INTRODUCTION: We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI).METHODS: Participants aged 65‐85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months.RESULTS: Of 531 participants, 406 completed the trial. The between‐group difference in composite score changes was 0.047 (95% CI: −0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels.DISCUSSION: The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required.Highlights: This trial evaluated the efficacy of multidomain intervention in individuals with MCI. The trial did not show a significant difference in preplanned cognitive outcomes. Interventions had positive effects on a wide range of secondary health outcomes. Those with adequate adherence or high risk of dementia benefited from interventions.
Background: Deterioration of hand motor function is a possible risk factor of cognitive impairment in older adults. Despite a growing body of research, a lack of clarity exists regarding the relationships. This review offers a synthesis of existing observational studies evaluating the associations of handgrip strength and hand dexterity with cognitive performance in community-dwelling older adults.Methods: PubMed, PsycINFO, and ScienceDirect were systematically searched (search dates: 1990–2016), and relevant articles were cross-checked for related and relevant publications.Results: Twenty-two observational studies assessed the association of handgrip strength or hand dexterity with cognitive performance; none evaluated handgrip strength and hand dexterity together. Handgrip strength was associated with global cognition, mostly assessed using the Mini-Mental State Examination, cross-sectionally and longitudinally. Also, one cross-sectional and three longitudinal studies found an association with cognitive domains, such as language, memory, visuospatial ability, working memory, and processing speed. Hand dexterity was only assessed cross-sectionally in four studies. These studies found an association with cognitive domains, such as executive function.Conclusions: Although handgrip strength was associated with cognitive performance, it is unclear which variable at baseline affects the other in the long-term. Cross-sectional studies indicate an association between hand dexterity and cognitive performance, yet longitudinal studies are needed to elucidate this association. The interaction effects of both decreased grip strength and hand dexterity on cognitive performance is still unclear; therefore, future studies will need to consider the interaction of the three variables cross-sectionally and longitudinally.
24 April 2019 in Geriatrics & Gerontology International
Background: To delay the onset of dementia, it is important for healthy adults to take preventive actions before the cognitive function clearly declines. Protein malnutrition is a potential risk factor for senile dementia, although the precise link between protein/amino acid nutrition and cognitive function is unknown. The purpose of this study was to examine the effect of the ingestion of seven selected essential amino acids as a granular powder, namely, leucine, phenylalanine, and lysine supplemented with isoleucine, histidine, valine, and tryptophan on cognitive and psychosocial functions in healthy adults.Methods: A double-blind, randomized, placebo-controlled trial was conducted. A total of 105 participants aged 55 years or older were randomly assigned to one of three groups: daily ingestion of 3 g (3gIG) or 6 g (6gIG) of the selected amino acids or daily ingestion of a placebo (PCG). Each group ingested the test powder for 12 weeks. As the main outcome, cognitive function was assessed before and after ingestion by a cognitive test battery. Psychosocial functions were also examined.Results: The numbers of participants excluding dropouts were 35 in PCG and 3gIG and 33 in 6gIG. Analysis of covariance revealed that the 6gIG showed significantly improved cognitive function (Trail Making Test B), social interaction and psychological health scores after ingestion compared to the PCG (multiplicity adjusted p < 0.05).Conclusions: Current findings suggested that ingestion of the seven essential amino acids led to improved attention and cognitive flexibility and psychosocial functioning, which is expected to prevent cognitive decline.Clinical Trial Registration: University Hospital Medical Information Network Clinical Trial Registry (URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037779, Identifier: UMIN000033174).
An association between handgrip strength, hand dexterity and global cognition is suggested; however, it is unclear whether both hand motor functions are associated with executive function, which is important for performing daily activities. Understanding this association will help identify motor risk factors for impairment of executive function in late adulthood. We aim to investigate the relationship of handgrip strength and hand dexterity with executive function in physically and mentally healthy community-dwelling older adults. Three hundred and twenty-six older adults (287 women, mean age ± SD, 70.1 ± 5.6) underwent handgrip strength and hand dexterity tests using a hand dynamometer and the Purdue Pegboard Test (PPT), respectively. Executive function was evaluated with the Trail Making Test (TMT)-A, TMT-B and Digit symbol; global cognition was assessed with the Mini-Mental State Examination (MMSE). Age-group differences showed that the younger groups (60–64, 65–69 and 70–74) had a significant better PPT and executive function performance than the oldest group (75 and older), whereas no significant age differences were observed for handgrip strength. Multiple regression analysis adjusted for potential covariates, including MMSE scores, showed that TMT-A, TMT-B, and Digit symbol were significantly associated with PPT scores; however, no significant association was observed between executive function variables and handgrip strength. Hand dexterity is vulnerable to the effects of aging and, contrary to handgrip strength, it strongly associates with executive function, independent of global cognition. Our results suggest that assessing hand dexterity may help identify individuals at higher risk of impairment of executive function among high-functioning older adults.
14 November 2018 in International Journal of Geriatric Psychiatry
Objectives: The purpose of this study is to clarify the influence of social interaction on the effect of a cognitive intervention program using Go.Methods: A single‐blind, randomized controlled trial using a classical board game “Go” was conducted. A total of 72 community‐dwelling older adults, without previous experience playing Go, were randomly assigned to three groups: (1) a face‐to‐face group (FG) in which members attended 12 Go group lessons held once a week; (2) a non‐face‐to‐face group (NFG) in which members individually underwent the same Go lessons as the FG using a tablet computer; or (3) a health education control group (CG). The main outcome variable, working memory, was assessed before and after the interventions using the Visual Memory Span Test (VMST) and the Visual Memory Span Backward (VMSB) task. Go performance and additional cognitive domains were also examined.Results: Analysis of covariance revealed that VMST scores significantly improved after the intervention in both the FG and NFG (both P < .05). Compared with the CG, the effect size of the FG (Cohen's d = 0.89) was greater than that of the NFG (Cohen's d = 0.67). Although VMSB scores significantly improved after the intervention in the FG (P < .05), no significant changes were observed in other groups.Conclusions: This study showed that Go game could improve visual working memory regardless of social interaction. Furthermore, findings suggested that playing board games face‐to‐face with others is more effective for cognitive function than playing alone.