; 95% CI, 1.52-3.53; P < 0.00001), and over 6 months (SMD = 4.12; 95% CI, 0.97-7.27; P = 0.01). The analysis indicates that cognitive training significantly benefits overall cognitive function, delayed memory, orientation, attention, and language skills in aged patients with MCI. Furthermore, cognitive training interventions are effective in enhancing cognitive function, irrespective of their duration.

Cognitive Training During Midlife: A Systematic Review and Meta-Analysis.

Midlife has been suggested to be a crucial time to introduce interventions for improving cognitive functions. The effects of cognitive training (CT) in healthy middle-aged populations and more specifically during the menopausal transition have not been systematically investigated. To investigate the effects of CT on cognition in healthy middle-aged adults and specifically in females during the menopause transition, literature was searched inception to July 2023 and studies were included that examined the effects of CT on a defined cognitive outcome. The improvement on cognitive performance following CT was the main outcome measured as mean difference (from baseline to immediate post) estimates with corresponding 95% confidence intervals (CI) in meta-analysis and was discussed with the support of subgroup analysis based on outcome type (i.e., far or near-transfer) and cluster tabulations. Nineteen articles were included in the qualitative synthesis with a total of 7765 individuals, and eight articles were included in the meta-analyses. CT was categorized into six type clusters: Game-based CT, General CT, Speed of Processing Training, Working Memory Training, Strategy-based CT, and Cognitive Remediation. Cognitive outcome was divided into six clusters: working memory, verbal memory, language, executive function, attention/processing speed, and visual memory. Meta-analysis reported significant improvement in the domain of executive function (0.48, 95% CI 0.08-0.87), verbal memory (0.22, 95% CI 0.11-0.33), and working memory (0.16, 95% CI 0.05-0.26). CT confers benefits on various cognitive domains, suggesting a potential role of CT to promote optimal cognitive functioning in the midlife and specifically in women during the menopause transition.

Predicting Adherence to Computer-Based Cognitive Training Programs Among Older Adults: Study of Domain Adaptation and Deep Learning.

Background: Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. Objective: The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. Methods: Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs. Results: Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. Conclusions: Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.

Five-year effects of cognitive training in individuals with mild cognitive impairment.

INTRODUCTION: In a 5-year follow-up study, we investigated the enduring effects of cognitive training on older adults with mild cognitive impairment (MCI). METHODS: A randomized controlled single-blind trial involved 145 older adults with MCI, assigned to cognitive training (MEMO+), an active control psychosocial intervention, or a no-contact condition. Five-year effects were measured on immediate and delayed memory recall, the Montreal Cognitive Assessment screening test (MoCA), self-reported strategy use, and daily living difficulties. RESULTS: At follow-up, participants who received cognitive training showed a smaller decline in delayed memory and maintained MoCA scores, contrasting with greater declines in the control groups. Cognitive training participants outperformed controls in both delayed memory and MoCA scores at the 5-year time point. No significant group differences were observed in self-reported strategy use or difficulties in daily living. DISCUSSION: Cognitive training provides long-term benefits by mitigating memory decline and slowing clinical symptom progression in older adults with MCI. Highlights: Cognitive training reduced the 5-year memory decline of persons with MCI.Cognitive training also reduced decline on the Montreal Cognitive Assessment (MoCA).No intervention effect was found on strategy use or activities of daily living.

The effect of computerized cognitive training and transcranial direct current stimulation on working memory among post-stroke individuals: a systematic review with meta-analysis and meta-regression.

