Zagaar M, Alhaider I, Dao A, Levine A, Alkarawi A, Alzubaidy M, Alkadhi K.

Neurobiol Dis. 2011 Dec 30.

Liberati G, Raffone A, Olivetti Belardinelli M.
Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA), IT, Rome, Italy.

Hare TA, Malmaud J, Rangel A.
Computation and Neural Systems and Humanities and Social Science Divisions, California Institute of Technology, Pasadena, California 91125.

J Neurosci. 2011 Jul 27;31(30):11077-87.

Ball K, Edwards JD, Ross LA, McGwin G Jr.

Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Abstract
OBJECTIVES: To test the effects of cognitive training on subsequent motor vehicle collision (MVC) involvement of older drivers.

DESIGN: Randomized, controlled, multisite, single-blind clinical trial.

SETTING: Community-dwelling seniors at four U.S. sites: Birmingham, Alabama; Baltimore, Maryland; Indianapolis, Indiana; and State College, Pennsylvania.

PARTICIPANTS: Nine hundred eight older drivers (mean age 73.1; 18.6% African American) who were randomized to one of three cognitive interventions or a control condition.

INTERVENTIONS: Up to 10 sessions of cognitive training for memory, reasoning, or speed of processing.

MEASUREMENTS: State-recorded MVC involvement up to 6 years after study enrollment.

RESULTS: Speed-of-processing and reasoning training resulted in lower rates of at-fault collision involvement over the subsequent approximately 6-year period than controls. After adjusting for age, sex, race, education, mental status, health, vision, depressive symptoms, and testing site, participants randomized to the speed-of-processing and reasoning interventions had an approximately 50% lower rate (per person-mile) of at-fault MVCs than the control group (rate ratio (RR) = 0.57, 95% confidence interval (CI) = 0.34-0.96 for speed of processing), and (RR = 0.50, 95% CI = 0.27-0.92 for reasoning). There was no significant difference observed for the memory group.

CONCLUSION: Cognitive speed-of-processing and reasoning training resulted in a lower at-fault MVC rate in older drivers than in controls. Considering the importance of driving mobility, the costs of crashes, and the benefits of cognitive training, these interventions have great potential to sustain independence and quality of life of older adults. More research is needed to understand the effects of different types and quantities of training.

© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
PMID: 21054291 [PubMed - indexed for MEDLINE]

Gulliksson M, Burell G, Vessby B, Lundin L, Toss H, Svärdsudd K.
Family Medicine and Clinical Epidemiology Section, Department of Public Health and Caring Sciences, Uppsala University Hospital, SE-751 22 Uppsala, Sweden. mats.gulliksson@pubcare.uu.se.
Abstract
BACKGROUND: Psychosocial factors are independently associated with increased risk of cardiovascular disease (CVD) morbidity and mortality, but the effects of psychosocial factor intervention on CVD are uncertain. We performed a randomized controlled clinical trial of cognitive behavioral therapy (CBT) to measure its effects on CVD recurrence.
METHODS: The study included 362 women and men 75 years or younger who were discharged from the hospital after a coronary heart disease event within the past 12 months. Patients were randomized to receive traditional care (reference group, 170 patients) or traditional care plus a CBT program (intervention group, 192 patients), focused on stress management, with 20 two-hour sessions during 1 year. Median attendance at each CBT session was 85%. Outcome variables were all-cause mortality, hospital admission for recurrent CVD, and recurrent acute myocardial infarction.
RESULTS: During a mean 94 months of follow-up, the intervention group had a 41% lower rate of fatal and nonfatal first recurrent CVD events (hazard ratio [95% confidence interval], 0.59 [0.42-0.83]; P = .002), 45% fewer recurrent acute myocardial infarctions (0.55 [0.36-0.85]; P = .007), and a nonsignificant 28% lower all-cause mortality (0.72 [0.40-1.30]; P = .28) than the reference group after adjustment for other outcome-affecting variables. In the CBT group there was a strong dose-response effect between intervention group attendance and outcome. During the first 2 years of follow-up, there were no significant group differences in traditional risk factors.
CONCLUSIONS: A CBT intervention program decreases the risk of recurrent CVD and recurrent acute myocardial infarction. This may have implications for secondary preventive programs in patients with coronary heart disease. Trial Registration  clinicaltrials.gov Identifier: NCT00888485.

