Elderly Individuals with Diabetes: Adding Cognitive Training to Psychoeducational Intervention

The present research examined the effects of a cognitive training program combined with psychoeducational intervention for diabetic elderly patients. Specifically, it aimed at assessing the effects of an eight-session cognitive training and educational program in diabetic elderly individuals and investigating changes in their awareness about specific aspects of diabetes. The final sample consisted of 34 individuals-19 in the experimental group (EG) and 15 in the control group (CG), all residing in the eastern region of the city of Sao Paulo. The protocol included clinical and sociodemographic questions; the Diabetes Attitudes Questionnaire (ATT-19); Diabetes Knowledge Scale (DKN-A); Mini Mental State Examination (MMSE); Verbal Fluency-animal category (VF); Geriatric Depression Scale (GDS); Short Cognitive Performance Test (SKT); and the Rivermead Behavioral Memory Test (RBMT). Results pointed to a significant difference between the two groups for the ATT-19, DKN, and SKT-memory and SKT-total, and a marginally significant difference for the RBMT history in the posttest. As for the remaining cognitive variables, no changes were observed. Retest effects were not observed in the CG. We concluded that cognitive training combined with psychoeducational intervention in diabetic elderly individuals may be effective in producing cognitive gains as well as attitude and knowledge improvement concerning diabetes mellitus (DM).

Effect of Nintendo Wii (TM)-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: A randomised clinical trial

Objectives To investigate the effect of Nintendo Wii (TM)-based motor cognitive training versus balance exercise therapy on activities of daily living in patients with Parkinson's disease. Design Parallel, prospective, single-blind, randomised clinical trial. Setting Brazilian Parkinson Association. Participants Thirty-two patients with Parkinson's disease (Hoehn and Yahr stages 1 and 2). Interventions Fourteen training sessions consisting of 30 minutes of stretching, strengthening and axial mobility exercises, plus 30 minutes of balance training. The control group performed balance exercises without feedback or cognitive stimulation, and the experimental group performed 10 Wii Fit (TM) games. Main outcome measure Section II of the Unified Parkinson's Disease Rating Scale (UPDRS-II). Randomisation Participants were randomised into a control group (n = 16) and an experimental group (n = 16) through blinded drawing of names. Statistical analysis Repeated-measures analysis of variance (RM-ANOVA). Results Both groups showed improvement in the UPDRS-II with assessment effect (RM-ANOVA P < 0.001, observed power = 0.999). There was no difference between the control group and the experimental group before training {8.9 [standard deviation (SD) 2.9] vs 10.1 (SD 3.8)}, after training [7.6 (SD 2.9) vs 8.1 (SD 3.5)] or 60 days after training [8.1 (SD 3.2) vs 8.3 (SD 3.6)]. The mean difference of the whole group between before training and after training was -0.9 (SD 2.3, 95% confidence interval -1.7 to -0.6). Conclusion Patients with Parkinson's disease showed improved performance in activities of daily living after 14 sessions of balance training, with no additional advantages associated with the Wii-based motor and cognitive training. Registered on http://www.clinicaltrials.gov (identifier: NCT01580787). (C) 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Cognitive Training and Educational Intervention for Individuals with Hypertension: Effects on Cognition

Objectives: To evaluate the possibility of combining cognitive training to an educational intervention composed by eight sessions about hypertension for a better management of the disease among the elderly. Methods: 64 older adults who reported having hypertension, divided into experimental group (EG, n=35) and control group (CG, n=29) participated in the study. Control participants received training after the post-test. The protocol contained socio-demographic and clinical data, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Rivermead Behavioral Memory Test (RBMT), Verbal Fluency Animal Category (VF) and Short Cognitive Test (SKT). Results: The EG showed better cognitive performance when compared with the CG, at post-test. Conclusion: Cognitive gains may occur after psychoeducational interventions for older adults with hypertension.

Treino cognitivo e intervenção psicoeducativa para indivíduos hipertensos: efeitos na cognição

OBJETIVOS: Avaliar a possibilidade de aliar o treino cognitivo à intervenção psicoeducativa de oito sessões sobre hipertensão visando melhor manejo desta condição crônica em idosos. MÉTODOS: Participaram 64 idosos que se declararam como hipertensos, divididos em grupo experimental (GE, n=35) e grupo controle (GC, n=29). O grupo controle recebeu treino após o pós teste. O protocolo incluiu dados sócio-demográficos e clínicos, o Mini-Exame do Estado Mental (MEEM), Escala de Depressão Geriátrica (EDG), Teste Comportamental de Memória de Rivermead (RBMT), Fluência Verbal categoria animais (FV) e Short Cognitive Test (SKT). RESULTADOS: Pôde-se observar que o GE apresentou melhor desempenho cognitivo, quando comparado ao GC, após a intervenção. CONCLUSÕES: Podem ocorrer ganhos cognitivos associados a uma intervenção psicoeducativa para idosos hipertensos.