BACKGROUND: Working memory (WM) impairment is a common phenomenon after stroke; however, its management in rehabilitation is less researched. This systematic review and meta-analysis aimed to provide a quantitative synthesis of the impact of computerised cognitive training (CCT) and transcranial direct current stimulation (tDCS) on WM span in post-stroke individuals. METHODS: The literature search in PubMed, Embase, Scopus, and Cochrane Library focused on randomized controlled trials testing the effect of CCT and tDCS on treated stroke patients as compared to untreated controls. Neuropsychological instruments such as Digit Span Forward/Backward and Visual Span Forward Tests defined the outcome of WM span. After extracting study characteristics and quality assessment using the Cochrane Risk of Bias Tool, we conducted a meta-analysis and meta-regression using standardised mean differences. RESULTS: The search yielded 4142 articles, nine of which (N = 461) fulfilled the inclusion criteria. In the case of CCT, we found significant improvement in Digit Span Backward Test (Z = 2.65, P = 0.008; 95% CI [0.10, 0.67]) and Visual Span Forward Test performance (Z = 3.05, P = 0.002; 95% CI [0.15, 0.69]), while for tDCS, we could not find a sufficient number of studies for the analysis. Furthermore, no significant moderating factor was found in the meta-regression. CONCLUSIONS: In conclusion, CCT appears to be a suitable choice to enhance WM span performance after stroke. However, further research is needed to investigate the effect of tDCS due to the limited number of studies. TRIAL REGISTRATION: The meta-analysis was conducted according to PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) standards with a PROSPERO registration protocol (ID: CRD42023387182).

Impact of VR-Based Cognitive Training on Working Memory and Inhibitory Control in IDD Young Adults.

BACKGROUND: Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. METHODS: This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). RESULTS: Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. CONCLUSIONS: These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

The combination of donepezil and cognitive training for improving treatment outcomes for alcohol use disorder: Design of a randomized controlled trial.

BACKGROUND: The development of alcohol use disorder (AUD) is a major concern in public health, and cognitive impairments caused by alcohol are involved in this process. Emerging neurobiological evidence suggests that donepezil, an anticholinesterase agent, may improve AUD treatment outcomes by enhancing neurocognitive functioning. Previous research has also suggested that cognitive remediation therapy (CRT) could potentially improve cognitive function and AUD treatment outcomes. We present the rationale and design of a trial to evaluate the combination of donepezil and cognitive remediation therapy (donepezil + CRT) as an intervention for AUD. METHODS: We propose a 13-week, randomized, double-blind, placebo-controlled, between-subjects trial comparing 4 groups (donepezil + CRT vs. donepezil alone vs. CRT alone vs. placebos) as an intervention for AUD. The main goal of the study is to evaluate if donepezil + CRT is superior to placebo in reducing heavy drinking days and improving neurocognitive functioning. A total of 160 patients (4 groups, 40 per each group) with AUD between the ages of 18-80 years will be recruited at Yale University and the VA Connecticut Healthcare System. Primary outcome measures include 1) heavy drinking by Timeline Follow Back (TLFB) over 13 weeks and 2) global neurocognitive functioning by a global index of neurocognitive function score at 7 and 13 weeks. DISCUSSION: This protocol paper describes the rationale and proposed methods for the randomized controlled trial for improving AUD treatment outcomes. This project has significant clinical potential to help patients suffering from AUD by improving their cognition and reducing alcohol consumption. TRIAL REGISTRATION: NCT05042102.

Cognitive Alterations Associated with Remission and Alcohol Dependence Severity in Ethnically Diverse Patients of Siberia.

Background: Impaired cognition in individuals with alcohol dependence may be associated with increased relapse risk. It has been recorded in more than half of patients during six months after treatment. In certain ethnic groups, for example, Tuvinians, the indigenous people of Siberia, relapses occur in extremely short periods of one to three months after treatment. An approach currently used to alcohol dependence treatment may be less effective for these patients. Objective: The study aimed to investigate cognitive sequelae in indigenous Tuvinian patients with alcohol dependence. Methods: The sample included 166 patients, 74 of indigenous ethnicity (Tuvinians) and 92 non-indigenous white patients. Data on inhibitory control, cognitive flexibility, attention, and working memory were collected from all the patients and processed using cluster analysis. The clustering data were then complemented by indicators of disorder dynamics, impulsivity, and emotion regulation. Results: The clustering procedure revealed groups with severe cognitive sequelae. More than four-fold attention decrease was found in 43.5% of non-indigenous patients, and more impaired cognitive flexibility was revealed among 60.8% of indigenous patients. Groups with severe cognitive sequelae had higher impulsivity, maladaptive emotion regulation, more hospitalizations, faster disease progression, and shorter remissions. The latter was significantly reduced to 90 days on average in the severe group of indigenous patients versus 135 days of remission in the non-indigenous severe group. Conclusion: Results obtained may advance tailored intervention in alcohol-dependent patients of the indigenous Tuvinian ethnicity. While little is still known about the alcohol dependence course and consequences in the indigenous Tuvinians of Siberia, this study contributes to the global mental health data on alcohol abuse and dependence in indigenous communities.

