Strategies for Older Adults

This concerns studies into strategies specifically for older adults, but that doesn't mean other cognitive strategies can't also be useful! See also Strategies and the specific strategy pages.

See also the separate page for Mental stimulation & cognitive reserve

An Indian study involving 648 dementia patients, of whom 391 were bilingual, has found that, overall, bilingual patients developed dementia 4.5 years later than the monolingual ones. There was no additional advantage to speaking more than two languages.

The effect remained after factors such as education, sex, occupation, and urban vs. rural dwelling, had been accounted for. The finding is consistent with previous research, and is not only the largest study so far on the subject, but the first to show the effect also applies to illiterate people who had not attended school. Moreover, the effect was found in three different types of dementia: frontotemporal, vascular, and Alzheimer’s disease.

http://www.eurekalert.org/pub_releases/2013-11/uoe-sas110613.php

http://www.psmag.com/health/evidence-bilingualism-delays-onset-dementia-69595/

[3548] Alladi S, Bak TH, Duggirala V, Surampudi B, Shailaja M, Shukla AK, Chaudhuri JR, Kaul S. Bilingualism delays age at onset of dementia, independent of education and immigration status. Neurology [Internet]. 2013 ;81(22):1938 - 1944. Available from: http://www.neurology.org/content/81/22/1938

Preliminary findings from a small study show that older adults (68-91), after learning to use Facebook, performed about 25% better on tasks designed to measure their ability to continuously monitor and to quickly add or delete the contents of their working memory (updating), compared to their baseline performance. Two other groups of 14 showed no change. The second group of 14 were taught to use a private online diary site (Penzu.com), while the third control group were told they were on a wait-list for Facebook training.

Wohltmann, Janelle. 2013. Presented at the International Neuropsychological Society’s annual meeting in Hawaii.

Report on Futurity

Here’s an encouraging study for all those who think that, because of age or physical damage, they must resign themselves to whatever cognitive impairment or decline they have suffered. In this study, older adults who had suffered from aphasia for a long time nevertheless improved their language function after six weeks of intensive training.

The study involved nine seniors with chronic aphasia and 10 age-matched controls. Those with aphasia were given six weeks of intensive and specific language therapy, after which they showed significantly better performance at naming objects. Brain scans revealed that the training had not only stimulated language circuits, but also integrated the default mode network (the circuits used when our brain is in its ‘resting state’ — i.e., not thinking about anything in particular), producing brain activity that was similar to that of the healthy controls.

Moreover, these new circuits continued to be active after training, with participants continuing to improve.

Previous research has implicated abnormal functioning of the default mode network in other cognitive disorders.

Although it didn’t reach significance, there was a trend suggesting that the level of integration of the default mode network prior to therapy predicted the outcome of the training.

The findings are especially relevant to the many seniors who no longer receive treatment for stroke damage they may have had for many years. They also add to the growing evidence for the importance of the default mode network. Changes in the integration of the default mode network with other circuits have also been implicated in age-related cognitive decline and Alzheimer’s.

Interestingly, some research suggests that meditation may help improve the coherence of brainwaves that overlap the default mode network. Meditation, already shown to be helpful for improving concentration and focus, may be of greater benefit for fighting age-related cognitive decline than we realize!

Here’s an exciting little study, implying as it does that one particular aspect of information processing underlies much of the cognitive decline in older adults, and that this can be improved through training. No, it’s not our usual suspect, working memory, it’s something far less obvious: temporal processing.

In the study, 30 older adults (aged 65-75) were randomly assigned to three groups: one that received ‘temporal training’, one that practiced common computer games (such as Solitaire and Mahjong), and a no-activity control. Temporal training was provided by a trademarked program called Fast ForWord Language® (FFW), which was developed to help children who have trouble reading, writing, and learning.

The training, for both training groups, occupied an hour a day, four days a week, for eight weeks.

Cognitive assessment, carried out at the beginning and end of the study, and for the temporal training group again 18 months later, included tests of sequencing abilities (how quickly two sounds could be presented and still be accurately assessed for pitch or direction), attention (vigilance, divided attention, and alertness), and short-term memory (working memory span, pattern recognition, and pattern matching).

Only in the temporal training group did performance on any of the cognitive tests significantly improve after training — on the sequencing tests, divided attention, matching complex patterns, and working memory span. These positive effects still remained after 18 months (vigilance was also higher at the end of training, but this improvement wasn’t maintained).

This is, of course, only a small pilot study. I hope we will see a larger study, and one that compares this form of training against other computer training programs. It would also be good to see some broader cognitive tests — ones that are less connected to the temporal training. But I imagine that, as I’ve discussed before, an effective training program will include more than one type of training. This may well be an important component of such a program.

[3075] Szelag E, Skolimowska J. Cognitive function in elderly can be ameliorated by training in temporal information processing. Restorative Neurology and Neuroscience [Internet]. 2012 ;30(5):419 - 434. Available from: http://dx.doi.org/10.3233/RNN-2012-120240

Previous research has been equivocal about whether cognitive training helps cognitively healthy older adults. One recent review concluded that cognitive training could help slow age-related decline in a range of cognitive tasks; another found no evidence that such training helps slow or prevent the development of Alzheimer’s in healthy older adults. Most of the studies reviewed looked at single-domain training only: memory, reasoning, processing speed, reading, solving arithmetic problems, or strategy training (1). As we know from other studies, training in specific tasks is undeniably helpful for improving your performance at those specific tasks. However, there is little evidence for wider transfer. There have been few studies employing multi-domain training, although two such have found positive benefits.

