Neurocognitive Training can boost Mental Performance

Neurocognitive training is a useful brain-stimulating activity that involves being actively engaged in tasks that challenge the brain. Computer-based tasks, creative writing, dance, theater, or music-related activities, and even learning new tasks such as digital photography, quilting, or crafting can afford seniors with numerous benefits.

Indeed, older individuals who learn new and challenging activities that are cognitively demanding tend to experience heightened thinking, memory, learning skills, and enhanced self-esteem. Neurocognitive training may also help improve social interactions while lowering stress.

Research indicates that specific types of brain stimulation can help slow down the rate of neurological decay or brain cell damage that can lead to cognitive decline. It is proposed that these types of activities may promote positive changes in the brain that create a cognitive reserve – which means the brain becomes more adaptable and may begin to compensate for age-related changes and health problems (that generally affect the brains of older persons).

One study, known as the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, addressed the issue that a large number of individuals over the age of 65 require some form of nursing home care or home-based therapeutic support. More importantly, the researchers used this trial to determine whether neurocognitive training could help seniors maintain functional independence and cognitive health. The cognitive abilities that were targeted included processing speed, reasoning, and memory (which are skills that are critical for optimal mental performance and independent living). 

Neurocognitive training was carried out in small groups for 60 to 75 minutes over six weeks. Memory training involved learning a new strategy and practicing it repeatedly. Reasoning training entailed problem-solving tasks, and speed training focused on visual searching activities that required the seniors to gradually process more information in shorter time intervals. Booster training was also offered at 11 months, as well as 35 months, following the initial neurocognitive training sessions.

The outcome of this trial indicated that each of the brain-stimulating activities led to cognitive improvements that persisted through five year follow-up visits. However, the interventions produced the most pronounced benefits immediately following the sessions, with some of the effects dissipating over time. This demonstrates the necessity of continuous (long-term) neurocognitive stimulation for older individuals. 

Additional research showed that elderly individuals with mild cognitive impairment (MCI) who received neurocognitive training demonstrated improved reasoning and information processing abilities. Overall, these studies indicate that activities which challenge the mind help reduce the occurrence of cognitive issues in seniors.

What has neurocognitive training got to do with Physical Therapy? Interestingly, the positive outcomes of neurocognitive training dramatically improve when this type of intervention is combined with other therapy, including Physical Therapy. This is because as individuals age, the onset of psychiatric disorders and mobility issues can negatively affect cognitive abilities. Physical Therapy exercise involves guided instruction, repetition, and practice, all of which can heighten mental performance. This means that as seniors learn techniques that help them regain mobility, they also target cognitive impairments by engaging in demanding mental tasks. Therefore, Physical Therapy along with brain training may begin to gain popularity as standard forms of intervention that help delay cognitive decline in older individuals.  The big take-home message: Never stop learning or moving!

References

1. Lenze EJ, Bowie CR. Cognitive Training for Older Adults: What Works? J Am Geriatr Soc. 2018;66(4):645-647. 

2. Wykes T, Huddy V, Cellard C, et al. A meta‚Äźanalysis of cognitive remediation for schizophrenia: Methodology and effect sizes. Am J Psychiatry 2011;168:472-485.

3. Park DC, et al. The Impact of Sustained Engagement on Cognitive Function in Older Adults: The Synapse Project. Psychol Sci. 2014;25(1): 103-112.  

4. The aging mind: neuroplasticity in response to cognitive training. Park DC, et al. Dialogues Clin Neurosci. 2013;15(1):109-119.

5. Tennstedt SL, Unverzagt FW. The ACTIVE Study: Study Overview and Major Findings. J Aging Health. 2013 Dec; 25(8 0):3S-20S. 

6. Willis SL, Jay GM, Diehl M, Marsiske M. Longitudinal Change and Prediction of Everyday Task Competence in the Elderly.. Res Aging. 1992;14(1):68-91.

7. Unverzagt FW, Kasten L, et al. Effect of memory impairment on training outcomes in ACTIVE. J Int Neuropsychol Soc. 2007;13(6):953-60.

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