Evaluation of the cognitive-motor training effectiveness in combination with drug therapy among patients with moderate cognitive disorders: the own research results
https://doi.org/10.21518/2079-701X-2022-16-2-44-51
Abstract
Introduction. Non-drug methods of therapy for cognitive impairment is one of the topical areas of neurology. Studies have shown that cognitive training may be beneficial for maintaining mental alertness in healthy older adults, while patients with dementia and mild cognitive impairment are more likely to benefit from cognitive-motor training or rehabilitation. It is possible that the severity and type of cognitive disorders, as well as patients’ adherence to training, the correct construction of tasks, may affect the effectiveness of non-drug therapy for cognitive disorders.
Аim. The aim of this study was to evaluate the effectiveness of cognitive-motor training developed at Sechenov University in patients with moderate cognitive impairment (MCI).
Materials and methods. 41 patients were included in the study, including 8 women and 33 men, the average age of patients was 60.3 ± 8.5 years, the average level of education was 14.2 ± 8.7 years, of which 15 patients met the criteria AD, 26 – VCI criteria. Patients underwent quantitative neuropsychological testing, assessment of emotional disorders, and also assessed such indicators as satisfaction with the quality of life, adherence to therapy. Subsequently, the patients were divided into groups of individual and group cognitive training. Classes with patients were held according to the standard scheme, 30–50 minutes a day, for 40 days. After 3 months, 10 patients were randomly selected from the individual training group and received an additional course of group cognitive-motor training.
Results. Тhe study showed that after 1.5 months, patients showed a significant decrease in the severity of cognitive disorders (p < 0.05). The greatest positive dynamics was noted in relation to the level of attention (p < 0.05), memory (including primary modal-nonspecific mnestic impairment, p < 0.05), logical operations (p < 0.05). The patients included in the study also showed a significant decrease in the severity of depression (p < 0.05). The analysis showed that significant positive dynamics was recorded both in patients of the individual CT group and in patients who received group CT (p < 0.05). The positive effect on cognitive functions was maintained during the three months of follow-up. Comparative analysis of study patients after 6 months showed that patients who received additional sessions with a trainer reported an additional improvement in well-being. These differences were statistically significant, despite the small number of patients included in the repeat CT group (p < 0.05).
Conclusions. The effectiveness of cognitive-motor training in patients with MCI was noted. The results obtained allow us to recommend this type of cognitive-motor training for use in clinical practice by neurologists, therapists and psychiatrists as an additional effective method for the treatment of cognitive impairment.
About the Authors
A. A. KindarovaRussian Federation
Postgraduate Student of the Department of Nervous Diseases and Neurosurgery
8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia
D. Fantalis
Russian Federation
Postgraduate Student of the Department of Nervous Diseases and Neurosurgery
8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia
I. S. Preobrazhenskaya
Russian Federation
Dr. Sci. (Med.), Professor of the Department of Nervous Diseases and Neurosurgery
8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia
References
1. Akbaraly T.N., Portet F., Fustinoni S., Dartigues J.F., Artero S., Rouaud O. et al. Leisure activities and the risk of dementia in the elderly results from the Three-City Study. Neurology. 2009;73(11):854–861. https://doi.org/10.1212/WNL.0b013e3181b7849b.
2. Bahar-Fuchs A., Webb S., Bartsch L., Clare L., Rebok G., Cherbuin N., Anstey K.J. Tailored and adaptive computerized cognitive training in older adults at risk for dementia: a randomized controlled trial. J Alzheimers Dis. 2017;60(3):889–911. https://doi.org/10.3233/JAD-170404.
3. Bahar-Fuchs A., Martyr A., Goh A., Sabates J., Clare L. Cognitive training for people with mild to moderate dementia. Cochrane Database Syst Rev. 2019;3(3):CD013069. https://doi.org/10.1192/bja.2019.74.
4. Tucker A.M., Stern Y. Cognitive reserve in aging. Curr Alzheimer Res. 2011;8(4):354–360. https://doi.org/10.2174/156720511795745320.
5. Soldan A., Pettigrew C., Cai Q., Wang J., Wang M.C., Moghekar A. et al. Cognitive reserve and long-term change in cognition in aging and preclinical Alzheimer’s disease. Neurobiol Aging. 2017;60:164–172. https://doi.org/10.1016/j.neurobiolaging.2017.09.002.
6. Ball K., Berch D.B., Helmers K.F., Jobe J.B., Leveck M.D., Marsiske M. et al. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002;288(18):2271–2281. https://doi.org/10.1001/jama.288.18.2271.
7. Valenzuela M., Sachdev P. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry. 2009;17(3):179–187. https://doi.org/10.1097/JGP.0b013e3181953b57.
8. Kalbe E., Roheger M., Paluszak K., Meyer J., Becker J., Fink G.R. et al. Effects of a Cognitive Training with and Without Additional Physical Activity in Healthy Older Adults: A Follow-Up 1 Year After a Randomized Controlled Trial. Front Aging Neurosci. 2018;10:407. https://doi.org/10.3389/fnagi.2018.00407.
9. Rodakowski J., Saghafi E., Butters M.A., Skidmore E.R. Non-pharmacological interventions for adults with mild cognitive impairment and early-stage dementia: Аn updated scoping review. Mol Aspects Med. 2015;43–44:38–53. https://doi.org/10.1016/j.mam.2015.06.003.
10. Zokaei N., Mac Kellar C., Cepukaityte G., Patai E.Z., Nobre A.C. Cognitive training in the elderly: bottlenecks and new avenues. J Cogn Neurosci. 2017;29(9):1473–1482. https://doi.org/10.1162/jocn_a_01080.