In a new Chinese study, 270 healthy older adults (65-75) were randomly assigned to one of three groups. In the two experimental groups, participants were given one-hour training sessions twice a week for 12 weeks. Training took place in small groups of around 15. The first 15 minutes of each hour involved a lecture focusing on diseases common in older adults. The next 30 minutes were spent in instruction in one specific technique and how to use it in real life. The last 15 minutes were used to consolidate the skills by solving real-life problems.

One group were trained using a multi-domain approach, involving memory, reasoning, problem solving, map reading, handicrafts, health education and exercise. The other group trained on reasoning only (involving the towers of Hanoi, numerical reasoning, Raven Progressive Matrices, and verbal reasoning). Homework was assigned. Six months after training, three booster sessions (a month apart) were offered to 60% of the participants. The third group (the control) was put on a waiting list. All three groups attended a lecture on aspects of healthy living every two months.

All participants were given cognitive tests before training and after training, and again after 6 months, and after one year. Cognitive function was assessed using the Stroop Test, the Trail Making test, the Visual Reasoning test, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Form A).

Both the multi-domain and single-domain cognitive training produced significant improvement in cognitive scores (the former in RBANS, visual reasoning, and immediate and delayed memory; the latter in RBANS, visual reasoning, word interference, and visuospatial/constructional score), although single-domain training produced less durable benefits (after a year, the multi-domain group still showed the benefit in RBANS, delayed memory and visual reasoning, while the single-domain group only showed benefits in word interference). Booster training also produced benefits, consolidating training in reasoning, visuospatial/constructional abilities and faster processing.

Reasoning ability seemed particularly responsive to training. Although it would be reasonable to assume that single-domain training, which focused on reasoning, would produce greater improvement than multi-domain training in this specific area, there was in fact no difference between the two groups right after training or at six months. And at 12 months, the multi-domain group was clearly superior.

In sum, the study provides evidence that cognitive training helps prevent cognitive decline in healthy older people, that specific training can generalize to other tasks, but that programs that involve several cognitive domains produce more lasting benefits.

While smartphones and other digital assistants have been found to help people with mild memory impairment, their use by those with greater impairment has been less successful. However, a training program developed at the Baycrest Centre for Geriatric Care has been using the power of implicit memory to help impaired individuals master new skills.

The study involved 10 outpatients, aged 18 to 55 (average age 44), who had moderate-to-severe memory impairment, the result of non-neurodegenerative conditions including ruptured aneurysm, stroke, tumor, epilepsy, closed-head injury, or anoxia after a heart attack. They all reported difficulty in day-to-day functioning.

Participants were trained in the basic functions of either a smartphone or another personal digital assistant (PDA) device, using an errorless training method that tapped into their preserved implicit /procedural memory. In this method, cues are progressively faded in such a way as to ensure there is enough information to prompt the correct response. The fading of the cues was based on the trainer’s observation of the patient’s behavior.

Participants were given several one-hour training sessions to learn calendaring skills such as inputting appointments and reminders. Each application was broken down into its component steps, and each step was given its own score in terms of how much support was needed. Support could either comprise a full explanation and demonstration; full explanation plus pointing to the next step; simply pointing to the next step; simply confirming a correct query; no support. The hour-long sessions occurred twice a week (with one exception, who only received one session a week). Training continued until the individual reached criterion-level performance (98% correct over a single session). On average, this took about 8 sessions, but as a general rule, those with relatively focal impairment tended to be substantially quicker than those with more extensive cognitive impairment.

After this first training phase, participants took their devices home, where they extended their use of the device through new applications mastered using the same protocol. These new tasks were carefully scaffolded to enable progressively more difficult tasks to be learned.

To assess performance, participants were given a schedule of 10 phone calls to complete over a two-week period at different times of the day. Additionally, family members kept a log of whether real-life tasks were successfully completed or not, and both participants and family members completed several questionnaires: one rating a list of common memory mistakes on a frequency-of-occurrence scale, another measuring confidence in dealing with various memory-demanding scenarios, and a third examining the participant's ability to use the device.

All 10 individuals showed improvement in day-to-day memory functioning after taking the training, and this improvement continued when the patients were followed up three to eight months later. Specifically, prospective memory (memory for future events) improved, and patient confidence in dealing with memory-demanding situations increased. Some patients also reported broadening their use of their device to include non-prospective memory tasks (e.g. entering names and/or photos of new acquaintances, or entering details of conversations).

It should be noted that these patients were some time past their injury, which was on average some 3 ½ years earlier (ranging from 10 months to over 25 years). Accordingly, they had all been through standard rehabilitation training, and already used many memory strategies. Questioning about strategy use prior to the training revealed that six participants used more memory strategies than they had before their injury, three hadn’t changed their strategy use, and one used fewer. Strategies included: calendars, lists, reminders from others, notebooks, day planner, placing items in prominent places, writing a note, relying on routines, alarms, organizing information, saying something out loud in order to remember it, mental elaboration, concentrating hard, mental retracing, computer software, spaced repetition, creating acronyms, alphabetic retrieval search.