A multimodal group-based immersive virtual reality intervention for improving cognition and mental health in patients with post-covid-19 condition. A quasi-experimental design study.

Introduction: Adults with Post-COVID-19 Condition (PCC) may show cognitive impairments in attention, processing speed, memory, and executive function. Multimodal programs that combine cognitive training, physical activity and emotional tasks, such as mindfulness-based interventions (MBIs), may offer a suitable alternative for improving PCC treatments. Immersive Virtual Reality (IVR) is a promising technology that can enhance traditional cognitive training, physical activity, and MBIs. The use of IVR technology may increase engagement with these interventions and potentially enhance the individual benefits of cognitive training, exercise and MBIs. The current study evaluated the impact of a multimodal IVR intervention, comparing this with a usual care intervention (control group), in order to assess changes in cognition and mental health in adults with PCC. We also aimed to assess user experience factors such as enjoyment, perceived improvement, and fatigue following each multimodal IVR session within the experimental group. Method: Thirty-one participants with PCC symptoms were assigned to either the experimental group (IVR, n = 15) or the control group (usual care intervention, n = 16) in a quasi-experimental design study. The multimodal IVR intervention consisted of MBI, cognitive training and physical exercise and was delivered in a 60-min group session with 5 participants, twice a week, for 8 weeks (16 sessions in total). Measures of global cognition, attention, processing speed, verbal episodic memory and subjective memory complaints (primary measures), and depressive and anxiety symptoms and fatigue (secondary measures) were assessed at baseline and also after 8 weeks (post-intervention). Results: Mixed between-group (group) and within-group (pre-post assessments) ANOVAs revealed significant group*time interactions in global cognition, simple attention, processing speed, memory and depressive symptoms, with large effect sizes (p < 0.05; partial η2 > 0.14). There was also a marginally significant group*time interaction for executive function (p = 0.05). Follow-up analyses comparing pre-and post-intervention outcomes for each group separately showed that the experimental group significantly improved in global cognition, processing speed, memory and depressive symptoms, while the control group showed no significant pre-post changes. Friedman tests showed a significant main effect of time (χ2(2) = 6.609, p = 0.04), with a gradual increase in enjoyment from the first, to the mid, and then to the final session. In addition, perceived improvement scores remained high throughout the intervention, and patient-reported fatigue levels did not fluctuate significantly throughout the intervention. Conclusion: To our knowledge, no previous research has combined cognitive training, physical exercise and MBI using an IVR paradigm in adults with PCC. Despite their inherent limitations, our findings mark a pioneering step toward improving cognition and mental health outcomes in PCC through the innovative use of new technology and multimodal approaches. This first study should be accompanied by more extensive, randomized clinical trials aimed at further exploring and refining these interventions.

The influence of eight cognitive training regimes upon cognitive screening tool performance in post-stroke survivors: a network meta-analysis.

Background: Traditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined. Objectives: This study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs. Methods: Searches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention's impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282). Results: Fifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions. Conclusion: The network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier in PROSPERO (CRD42023463282).

The effects of language learning on cognitive functioning and psychosocial well-being in cognitively healthy older adults: A semi-blind randomized controlled trial.

