Project description:ObjectivesWith increasing global life expectancy, cognitive interventions hold promise in mitigating cognitive decline and fostering healthy aging. Despite the demand for evidence-based interventions, there have been few attempts to summarize existing evidence. This study aims to assess the effectiveness and feasibility of unimodal and multimodal cognitive interventions for cognitively healthy older adults.MethodSystematic meta-review, selecting articles from four databases: PubMed, Web of Science, Embase, and Cochrane Library. Quality assessment carried out with AMSTAR2. Findings were summarized and discussed narratively.ResultsThirty-nine articles were included, with 21 meta-analyses and 18 qualitative systematic reviews. The total number of reviews was 38 for cognitive training, 4 for cognitive stimulation, and 1 for multicomponent interventions. Most reviews had low or critically low quality.ConclusionsThe prevailing evidence supports cognitive training. Continued research into cognitive stimulation and multicomponent protocols is encouraged. Longer follow-ups are important for identifying combined and clinically significant results. Rigorous risk of bias and quality assessment is necessary to enhance the evidence base.
Project description:BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies.AimThe aim of this study was to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing.MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis.ResultsThree main themes and twelve sub-themes addressing our study aim resulted from the data obtained. The main themes revolved around favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations.ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact were also addressed by participants as key considerations.
Project description:Mild cognitive impairment is frequent among people with Parkinson’s disease. Cognitive training seems effective for cognitive status and for mitigating anxiety and depression. With the COVID-19 outbreak, such therapeutic interventions were delivered online. This longitudinal mixed-method study was aimed at evaluating the effectiveness of an online cognitive treatment, carried out during COVID times and based on Parkinson’s-Adapted Cognitive Stimulation Therapy, on cognitive domains and mood of 18 older people with Parkinson’s disease. After screening, the cognitive status and mood were assessed three times by Addenbrooke’s Cognitive Examination-Revised scale and the Geriatric Depression Scale-Short Form. At the follow-up, patients were also interviewed for understanding their experience with the technology. Such treatment was effective on the participants’ cognitive functions, but not on their mood. Despite some initial problems with the technology, the online intervention was experienced as a way of not being ‘left behind’, staying in contact with others, and being safe during the lockdown. This suggests that online cognitive treatment can be adopted to integrate face-to-face interventions by increasing their efficacy, accessibility, and long-term outcomes. Suggestions for future research are given.
Project description:ObjectiveTo test the efficacy of a tablet computer training intervention to improve cognitive abilities of older adults.DesignProspective randomized controlled trial.SettingCommunity-based aging intervention study, Edinburgh, UK.ParticipantsForty-eight healthy older adults aged 65 to 76 years were recruited at baseline with no or minimal tablet experience; 43 completed follow-up testing.InterventionTwenty-two participants attended a weekly 2-hour class for 10 weeks during which they learned how to use a tablet and various applications on it.MeasurementsA battery of cognitive tests from the WAIS-IV measuring the domains of Verbal Comprehension, Perceptual Processing, Working Memory, and Processing Speed, as well as health, psychological, and well-being measures.ResultsA 2 × 2 mixed model ANOVA suggested that the tablet intervention group (N = 22) showed greater improvements in Processing Speed (η2 = 0.10) compared with controls (N = 21), but did not differ in Verbal Comprehension, Perceptual Processing, or Working Memory (η2 ranged from -0.03 to 0.04).ConclusionsEngagement in a new mentally challenging activity (tablet training) was associated with improved processing speed. Acquiring skills in later life, including those related to adopting new technologies, may therefore have the potential to reduce or delay cognitive changes associated with ageing. It is important to understand how the development of these skills might further facilitate everyday activities, and also improve older adults' quality of life.
Project description:BackgroundThe molecular factors which control circulating levels of inflammatory proteins are not well understood. Furthermore, association studies between molecular probes and human traits are often performed by linear model-based methods which may fail to account for complex structure and interrelationships within molecular datasets.MethodsIn this study, we perform genome- and epigenome-wide association studies (GWAS/EWAS) on the levels of 70 plasma-derived inflammatory protein biomarkers in healthy older adults (Lothian Birth Cohort 1936; n = 876; Olink® inflammation panel). We employ a Bayesian framework (BayesR+) which can account for issues pertaining to data structure and unknown confounding variables (with sensitivity analyses using ordinary least squares- (OLS) and mixed model-based approaches).ResultsWe identified 13 SNPs associated with 13 proteins (n = 1 SNP each) concordant across OLS and Bayesian methods. We identified 3 CpG sites spread across 3 proteins (n = 1 CpG each) that were concordant across OLS, mixed-model and Bayesian analyses. Tagged genetic variants accounted for up to 45% of variance in protein levels (for MCP2, 36% of variance alone attributable to 1 polymorphism). Methylation data accounted for up to 46% of variation in protein levels (for CXCL10). Up to 66% of variation in protein levels (for VEGFA) was explained using genetic and epigenetic data combined. We demonstrated putative causal relationships between CD6 and IL18R1 with inflammatory bowel disease and between IL12B and Crohn's disease.ConclusionsOur data may aid understanding of the molecular regulation of the circulating inflammatory proteome as well as causal relationships between inflammatory mediators and disease.