The purpose of this small study, which built on an earlier study involving only two patients, was to demonstrate the generalizability of the training method to a larger number of individuals with moderate-to-severe memory impairment. Hopefully, it will also reassure such individuals, who tend not to use electronic memory aids, that these are a useful tool that they can, with the right training, learn to use successfully.

A number of studies have found evidence that older adults can benefit from cognitive training. However, neural plasticity is thought to decline with age, and because of this, it’s thought that the younger-old, and/or the higher-functioning, may benefit more than the older-old, or the lower-functioning. On the other hand, because their performance may already be as good as it can be, higher-functioning seniors may be less likely to benefit. You can find evidence for both of these views.

In a new study, 19 of 39 older adults (aged 60-77) were given training in a multiplayer online video game called World of Warcraft (the other 20 formed a control group). This game was chosen because it involves multitasking and switching between various cognitive abilities. It was theorized that the demands of the game would improve both spatial orientation and attentional control, and that the multiple tasks might produce more improvement in those with lower initial ability compared to those with higher ability.

WoW participants were given a 2-hour training session, involving a 1-hour lecture and demonstration, and one hour of practice. They were then expected to play the game at home for around 14 hours over the next two weeks. There was no intervention for the control group. All participants were given several cognitive tests at the beginning and end of the two week period: Mental Rotation Test; Stroop Test; Object Perspective Test; Progressive Matrices; Shipley Vocabulary Test; Everyday Cognition Battery; Digit Symbol Substitution Test.

As a group, the WoW group improved significantly more on the Stroop test (a measure of attentional control) compared to the control group. There was no change in the other tests. However, those in the WoW group who had performed more poorly on the Object Perspective Test (measuring spatial orientation) improved significantly. Similarly, on the Mental Rotation Test, ECB, and Progressive Matrices, those who performed more poorly at the beginning tended to improve after two weeks of training. There was no change on the Digit Symbol test.

The finding that only those whose performance was initially poor benefited from cognitive training is consistent with other studies suggesting that training only benefits those who are operating below par. This is not really surprising, but there are a few points that should be made.

First of all, it should be noted that this was a group of relatively high-functioning young-old adults — poorer performance in this case could be (relatively) better performance in another context. What it comes down to is whether you are operating at a level below which you are capable of — and this applies broadly, for example, experiments show that spatial training benefits females but not males (because males tend to already have practiced enough).

Given that, in expertise research, training has an on-going, apparently limitless, effect on performance, it seems likely that the limited benefits shown in this and other studies is because of the extremely limited scope of the training. Fourteen hours is not enough to improve people who are already performing adequately — but that doesn’t mean that they wouldn’t improve with more hours. I have yet to see any interventions with older adults that give them the amount of cognitive training you would expect them to need to achieve some level of mastery.

My third and final point is the specific nature of the improvements. This has also been shown in other studies, and sometimes appears quite arbitrary — for example, one 3-D puzzle game apparently improved mental rotation, while a different 3-D puzzle game had no effect. The point being that we still don’t understand the precise attributes needed to improve different skills (although the researchers advocate the use of a tool called cognitive task analysis for revealing the underlying qualities of an activity) — but we do understand that it is a matter of precise attributes, which is definitely a step in the right direction.

The main thing, then, that you should take away from this is the idea that different activities involve specific cognitive tasks, and these, and only these, will be the ones that benefit from practicing the activities. You therefore need to think about what tasks you want to improve before deciding on the activities to practice.

I’ve spoken before about the association between hearing loss in old age and dementia risk. Although we don’t currently understand that association, it may be that preventing hearing loss also helps prevent cognitive decline and dementia. I have previously reported on how music training in childhood can help older adults’ ability to hear speech in a noisy environment. A new study adds to this evidence.

The study looked at a specific aspect of understanding speech: auditory brainstem timing. Aging disrupts this timing, degrading the ability to precisely encode sound.

In this study, automatic brain responses to speech sounds were measured in 87 younger and older normal-hearing adults as they watched a captioned video. It was found that older adults who had begun musical training before age 9 and engaged consistently in musical activities through their lives (“musicians”) not only significantly outperformed older adults who had no more than three years of musical training (“non-musicians”), but encoded the sounds as quickly and accurately as the younger non-musicians.

The researchers qualify this finding by saying that it shows only that musical experience selectively affects the timing of sound elements that are important in distinguishing one consonant from another, not necessarily all sound elements. However, it seems probable that it extends more widely, and in any case the ability to understand speech is crucial to social interaction, which may well underlie at least part of the association between hearing loss and dementia.

The burning question for many will be whether the benefits of music training can be accrued later in life. We will have to wait for more research to answer that, but, as music training and enjoyment fit the definition of ‘mentally stimulating activities’, this certainly adds another reason to pursue such a course.

Growing evidence points to greater education and mentally stimulating occupations and activities providing a cognitive reserve that enables people with developing Alzheimer's to function normally for longer. Cognitive reserve means that your brain can take more damage before it has noticeable effects. A 2006 review found that some 30% of older adults found to have Alzheimer’s when autopsied had shown no signs of it when alive.