This study investigated the impact of language learning in comparison to other complex learning activities on cognitive functioning and psychosocial well-being in cognitively healthy, community-dwelling older adults. In a randomized controlled trial, 43 Dutch functionally monolinguals aged 65-78 completed a three-month English course (n = 15), music training (n = 13), or a lecture series (n = 15). Cognitive functioning (global cognition, cognitive flexibility, episodic memory, working memory, verbal fluency, and attention) and psychosocial well-being were assessed before and immediately after the intervention, and at a four-month follow-up. The language learners significantly improved on episodic memory and cognitive flexibility. However, the magnitude of cognitive change did not significantly differ between the language learning and music training conditions, except for a larger positive change in cognitive flexibility for the language learners from pretest to follow-up. Our results suggest that language learning in later life can improve some cognitive functions and fluency in the additional language, but that its unique effects seem limited.

[Efficiency of computerized cognitive training for prevention of cognitive impairments and stimulation of neuroplasticity.]

Computerized cognitive training (CCT) is a rapidly developing area of cognitive rehabilitation at the intersection of information technology and healthcare, the constantly updated results of which can be successfully translated into practical application in clinical medicine and in particular in gerontology. The basis of CCT, as a non-invasive method of influencing the functional activity of the brain and the processes of neuroplasticity, is software for stimulating cognitive functions in order to improve their productivity. The level of scientific and practical interest in CCP technology is growing rapidly. The article reports on the current state of research on the use of CCT aimed at correcting cognitive impairment. The purpose of this work is to systematize the available scientific data in this area, as well as to promote further integration of research in the field of information technology into clinical practice, in particular, to study the potential of CCT as a promising therapeutic tool in the paradigm of successful aging and prevention of the progression of cognitive impairment. This noninvasive intervention may improve global cognitive function in patients with clinically defined impairments and during normal aging in cognitively healthy older adults. However, new studies with fully comparable protocols are needed to evaluate in more detail the duration of the effect and the effectiveness of CCT in preventing cognitive decline in the long term.

A Systematic Review and Narrative Synthesis of Cognitive Training in the Treatment of Mental Illness and Substance Use Disorder.

Introduction: The one unifying and distinguishing feature of all neuropsychiatric illnesses is the co-occurrence of cognitive dysfunction. Cognitive training (CT) was developed to enhance neural connectivity and cognition and improve day-to-day functioning. However, the benefits of CT are still debated. This current systematic review aimed to examine the efficacy of CT and to identify diagnostic and CT characteristics associated with superior outcomes across a range of psychiatric disorders. Method: Studies investigating CT in psychiatric illnesses were extracted from Embase, PubMed, CINAHL, PsycINFO, and PsycARTICLES up to 17 August 2023. Inclusion criteria were randomised control trials (RCT) and English language. The primary search strategy included terms relating to cognitive training, cognitive remediation, cognitive enhancement, or cognitive rehabilitation and randomised control trials, clinical trials, or experiments. Risk of bias was assessed using RevMan Web version 8.1.1. Narrative synthesis was used to analyse findings. Due to the heterogeneity of participant demographics, diagnoses, and interventions, meta-analyses were considered inappropriate. Results: Fifteen studies, including a total of 1075 participants, were identified. Approximately 67% of studies reported significant improvements in at least one trained domain of cognitive function after CT, and 47% observed improvements in psychiatric symptoms or function. Cognitive transfer effects were not observed. Sample sizes for studies were generally small, and most CT durations were 6 weeks or less. Conclusions: Findings suggest that CT can improve cognitive function in trained domains, though little evidence of cognitive transfer effects was observed. Due to the lack of standardisation in CT format and delivery, and inadequate measures of psychiatric symptoms or daily function, there is insufficient evidence to conclude whether or not this technique may benefit cognitive impairment in psychiatric disorders, or lead to subsequent improvement in disease symptomatology. Further studies of longer duration and using consistent methodologies must be conducted to identify the benefits of CT in psychiatric disorders.

Long-Term Effects of the Multicomponent Program BrainProtect® on Cognitive Function: One-Year Follow-Up in Healthy Adults.