Treino cognitivo em adultos maduros e idosos: impacto de estratégias segundo faixas de escolaridade

Objetivou-se com este estudo testar a eficácia de treino cognitivo de seis sessões, baseado na apresentação e prática de estratégias de memória (categorização) e na realização de atividades que recrutam as funções executivas, oferecido a idosos. Objetivou-se, também, identificar e comparar as estratégias mnemônicas utilizadas pelos participantes antes e após treino, segundo faixas de escolaridade. Participaram do estudo 31 idosos, divididos em Grupo 1 (com até 8 anos de escolaridade) e Grupo 2 (com 9 anos ou mais). Foram aplicadas questões sociodemográficas, escalas cognitivas e uma lista de estratégias possíveis para identificação das estratégias usadas. Os resultados indicaram a influência da escolaridade no uso de estratégias de memória no pré-teste. No pós-teste, apontaram para aumento na velocidade de processamento e na utilização de estratégias. Concluiu-se que o uso de estratégias, a autoeficácia para a memória e o ganho após o treino cognitivo podem ser influenciados pela escolaridade.

Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease - effect of motor and cognitive demands of games: a longitudinal, controlled clinical study

Objectives To evaluate the learning, retention and transfer of performance improvements after Nintendo Wii Fit (TM) training in patients with Parkinson's disease and healthy elderly people. Design Longitudinal, controlled clinical study. Participants Sixteen patients with early-stage Parkinson's disease and 11 healthy elderly people. Interventions Warm-up exercises and Wii Fit training that involved training motor (shifts centre of gravity and step alternation) and cognitive skills. A follow-up evaluative Wii Fit session was held 60 days after the end of training. Participants performed a functional reach test before and after training as a measure of learning transfer. Main outcome measures Learning and retention were determined based on the scores of 10 Wii Fit games over eight sessions. Transfer of learning was assessed after training using the functional reach test. Results Patients with Parkinson's disease showed no deficit in learning or retention on seven of the 10 games, despite showing poorer performance on five games compared with the healthy elderly group. Patients with Parkinson's disease showed marked learning deficits on three other games, independent of poorer initial performance. This deficit appears to be associated with cognitive demands of the games which require decision-making, response inhibition, divided attention and working memory. Finally, patients with Parkinson's disease were able to transfer motor ability trained on the games to a similar untrained task. Conclusions The ability of patients with Parkinson's disease to learn, retain and transfer performance improvements after training on the Nintendo Wii Fit depends largely on the demands, particularly cognitive demands, of the games involved, reiterating the importance of game selection for rehabilitation purposes. (C) 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Memory-rescuing effects of cannabidiol in an animal model of cognitive impairment relevant to neurodegenerative disorders

Rationale Cannabidiol, the main nonpsychotropic constituent of Cannabis sativa, possesses a large number of pharmacological effects including anticonvulsive, sedative, hypnotic, anxiolytic, antipsychotic, anti-inflammatory, and neuroprotective, as demonstrated in clinical and preclinical studies. Many neurodegenerative disorders involve cognitive deficits, and this has led to interest in whether cannabidiol could be useful in the treatment of memory impairment associated to these diseases. Objectives We used an animal model of cognitive impairment induced by iron overload in order to test the effects of cannabidiol in memory-impaired rats. Methods Rats received vehicle or iron at postnatal days 12-14. At the age of 2 months, they received an acute intraperitoneal injection of vehicle or cannabidiol (5.0 or 10.0 mg/kg) immediately after the training session of the novel object recognition task. In order to investigate the effects of chronic cannabidiol, iron-treated rats received daily intraperitoneal injections of cannabidiol for 14 days. Twenty-four hours after the last injection, they were submitted to object recognition training. Retention tests were performed 24 h after training. Results A single acute injection of cannabidiol at the highest dose was able to recover memory in iron-treated rats. Chronic cannabidiol improved recognition memory in iron-treated rats. Acute or chronic cannabidiol does not affect memory in control rats. Conclusions The present findings provide evidence suggesting the potential use of cannabidiol for the treatment of cognitive decline associated with neurodegenerative disorders. Further studies, including clinical trials, are warranted to determine the usefulness of cannabidiol in humans suffering from neurodegenerative disorders.

Meditation training increases brain efficiency in an attention task

Meditation is a mental training, which involves attention and the ability to maintain focus on a particular object. In this study we have applied a specific attentional task to simply measure the performance of the participants with different levels of meditation experience, rather than evaluating meditation practice per se or task performance during meditation. Our objective was to evaluate the performance of regular meditators and non-meditators during an fMRI adapted Stroop Word-Colour Task (SWCT), which requires attention and impulse control, using a block design paradigm. We selected 20 right-handed regular meditators and 19 non-meditators matched for age, years of education and gender. Participants had to choose the colour (red, blue or green) of single words presented visually in three conditions: congruent, neutral and incongruent. Non-meditators showed greater activity than meditators in the right medial frontal, middle temporal, precentral and postcentral gyri and the lentiform nucleus during the incongruent conditions. No regions were more activated in meditators relative to non-meditators in the same comparison. Non-meditators showed an increased pattern of brain activation relative to regular meditators under the same behavioural performance level. This suggests that meditation training improves efficiency, possibly via improved sustained attention and impulse control. (C) 2011 Elsevier Inc. All rights reserved.