There are two relevant concepts behind the protection some brains have: cognitive reserve (which I have mentioned on a number of occasions), and brain reserve, which is more structural. ‘Brain reserve’ encapsulates the idea that certain characteristics, such as a greater brain size, help protect the brain from damage. Longitudinal studies have provided evidence, for example, that a larger head size in childhood helps reduce the risk of developing Alzheimer’s.

While cognitive reserve has been most often associated with education, it has also been associated with occupation, bilingualism, and music. A new study provides physical evidence for how effective bilingualism is.

The Toronto study involved 40 patients with a diagnosis of probable Alzheimer’s, of whom half were bilingual (fluent in a second language, and consistent users of both languages throughout their lives). Bilingual and monolingual patients were matched on a test of cognitive function (the Behavioral Neurology Assessment). The two groups were similar in education levels, gender, and performance on the MMSE and the clock drawing test. The groups did differ significantly in occupational status, with the monolinguals having higher job status than the bilinguals.

Notwithstanding this similarity in cognitive performance, brain scans revealed that the bilingual group had substantially greater atrophy in the medial temporal lobe and the temporal lobe. The two groups did not differ in measures of central and frontal atrophy, however — these regions are not associated with Alzheimer’s.

In other words, bilingualism seems to specifically help protect those areas implicated in Alzheimers, and the bilinguals could take much greater damage to the brain before it impacted their cognitive performance. It is suggested that the act of constantly switching between languages, or suppressing one language in favor of other, may help train the brain to be more flexible when the need comes to compensate for damaged areas.

The findings are consistent with previous observational studies suggesting that bilingualism delays the onset of Alzheimer's symptoms by up to five years.

[2712] Schweizer TA, Ware J, Fischer CE, Craik FIM, Bialystok E. Bilingualism as a contributor to cognitive reserve: Evidence from brain atrophy in Alzheimer’s disease. Cortex [Internet]. 2011 . Available from: http://www.cortexjournal.net/article/S0010-9452(11)00104-3/abstract

Valenzuela MJ and Sachdev P. 2006. Brain reserve and dementia: A systematic review. Psychological Medicine, 36(4): 441e454.

Research has shown that younger adults are better decision makers than older adults — a curious result. A new study tried to capture more ‘real-world’ decision-making, by requiring participants to evaluate each result in order to strategize the next choice.

This time (whew!), the older adults did better.

In the first experiment, groups of older (60-early 80s) and younger (college-age) adults received points each time they chose from one of four options and tried to maximize the points they earned.  For this task, the younger adults were more efficient at selecting the options that yielded more points.

In the second experiment, the rewards received depended on the choices made previously.  The “decreasing option” gave a larger number of points on each trial, but caused rewards on future trials to be lower. The “increasing option” gave a smaller reward on each trial but caused rewards on future trials to increase.  In one version of the test, the increasing option led to more points earned over the course of the experiment; in another, chasing the increasing option couldn’t make up for the points that could be accrued grabbing the bigger bite on each trial.

The older adults did better on every permutation.

Understanding more complex scenarios is where experience tells. The difference in performance also may reflect the different ways younger and older adults use their brains. Decision-making can involve two different reward learning systems, according to recent thinking. In the model-based system, a cognitive model is constructed that shows how various actions and their rewards are connected to each other. Decisions are made by simulating how one decision will affect future decisions. In the model-free system, on the other hand, only values associated with each choice are considered.

These systems are rooted in different parts of the brain. The model-based system uses the intraparietal sulcus and lateral prefrontal cortex, while the model-free system uses the ventral striatum. There is some evidence that younger adults use the ventral striatum (involved in habitual, reflexive learning and immediate reward) for decision-making more than older adults, and older adults use the dorsolateral prefrontal cortex (involved in more rational, deliberative thinking) more than younger adults.

In a study involving 115 seniors (average age 81), those who participated in a six-week, 12-session memory training program significantly improved their verbal memory. 15-20 seniors participated in each hour-long class, which included explanations of how memory works, quick strategies for remembering names, faces and numbers, basic memory strategies such as linking ideas and creating visual images, and information on a healthy lifestyle for protecting and maintaining memory.

Most of the study participants were women, Caucasian and had attained a college degree or higher level of education.

Following a 1994 study that found that errorless learning was better than trial-and-error learning for amnesic patients and older adults, errorless learning has been widely adopted in the rehabilitation industry. Errorless learning involves being told the answer without repeatedly trying to answer the question and perhaps making mistakes. For example, in the 1994 study, participants in the trial-and-error condition could produce up to three errors in answer to the question “I am thinking of a word that begins with QU”, before being told the answer was QUOTE; in contrast, participants in the errorless condition were simply told “I am thinking of a word that begins with QU and it is ‘QUOTE’.”

In a way, it is surprising that errorless learning should be better, given that trial-and-error produces much deeper and richer encoding, and a number of studies with young adults have indeed found an advantage for making errors. Moreover, it’s well established that retrieving an item leads to better learning than passively studying it, even when you retrieve the wrong item. This testing effect has also been found in older adults.

In another way, the finding is not surprising at all, because clearly the trial-and-error condition offers many opportunities for confusion. You remember that QUEEN was mentioned, for example, but you don’t remember whether it was a right or wrong answer. Source memory, as I’ve often mentioned, is particularly affected by age.