11. Karssemeijer E.G.A., Aaronson J.A., Bossers W.J., Smits T., Olde-Rikkert M.G.M, Kessels R.P.C. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: a meta-analysis. Ageing Res Rev. 2017;40:75–83. https://doi.org/10.1016/j.arr.2017.09.003.
12. Giuli C., Papa R., Lattanzio F., Postacchini D. The Effects of Cognitive Training for Elderly: Results from My Mind Project. Rejuvenation Res. 2016;19(6):485–494. https://doi.org/10.1089/rej.2015.1791.
13. Gates N.J., Vernooij R.W.M., Di Nisio M., Karim S., March E., Martínez G., Rutjes A.W.S. Computerized cognitive training for preventing dementia in people with mild cognitive impairment. Cochrane Database Syst Rev. 2019;3(3):CD012279. https://doi.org/10.1002/14651858.CD012279.pub2.
14. Da Cruz T.J., Sá S.P., Lindolpho M.D.C., Caldas C.P. Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver. Rev Bras Enfеrm. 2015;68(3):450–456. https://doi.org/10.1590/0034-7167.2015680319i.
15. García-Casal J.A., Loizeau A., Csipke E., Franco-Martín M., PereaBartolomé M.V., Orrell M. Computer-based cognitive interventions for people living with dementia: a systematic literature review and meta-analysis. Aging Ment Health. 2016;21(5):454–467. https://doi.org/10.1080/13607863.2015.1132677.
16. Green C.S., Newcombe N.S. Cognitive Training: How Evidence, Controversies, and Challenges Inform Education Policy. Policy Insights from the Behavioral and Brain Sciences. 2020;7(1):80–86. https://doi.org/10.1177/2372732219870202.
17. Hill N.T.M., Mowszowski L., Naismith S.L., Chadwick V.L., Valenzuela M., Lampit A. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry. 2017;174(4):329–340. https://doi.org/10.1176/appi.ajp.2016.16030360.
18. Levin O., Netz Y., Ziv G. The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review. Eur Rev Aging Phys Act. 2017;14:20. https://doi.org/10.1186/s11556-017-0189-z.
19. Forsman A.K., Nordmyr J., Wahlbeck K. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promot Int. 2011;26(1 Suppl.):i85–i107. https://doi.org/10.1093/heapro/dar074.
20. Palmer K., Wang H.X., Bäckman L., Winblad B., Fratiglioni L. Differential evolution of cognitive impairment in nondemented older persons: results from the Kungsholmen Project. Am J Psychiatry. 2002;159(3): 436–442. https://doi.org/10.1176/appi.ajp.159.3.436.
21. Woods B., Aguirre E., Spector A., Orrell M. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev. 2012;(2):CD005562. https://doi.org/10.1002/14651858.CD005562.pub2.
22. Sun Q., Xu S., Guo S., You Y., Xia R., Liu J. Effects of Combined Physical Activity and Cognitive Training on Cognitive Function in Older Adults with Subjective Cognitive Decline: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. 2021;2021:1–14. https://doi.org/10.1155/2021/8882961.
23. Smid C., Karbach J., Steinbeis N. Toward a Science of Effective Cognitive Training. Current Directions in Psychological Science. 2020;29(6):531–537. https://doi.org/10.1177%2F0963721420951599.
24. Hampshire A., Sandrone S., Hellyer P.J. A Large-Scale, Cross-Sectional Investigation into the Efficacy of Brain Training. Front Hum Neurosci. 2019;13:221. https://doi.org/10.3389/fnhum.2019.00221.
25. Roy L.F, Kessels P.S., Maes J.H.R. The effect of cognitive training in older adults: be aware of CRUNCH. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2020;27(6):949–962. https://doi.org/10.1080/13825585.2019.1708251.
26. Belling P.R., Ward P. Time to Start Training: A Review of Cognitive Research in Sport and Bridging the Gap from Academia to the Field. Procedia Manufacturing. 2015;3:1219–1224. https://doi.org/10.1016/j.promfg.2015.07.202.
27. Sala G., Aksayli N.D., Tatlidil K.S., Tatsumi T., Gondo Y., Gobet F. Near and Far Transfer in Cognitive Training: A Second-Order Meta-Analysis. Collabra: Psychology. 2019;5(1):18. https://doi.org/10.1525/collabra.203.
28. Bureš V., Čech P., Mikulecká J., Ponce D., Kuca K. The effect of cognitive training on the subjective perception of well-being in older adults. PeerJ. 2016;4:e2785. https://doi.org/10.7717/peerj.2785.
29. Lee T.-S., Goh S.J.A., Quek S.Y., Phillips R., Guan C., Cheung Y.B. et al. A Brain-Computer Interface Based Cognitive Training System for Healthy Elderly: A Randomized Control Pilot Study for Usability and Preliminary Efficacy. PLoS ONE. 2013;8(11):e79419. https://doi.org/10.1371/journal.pone.0079419.
30. Kang J.M., Kim N., Lee S.Y., Woo S.K., Park G., Yeon B.K. et al. Effect of Cognitive Training in Fully Immersive Virtual Reality on Visuospatial Function and Frontal-Occipital Functional Connectivity in Predementia: Randomized Controlled Trial. J Med Internet Res. 2021;23(5):e24526. https://doi.org/10.2196/24526.
31. Willis S.L., Tennstedt S.L., Marsiske M., et al. Long-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults. JAMA. 2006;296(23):2805–2814. https://doi.org/10.1001/jama.296.23.2805.
Review
For citations:
Kindarova AA, Fantalis D, Preobrazhenskaya IS. Evaluation of the cognitive-motor training effectiveness in combination with drug therapy among patients with moderate cognitive disorders: the own research results. Meditsinskiy sovet = Medical Council. 2022;(2):44-51. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-2-44-51