Martin M, Clare L, Altgassen AM, Cameron MH, Zehnder F.
Psychologisches Institut, Universität Zürich, Lehrstuhl Gerontopsychologie, Binzmühlestrasse 14/24, Zürich, Switzerland, CH-8050.
Abstract
BACKGROUND: Evidence from some, but not all non-randomised studies suggest the possibility that cognitive training may influence cognitive functioning in older people. Due to the differences among cognitive training interventions reported in the literature, giving a general overview of the current literature remains difficult.
OBJECTIVES: To systematically review the literature and summarize the effect of cognitive training interventions on various domains of cognitive function (ie memory, executive function, attention and speed) in healthy older people and in people with mild cognitive impairment.
SEARCH STRATEGY: The CDCIG Specialized Register was searched on 30 September 2007 for all years up to December 2005. The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL were searched separately on 30 September 2007 to find trials with healthy people. These results were supplemented by searches from January 1970 to September 2007 in PsychInfo/Psyndex, ISI Web of Knowledge and PubMed.
SELECTION CRITERIA: RCTs of interventions evaluating the effectiveness of cognitive training for healthy older people and people with mild cognitive impairment from 1970 to 2007 that met inclusion criteria were selected.
DATA COLLECTION AND ANALYSIS: Authors independently extracted data and assessed trial quality. Meta-analysis was performed when appropriate.
MAIN RESULTS: Only data on memory training could be pooled for analysis. Within this domain, training interventions were grouped according to several outcome variables. Results showed that for healthy older adults, immediate and delayed verbal recall improved significantly through training compared to a no-treatment control condition. We did not find any specific memory training effects though as the improvements observed did not exceed the improvement in the active control condition. For individuals with mild cognitive impairment, our analyses demonstrate the same pattern. Thus, there is currently little evidence on the effectiveness and specificity of memory interventions for healthy older adults and individuals with mild cognitive impairment.
AUTHORS’ CONCLUSIONS: There is evidence that cognitive interventions do lead to performance gains but none of the effects observed could be attributable specifically to cognitive training, as the improvements observed did not exceed the improvement in active control conditions. This does not mean that longer, more intense or different interventions might not be effective, but that those which have been reported thus far have only limited effect. We therefore suggest more standardized study protocols in order to maximize comparability of studies and to maximize the possibility of data pooling – also in other cognitive domains than memory.

Almeida OP, Garrido GJ, Alfonso H, Hulse G, Lautenschlager NT, Hankey GJ, Flicker L.
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia.
Abstract
BACKGROUND: Observational studies investigating the association between smoking, cognitive decline and dementia have produced conflicting results. We completed this trial to determine if smoking cessation decreases the progression of cognitive decline in later life.
METHODS: We recruited older smokers (n=229) and never smokers (n=98) and invited smokers to join a smoking cessation trial. The primary outcome of interest was change in Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog) scores over 24months. Secondary measures included the Logical Memory test and changes in gray matter density. Successful smoking cessation was defined as a minimum of 547 smoking free days during follow up.
RESULTS: The ADAS-cog scores of unsuccessful quitters (UQ) increased (i.e., became worse) 1.1±0.3 and 1.2±0.4 points more than the scores of never smokers (NS) (p=0.001) and successful quitters (SQ) (p=0.006) respectively over the 24months of follow up. Similarly, the scores of UQ declined (i.e., became worse) relative to NS on measures of immediate (p=0.004) and delayed recall (p=0.029). All analyses were adjusted for age, years of education, baseline cognitive performance, alcohol use, depression scores, and the presence of chronic respiratory disease. Thirty-six NS, 18 SQ and 48 UQ completed the imaging substudy. Compared with NS, UQ showed a disproportional loss of gray matter density in the right thalamus, right and left inferior semi-lunar lobule, as well as left superior and inferior parietal lobule over 24months. SQ showed loss of gray matter compared with NS in the right middle and inferior occipital gyri, right and left culmen, and the left superior frontal gyrus. We did not find any brain regions in which UQ had lost more gray matter than SQ over 2years.
CONCLUSION: These results are consistent with the hypothesis that smoking causes cognitive decline and loss of gray matter tissue in the brain over time.
Copyright © 2011. Published by Elsevier Inc.
PMID: 21281718 [PubMed - as supplied by publisher]