So there are good theoretical reasons for both positions regarding the value of mistakes, and there’s experimental evidence for both. Clearly it’s a matter of circumstance. One possible factor influencing the benefit or otherwise of error concerns the type of processing. Those studies that have found a benefit have generally involved conceptual associations (e.g. What’s Canada’s capital? Toronto? No, Ottawa). It may be that errors are helpful to the extent that they act as retrieval cues, and evoke a network of related concepts. Those studies that have found errors harm learning have generally involved perceptual associations, such as word stems and word fragments (e.g., QU? QUeen? No, QUote). These errors are arbitrary, produce interference, and don’t provide useful retrieval cues.

So this new study tested the idea that producing errors conceptually associated with targets would boost memory for the encoding context in which information was studied, especially for older adults who do not spontaneously elaborate on targets at encoding.

In the first experiment, 33 young (average age 21) and 31 older adults (average age 72) were shown 90 nouns presented in three different, intermixed conditions. In the read condition (designed to provide a baseline), participants read aloud the noun fragment presented without a semantic category (e.g., p­_g). In the errorless condition, the semantic category was presented with the target word fragment (e.g. a farm animal  p­_g), and the participants read aloud the category and their answer. The category and target were then displayed. In the trial-and-error condition, the category was presented and participants were encouraged to make two guesses before being shown the target fragment together with the category. The researchers changed the target if it was guessed. Participants were then tested using a list of 70 words, of which 10 came from each of the study conditions, 10 were new unrelated words, and 30 were nontarget exemplars from the TEL categories. Those that the subject had guessed were labeled as learning errors; those that hadn’t come up were labeled as related lures. In addition to an overall recognition test (press “yes” to any word you’ve studied and “no” to any new word), there were two tests that required participants to endorse items that were studied in the TEL condition and reject those studied in the EL condition, and vice versa.

The young adults did better than the older on every test. TEL produced better learning than EL, and both produced better learning than the read condition (as expected). The benefit of TEL was greater for older adults. This is in keeping with the idea that generating exemplars of a semantic category, as occurs in trial-and-error learning, helps produce a richer, more elaborated code, and that this is of greater to older adults, who are less inclined to do this without encouragement.

There was a downside, however. Older adults were also more prone to falsely endorsing prior learning errors or semantically-related lures. It’s worth noting that both groups were more likely to falsely endorse learning errors than related lures.

But the main goal of this first experiment was to disentangle the contributions of recollection and familiarity to the two types of learning. It turns out that there was no difference between young and older adults in terms of familiarity; the difference in performance between the two groups stemmed from recollection. Recollection was a problem for older adults in the errorless condition, but not in the trial-and-error condition (where the recollective component of their performance matched that of young adults). This deficit is clearly closely related to age-related deficits in source memory.

It was also found that familiarity was marginally more important in the errorless condition than the trial-and-error condition. This is consistent with the idea that targets learned without errors acquire greater fluency than those learned with errors (with the downside that they don’t pick up those contextual details that making errors can provide).

In the second experiment, 15 young and 15 older adults carried out much the same procedure, except that during the recognition test they were also required to mention the context in which the words were learned was tested (that is, were the words learned through trial-and-error or not).

Once again, trial-and-error learning was associated with better source memory relative to errorless learning, particularly for the older adults.

These results support the hypothesis that trial-and-error learning is more beneficial than errorless learning for older adults when the trials encourage semantic elaboration. But another factor may also be involved. Unlike other errorless studies, participants were required to attend to errors as well as targets. Explicit attention to errors may help protect against interference.

In a similar way, a recent study involving young adults found that feedback given in increments (thus producing errors) is more effective than feedback given all at once in full. Clearly what we want is to find that balance point, where elaborative benefits are maximized and interference is minimized.

[2496] Cyr A-A, Anderson ND. Trial-and-error learning improves source memory among young and older adults. Psychology and Aging. 2011 :No Pagination Specified - No Pagination Specified.

Following on from research showing that long-term meditation is associated with gray matter increases across the brain, an imaging study involving 27 long-term meditators (average age 52) and 27 controls (matched by age and sex) has revealed pronounced differences in white-matter connectivity between their brains.

The differences reflect white-matter tracts in the meditators’ brains being more numerous, more dense, more myelinated, or more coherent in orientation (unfortunately the technology does not yet allow us to disentangle these) — thus, better able to quickly relay electrical signals.

While the differences were evident among major pathways throughout the brain, the greatest differences were seen within the temporal part of the superior longitudinal fasciculus (bundles of neurons connecting the front and the back of the cerebrum) in the left hemisphere; the corticospinal tract (a collection of axons that travel between the cerebral cortex of the brain and the spinal cord), and the uncinate fasciculus (connecting parts of the limbic system, such as the hippocampus and amygdala, with the frontal cortex) in both hemispheres.

These findings are consistent with the regions in which gray matter increases have been found. For example, the tSLF connects with the caudal area of the temporal lobe, the inferior temporal gyrus, and the superior temporal gyrus; the UNC connects the orbitofrontal cortex with the amygdala and hippocampal gyrus

It’s possible, of course, that those who are drawn to meditation, or who are likely to engage in it long term, have fundamentally different brains from other people. However, it is more likely (and more consistent with research showing the short-term effects of meditation) that the practice of meditation changes the brain.