Background: Age-related neuronal changes impact cognitive integrity, which is a major contributor to health and quality of life. The best strategy to prevent cognitive decline and Alzheimer's disease is still debated. Objective: To investigate the long-term effects of the eight-week multicomponent training program BrainProtect® on cognitive abilities compared to general health counseling (GHC) in cognitively healthy adults in Germany. Methods: Healthy adults (age ≥50 years) previously randomized to either GHC (n = 72) or BrainProtect (intervention group, IG, n = 60) for eight-weeks (once weekly, 90 minutes, group-based) underwent a comprehensive neuropsychological test battery and health-related quality of life (HRQoL) evaluation 3- and 12-months after intervention end. Results: Dropout rates were n = 8 after 3 months and n = 19 after 12 months. No significant long-term effect of BrainProtect was observed for the primary endpoint Consortium to Establish a Registry for Alzheimer's Disease (CERAD-Plus) total score. Logical reasoning was significantly improved (p = 0.024) 12 months after completion of the training program in IG participants compared to the GHC group independent of sex, age, education, diet, and physical activity. In IG participants, thinking flexibility (p = 0.019) and confrontational naming (p = 0.010) were improved 3 months after completing the intervention compared to the GHC group, however, after conservative Bonferroni adjustment, significance was lost. Conclusions: BrainProtect® independently improved logical reasoning compared to GHC up to 12 months after cognitive training's end in healthy adults. To uncover the long-term clinical significance of multicomponent cognitive training in healthy adults, studies with larger sample size and frequent follow up visits are necessary.

Effects of computer-based cognitive training vs. paper-and-pencil-based training on the cognitive development of typically developing children: Protocol for a randomized controlled trial.

The research aims to evaluate the effectiveness of a computerized cognitive training program in improving executive functions and attention in elementary school children, compared to a traditional paper-and-pencil intervention. The study has been formulated as a randomized controlled trial with pre- and post-intervention measures. For the study, third-grade children with typical development aged between 7 and 9 years will be recruited. Participants will be randomly assigned to the two study arms (control and experimental). The experimental group will participate in a computerized intervention using the NeuronUp cognitive stimulation platform for 8 weeks, twice a week. Sessions will be conducted using computers in the computer lab of the participating educational institution. The active control group will engage in paper-and-pencil cognitive training for the same duration and intensity as the experimental group. Evaluators will be blinded to the assignment, and participants will be blinded to the target intervention. Hypothesis testing will be conducted through ANOVA-MR, and logistic regressions will be implemented to assess the effect of socioeconomic variables on children's performance. These results are expected to contribute to the discussion on the opportunities and benefits offered by cognitive training programs on the cognitive development of typically developing children.

Immersive Virtual Reality Cognitive Training for Improving Cognition and Depressive Symptoms Among Older Adults. Current Evidence and Future Recommendations. A Systematic Review.

Older adults, particularly impacted by the pandemic, are anticipated to face considerable challenges to their cognitive and psychological health. Various cognitive training methods have been proposed to improve their cognitive decline through regular practice. Immersive virtual reality (IVR) offers a promising avenue to bolster cognitive and mental health care accessibility for older adults and has shown potential in augmenting traditional cognitive training methods. This systematic review aims to assess the efficacy of IVR-based cognitive training on improving cognitive impairments and depressive symptoms among older adults, irrespective of their level of cognitive decline. Systematic searches were conducted across MEDLINE-PubMed, EMBASE, and Web of Science databases from inception to December 2022. Only peer-reviewed articles reporting results from randomized controlled trials and pilot studies, focusing on the effects of VR-based cognitive training on adults aged 55 or older, were deemed eligible. Using the Cochrane Handbook for Systematic Reviews of Interventions, the risk of bias was appraised for each selected study. Out of 3,835 studies identified, 9 met the inclusion criteria. The qualitative analyses concluded that IVR cognitive training interventions enhanced certain cognitive functions and well-being among older adults, notably those with mild cognitive impairments. These interventions were particularly effective in boosting memory, visuospatial abilities, and measures related to depressive symptoms and overall well-being. However, enhancements were less pronounced for executive functions, attention, and global cognition. Based on these findings, we propose a set of tailored, inclusive, and evidence-based recommendations to adapt emerging technologies to better accommodate the needs of older adults.