Project description:Retirement is a critical step in older adults' lives, so it is important to motivate them to stay physically active, mentally healthy, and socially connected in the transition from work to retirement, including through digital health coaching programs. This study aims to: evaluate the impact of a digital coaching intervention to enhance three healthy ageing dimensions, i.e., physical activity, mental well-being, and socialization of a group of adults near retirement; understand the users' experience; and identify the system strengths and weaknesses. This longitudinal mixed-methods study, carried out in 2021 in Italy and the Netherlands, enrolled 62 individuals. In the first 5 weeks of the trial, participants used a digital coach with the support of human coaches, and then they continued autonomously for another 5 weeks. The use of the digital coach improved the participants' physical activity, mental well-being and self-efficacy during the first period and only the physical activity in the second. An effective coaching system should be flexible and attractive. High levels of personalization remain the golden key to aligning the health program to the physical, cognitive and social status of the intended target, thus increasing the user-system interaction, usability, and acceptability, as well as enhancing adherence to the intervention.
Project description:IntroductionDigital game-based training interventions are scalable solutions that may improve cognitive function for many populations. This protocol for a two-part review aims to synthesise the effectiveness and key features of digital game-based interventions for cognitive training in healthy adults across the life span and adults with cognitive impairment, to update current knowledge and impact the development of future interventions for different adult subpopulations.Methods and analysisThis systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. A systematic search was performed in PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PsycINFO and IEEE Explore on 31 July 2022 for relevant literature published in English from the previous 5 years. Experimental, observational, exploratory, correlational, qualitative and mixed methods studies will be eligible if they report at least one cognitive function outcome and include a digital game-based intervention intended to improve cognitive function. Reviews will be excluded but retained to search their reference lists for other relevant studies. All screening will be done by at least two independent reviewers. The appropriate Joanna Briggs Institute Critical Appraisal Tool, according to the study design, will be applied to perform the risk of bias assessment. Outcomes related to cognitive function and digital game-based intervention features will be extracted. Results will be categorised by adult life span stages in the healthy adult population for part 1 and by neurological disorder in part 2. Extracted data will be analysed quantitatively and qualitatively, according to study type. If a group of sufficiently comparable studies is identified, we will perform a meta-analysis applying the random effects model with consideration of the I2 statistic.Ethics and disseminationEthics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publications and conference presentations.Prospero registration numberCRD42022351265.
Project description:The expression of microRNA (miRNA) is influenced by ongoing biological processes, including aging, and has begun to play a role in the measurement of neurodegenerative processes in central nervous system. The purpose of this study is to utilize machine learning approaches to determine whether miRNA can be utilized as a blood-based biomarker of cognitive aging. A random forest regression combining miRNA with biological (brain volume), clinical (comorbid conditions), and demographic variables in 115 typically aging older adults explained the greatest level of variance in cognitive performance compared to the other machine learning models explored. Three miRNA (miR-140-5p, miR-197-3p, and miR-501-3p) were top-ranked predictors of multiple cognitive outcomes (Fluid, Crystallized, and Overall Cognition) and past studies of these miRNA link them to cellular senescence, inflammatory signals for atherosclerotic formation, and potential development of neurodegenerative disorders (e.g., Alzheimer's disease). Several novel miRNAs were also linked to age and multiple cognitive functions, findings which together warrant further exploration linking these miRNAs to brain-derived metrics of neurodegeneration in typically aging older adults.
Project description:IntroductionDespite the positive effects of physical activity (PA) to prevent lifestyle diseases and improve health and well-being, only one-third of Norwegian adults meet the minimum recommendations on PA. Digital interventions to promote PA in inactive adults may improve health and well-being by being available, personalized and adequate. Knowledge on users' adoption, acceptability and sustainability of digital interventions to promote PA is still limited.ObjectiveTo investigate the adoption, acceptability and sustained use of three digital interventions for promoting PA among inactive adults.DesignA randomized control trial (ONWARDS) with 183 participants assigned to 3 groups and followed up for 18 months. All participants received a wearable activity tracker with the personalized metric Personal Activity Intelligence (PAI) on a mobile app, two groups received additional access to online training and one group had also access to online social support.MethodsA mixed-methods approach was used to address the study objective. Acceptability was evaluated through the System Usability Scale (SUS) (n = 134) at 6 months. Adoption and sustained use were evaluated through a set of questions administered at 12 months (n = 109). Individual interviews were performed at 6 months with a sample of participants (n = 18). Quantitative data were analyzed with descriptive statistics, whereas qualitative data were analyzed using the Framework approach.ResultsPAI was the most successful intervention, with satisfactory usability and positive effects on motivation and behavior change, contributing to high adoption and sustained use. Online social support had a high acceptability and sustained use, but the intervention was not perceived as motivational to increase PA. Online training had low adoption, usability and sustained use. The qualitative interviews identified five main themes: (1) overall approach to physical activity, (2) motivation, (3) barriers to perform PA, (4) effects of PA, and (5) usability and acceptability of the digital interventions.ConclusionPersonalized digital interventions integrating behavior change techniques such as individual feedback and goal setting are more likely to increase acceptability, adoption and sustained use. Future studies should investigate which digital interventions or combinations of different interventions are more successful in promoting PA among inactive adults according to the characteristics and preferences of the users.Trial registrationClinical trial registered at ClinicalTrials.gov: NCT04526444.