The precise mechanism whereby meditation might have these effects can only be speculated. However, more broadly, we can say that meditation might induce physical changes in the brain, or it might be protecting against age-related reduction. Most likely of all, perhaps, both processes might be going on, perhaps in different regions or networks.

Regardless of the mechanism, the evidence that meditation has cognitive benefits is steadily accumulating.

The number of years the meditators had practiced ranged from 5 to 46. They reported a number of different meditation styles, including Shamatha, Vipassana and Zazen.

A training program designed to help older adults with MCI develop memory strategies has found that their brains were still sufficiently flexible to learn new ways to compensate for impairment in some brain regions. The study involved 30 older adults, of whom 15 had MCI. Participants’ brains were scanned 6 weeks prior to memory training, one week prior to training and one week after training.

Before training, those with MCI showed less activity in brain regions associated with memory. After training they showed increased activation in these areas as well as in areas associated with language processing, spatial and object memory and skill learning. In particular, new activity in the right inferior parietal gyrus was associated with improvement on a memory task.

The findings demonstrate that even once diagnosed with MCI (a precursor to Alzheimer’s disease), brains can still be ‘rewired’ to use undamaged brain regions for tasks customarily done by now-damaged regions.

Clinical records of 211 patients diagnosed with probable Alzheimer's disease have revealed that those who have spoken two or more languages consistently over many years experienced a delay in the onset of their symptoms by as much as five years. It’s thought that lifelong bilingualism may contribute to cognitive reserve in the brain, enabling it to compensate for memory loss, confusion, and difficulties with problem-solving and planning.

Of the 211 patients of the Sam and Ida Ross Memory Clinic at Baycrest, 102 patients were classified as bilingual and 109 as monolingual. Bilingual patients had been diagnosed with Alzheimer's 4.3 years later than the monolingual patients on average, and had reported the onset of symptoms 5.1 years later. The groups were equivalent on measures of cognitive and occupational level, there was no apparent effect of immigration status, and there were no gender differences.

The findings confirm an earlier study from the same researchers, from the clinical records of 184 patients diagnosed with probable Alzheimer's and other forms of dementia.

[2039] Craik FIM, Bialystok E, Freedman M. Delaying the onset of Alzheimer disease. Neurology [Internet]. 2010 ;75(19):1726 - 1729. Available from: http://www.neurology.org/content/75/19/1726.abstract

On the subject of the benefits of walking for seniors, it’s intriguing to note a recent pilot study that found frail seniors who walked slowly (no faster than one meter per second) benefited from a brain fitness program known as Mindfit. After eight weeks of sessions three times weekly (each session 45-60 minutes), all ten participants walked a little faster, and significantly faster while talking. Walking while talking requires considerably more concentration than normal walking. The success of this short intervention (which needs to be replicated in a larger study) offers the hope that frail elderly who may be unable to participate in physical exercise, could improve their mobility through brain fitness programs. Poor gait speed is also correlated with a higher probability of falls.

The connection between gait speed and cognitive function is an interesting one. Previous research has indicated that slow gait should alert doctors to check for cognitive impairment. One study found severe white matter lesions were more likely in those with gait and balance problems. Most recently, a longitudinal study involving over 900 older adults has found poorer global cognitive function, verbal memory, and executive function, were all predictive of greater decline in gait speed.

The study involved 13 patients and 14 controls, who listened to either spoken lyrics or lyrics sung with full musical accompaniment while reading the printed lyrics on a screen. The 40 lyrics were four-line excerpts of children’s songs, all characterized by having simple, unrepeated lyrics, repetitive melodies, and a perfect end-rhyme scheme for the four lines. The participants were then given these 40 lyrics mixed in with 40 other similar lyrics, and asked whether they had heard it earlier. Alzheimer’s patients were markedly more likely to recognize those they had heard sung (40% compared to 28% of the spoken). Interestingly, the controls showed no difference, although of course their performance was considerably better (77% and 74%).

It may be that setting new information, such as simple instructions, to music might help Alzheimer’s patients remember it.

On a side note, a recent study found that classical music (four short pieces by different composers) affected the heart rates of people in a vegetative state in the same way as they did those of healthy listeners, suggesting that music affects emotion at very deep level. (see http://www.newscientist.com/article/dn19123-classical-music-moves-the-he...)

While brain training programs can certainly improve your ability to do the task you’re practicing, there has been little evidence that this transfers to other tasks. In particular, the holy grail has been very broad transfer, through improvement in working memory. While there has been some evidence of this in pilot programs for children with ADHD, a new study is the first to show such improvement in older adults using a commercial brain training program.

A study involving 30 healthy adults aged 60 to 89 has demonstrated that ten hours of training on a computer game designed to boost visual perception improved perceptual abilities significantly, and also increased the accuracy of their visual working memory to the level of younger adults. There was a direct link between improved performance and changes in brain activity in the visual association cortex.

The computer game was one of those developed by Posit Science. Memory improvement was measured about one week after the end of training. The improvement did not, however, withstand multi-tasking, which is a particular problem for older adults. The participants, half of whom underwent the training, were college educated. The training challenged players to discriminate between two different shapes of sine waves (S-shaped patterns) moving across the screen. The memory test (which was performed before and after training) involved watching dots move across the screen, followed by a short delay and then re-testing for the memory of the exact direction the dots had moved.

A rat study demonstrates how specialized brain training can reverse many aspects of normal age-related cognitive decline in targeted areas. The month-long study involved daily hour-long sessions of intense auditory training targeted at the primary auditory cortex. The rats were rewarded for picking out the oddball note in a rapid sequence of six notes (five of them of the same pitch). The difference between the oddball note and the others became progressively smaller. After the training, aged rats showed substantial reversal of their previously degraded ability to process sound. Moreover, measures of neuron health in the auditory cortex had returned to nearly youthful levels.

Loss of memory and problems with judgment in dementia patients can cause difficulties in relation to eating and nutrition; these problems in turn can lead to poor quality of life, pressure ulcers and infections. A study used two different step-by-step training programs to help dementia patients regain eating skills. Three institutions, involving 85 patients, were assigned to one of three programs: spaced retrieval training; Montessori-based training; control. Training consisted of three 30-40 min sessions per week, for 8 weeks. Both training programs resulted in significantly improved feeding skills, however the Montessori group needed more physical and verbal assistance. Nutritional status was significantly higher in the spaced-retrieval group compared to the control.

Lin, L., Huang, Y., Su, S., Watson, R., Tsai, B. W., & Wu, S. (2010). Using spaced retrieval and Montessori-based activities in improving eating ability for residents with dementia. International Journal of Geriatric Psychiatry, 9999(9999), n/a. doi: 10.1002/gps.2433.

It’s now well established that older brains tend to find it harder to filter out irrelevant information. But now a new study suggests that that isn’t all bad. The study compared the performance of 24 younger adults (17-29) and 24 older adults (60-73) on two memory tasks separated by a 10-minute break. In the first task, they were shown pictures overlapped by irrelevant words, told to ignore the words and concentrate on the pictures only, and to respond every time the same picture appeared twice in a row. The second task required them to remember how the pictures and words were paired together in the first task. The older adults showed a 30% advantage over younger adults in their memory for the preserved pairs. It’s suggested that older adults encode extraneous co-occurrences in the environment and transfer this knowledge to subsequent tasks, improving their ability to make decisions.

[276] Campbell KL, Hasher L, Thomas RC. Hyper-binding: a unique age effect. Psychological Science: A Journal of the American Psychological Society / APS [Internet]. 2010 ;21(3):399 - 405. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20424077

Full text available at http://pss.sagepub.com/content/early/2010/01/15/0956797609359910.full

A study involving 155 women aged 65-75 has found that those who participated in resistance training once or twice weekly for a year significantly improved their selective attention (maintaining mental focus) and conflict resolution (as well as muscular function of course!), compared to those who participated in twice-weekly balance and tone training. Performance on the Stroop test improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups respectively, while it deteriorated by 0.5% in the balance and tone group. Improved attention and conflict resolution was also significantly associated with increased gait speed.

A study involving 54 older adults (66-76) and 58 younger adults (18-35) challenges the idea that age itself causes people to become more risk-averse and to make poorer decisions. Analysis revealed that it is individual differences in processing speed and memory that affect decision quality, not age. The stereotype has arisen no doubt because more older people process slowly and have poorer memory. The finding points to the need to identify ways in which to present information that reduces the demand on memory or the need to process information very quickly, to enable those in need of such help (both young and old) to make the best choices. Self-knowledge also helps — recognizing if you need to take more time to make a decision.

And in another pilot study, people deprived of speech following a stroke were taught to sing words instead of speaking them in a technique known as 'melodic intonation therapy'. Brain scans also showed functional and structural changes in the undamaged hemisphere after they had received the therapy. Doctors are now testing the therapy in 30 stroke patients to assess how many people who lose their speech after a stroke would benefit.

The findings were reported at the American Association for the Advancement of Science meeting in San Diego.

It has been well-established that, compared to younger adults, older adults require more practice to achieve the same level of performance1. Sometimes, indeed, they may need twice as much2.

In the present study, two groups of adult subjects were given paired items to learn during multiple study-test trials. During each trial items were presented at the subject's pace. Afterwards the subjects were asked to judge how likely they were to be able to recall each item in a test.

It was found that people were very good at accurately judging the likelihood of their correct recall. Correlations between judgments and the amount of time the subjects studied the items suggested that people were monitoring their learning and using this to allocate study time.

However, older adults (with a mean age of 67) used monitoring to a lesser degree than the younger adults (with a mean age of 22), and the results suggested that part of the reason for the deficit in recall commonly found with older adults is due to this factor.

References

1. For a review, see Kausler, D.H. 1994. Learning and memory in normal aging. New York: Academic Press.

2. Delbecq-Derousné, J. & Beauvois, M. 1989. Memory processes and aging: A defect of automatic rather than controlled processes? Archives of Gerontology & Geriatrics, 1 (Suppl), 121-150.

Salthouse, T.A. & Dunlosky, J. 1995. Analyses of adult age differences in associative learning. Zeitschrift für Psychologie, 203, 351-360

Dunlosky, J. & Connor, L.T. (1997). Age differences in the allocation of study time account for age differences in memory performance. Memory and Cognition, 25, 691-700.

Older news items (pre-2010) brought over from the old website

Characteristics of age-related cognitive decline in semantic memory

A study involving 117 healthy elderly (aged 60-91) has found that, while increasing age was associated with poorer memory for names of famous people, age didn’t affect memory for biographical details about them. It also found that names served as better cues to those details than faces did. A follow-up study (to be published in Neuropsychologia) found that, in contrast, those with mild cognitive impairment and early Alzheimer’s showed not only an increased inability to remember names, but also a decline in memory for biographical details.

[1308] Langlois R, Fontaine F, Hamel C, Joubert S. [The impact of aging on the ability to recognize famous faces and provide biographical knowledge of famous people]. Canadian Journal on Aging = La Revue Canadienne Du Vieillissement [Internet]. 2009 ;28(4):337 - 345. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19925699

http://www.eurekalert.org/pub_releases/2009-12/uom-whn121809.php

Rote learning may improve verbal memory in seniors

A study involving 24 older adults (aged 55—70) has found that six weeks of intensive rote learning (memorizing a newspaper article or poem of 500 words every week) resulted in measurable changes in N-acetylaspartate, creatine and choline, three metabolites in the brain that are related to memory performance and neural cell health, in the left posterior hippocampus — but only after a six-week rest period, at which time the participants also showed improvements in their verbal and episodic memory, and also only in one of the two learning groups. The group that didn’t show any change were said to have low compliance with the memorization task.

McNulty, J. et al. The Identification of Neurometabolic Sequelae Post-learning Using Proton Magnetic Resonance Spectroscopy. Presented November 26 at the annual meeting of the Radiological Society of North America (RSNA).

http://www.eurekalert.org/pub_releases/2006-11/rson-rli112206.php

Actors’ memory tricks help students and older adults

The ability of actors to remember large amounts of dialog verbatim is a marvel to most of us, and most of us assume they do by painful rote memorization. But two researchers have been studying the way actors learn for many years and have concluded that the secret of actors' memories is in the acting; an actor learning lines by focusing on the character’s motives and feelings — they get inside the character. To do this, they break a script down into a series of logically connected "beats" or intentions. The researchers call this process active experiencing, which uses "all physical, mental, and emotional channels to communicate the meaning of material to another person." This principle can be applied in other contexts. For example, students who imagined themselves explaining something to somebody else remembered more than those who tried to memorize the material by rote. Physical movement also helps — lines learned while doing something, such as walking across the stage, were remembered better than lines not accompanied with action. The principles have been found useful in improving memory in older adults: older adults who received a four-week course in acting showed significantly improved word-recall and problem-solving abilities compared to both a group that received a visual-arts course and a control group, and this improvement persisted four months afterward.

[2464] Noice H, Noice T. What Studies of Actors and Acting Can Tell Us About Memory and Cognitive Functioning. Current Directions in Psychological Science [Internet]. 2006 ;15(1):14 - 18. Available from: http://dx.doi.org/10.1111/j.0963-7214.2006.00398.x

http://www.eurekalert.org/pub_releases/2006-01/aps-bo012506.php

'Imagination' helps older people remember to comply with medical advice

A new study suggests a way to help older people remember to take medications and follow other medical advice. Researchers found older adults (aged 60 to 81) who spent a few minutes picturing how they would test their blood sugar were 50% more likely to actually do these tests on a regular basis than those who used other memory techniques. Participants were assigned to one of three groups. One group spent one 3-minute session visualizing exactly what they would be doing and where they would be the next day when they were scheduled to test their blood sugar levels. Another group repeatedly recited aloud the instructions for testing their blood. The last group were asked to write a list of pros and cons for testing blood sugar. All participants were asked not to use timers, alarms or other devices. Over 3 weeks, the “imagination” group remembered 76% of the time to test their blood sugar at the right times of the day compared to an average of 46% in the other two groups. They were also far less likely to go an entire day without testing than those in the other two groups.

[473] Liu LL, Park DC. Aging and medical adherence: the use of automatic processes to achieve effortful things. Psychology and Aging [Internet]. 2004 ;19(2):318 - 325. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15222825

http://www.eurekalert.org/pub_releases/2004-06/nioa-ho060104.php

How to benefit from memory training

Brain and memory training programs are increasingly popular, but they don't work well for everyone. In particular, they tend to be much less effective for those who need them the most — those 80 and older, and those with lower initial ability. But a new study shows the problem is not intrinsic, but depends on the strategies people use.  The study found that people in their 60s and 70s used a strategy of spending most of their time on studying the materials and very little on the test, and showed large improvements over the testing sessions. By contrast, most people in their 80s and older spent very little time studying and instead spent most of their time on the test. These people did not do well and showed very little improvement even after two weeks of training.

[882] Bissig D[1], Lustig C[2]. Who Benefits From Memory Training?. Psychological Science [Internet]. 2007 ;18:720 - 726. Available from: http://www.ingentaconnect.com/content/bpl/psci/2007/00000018/00000008/art00013

http://www.eurekalert.org/pub_releases/2007-08/uom-dpt082007.php

Add comment

Filtered HTML

  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
By submitting this form, you accept the Mollom privacy policy.