aging

Fluctuating sense of control linked to cognitive ability in older adults

April, 2012

A small study has found that, in older adults, their sense of control fluctuates over the course of a day, and this affects their cognitive abilities.

Previous research has pointed to a typical decline in our sense of control as we get older. Maintaining a sense of control, however, appears to be a key factor in successful aging. Unsurprisingly, in view of the evidence that self-belief and metacognitive understanding are important for cognitive performance, a stronger sense of control is associated with better cognitive performance. (By metacognitive understanding I mean the knowledge that cognitive performance is malleable, not fixed, and strategies and training are effective in improving cognition.)

In an intriguing new study, 36 older adults (aged 61-87, average age 74) had their cognitive performance and their sense of control assessed every 12 hours for 60 days. Participants were asked questions about whether they felt in control of their lives and whether they felt able to achieve goals they set for themselves.

The reason I say this is intriguing is that it’s generally assumed that a person’s sense of control — how much they feel in control of their lives — is reasonably stable. While, as I said, it can change over the course of a lifetime, until recently we didn’t think that it could fluctuate significantly in the course of a single day — which is what this study found.

Moreover, those who normally reported having a low sense of control performed much better on inductive reasoning tests during periods when they reported feeling a higher sense of control. Similarly, those who normally reported feeling a high sense of control scored higher on memory tests when feeling more in control than usual.

Although we can’t be sure (since this wasn’t directly investigated), the analysis suggests that the improved cognitive functioning stems from the feeling of improved control, not vice versa.

The study builds on an earlier study that found weekly variability in older adults’ locus of control and competency beliefs.

Assessment was carried out in the form of a daily workbook, containing a number of measures, which participants completed twice daily. Each assessment took around 30-45 minutes to complete. The measures included three cognitive tests (14 alternate forms of each of these were used, to minimize test familiarity):

  • Letter series test: 30 items in which the next letter in a series had to be identified. [Inductive reasoning]
  • Number comparison: 48 items in which two number strings were presented beside each other, and participants had to identify where there was any mismatch. [Perceptual speed]
  • Rey Auditory Verbal Learning Task: participants have to study a list of 15 unrelated words for one minute, then on another page recall as many of the words as they could. [Memory]

Sense of control over the previous 12 hours was assessed by 8 questions, to which participants indicated their agreement/disagreement on a 6-point scale. Half the questions related to ‘locus of control’ and half to ‘perceived competence’.

While, unsurprisingly, compliance wasn’t perfect (it’s quite an arduous regime), participants completed on average 115 of 120 workbooks. Of the possible 4,320 results (36 x 120), only 166 were missing.

One of the things that often annoys me is the subsuming of all within-individual variability in cognitive scores into averages. Of course averages are vital, but so is variability, and this too often is glossed over. This study is, of course, all about variability, so I was very pleased to see people’s cognitive variability spelled out.

Most of the variance in locus of control was of course between people (86%), but 14% was within-individual. Similarly, the figures for perceived competence were 88% and 12%. (While locus of control and perceived competence are related, only 26% of the variability in within-person locus of control was associated with competence, meaning that they are largely independent.)

By comparison, within-individual variability was much greater for the cognitive measures: for the letter series (inductive reasoning), 32% was within-individual and 68% between-individual; for the number matching (perceptual speed), 21% was within-individual and 79% between-individual; for the memory test, an astounding 44% was within-individual and 56% between-individual.

Some of this within-individual variability in cognitive performance comes down to practice effects, which were significant for all cognitive measures. For the memory test, time of day was also significant, with performance being better in the morning. For the letter and number series tests, previous performance also had a small effect on perceived competence. For the number matching, increase in competence subsequent to increased performance was greatest for those with lower scores. However, lagged analyses indicated that beliefs preceded performance to a greater extent than performance preceding beliefs.

While it wasn’t an aspect of this study, it should also be noted that a person’s sense of control may well vary according to domain (e.g., cognition, social interaction, health) and context. In this regard, it’s interesting to note the present findings that sense of control affected inductive reasoning for low-control individuals, but memory for high-control individuals, suggesting that the cognitive domain also matters.

Now this small study was a preliminary one and there are several limitations that need to be tightened up in subsequent research, but I think it’s important for three reasons:

  • as a demonstration that cognitive performance is not a fixed attribute;
  • as a demonstration of the various factors that can affect older adults’ cognitive performance;
  • as a demonstration that your beliefs about yourself are a factor in your cognitive performance.

Reference: 

[2794] Neupert, S. D., & Allaire J. C.
(2012).  I think I can, I think I can: Examining the within-person coupling of control beliefs and cognition in older adults.
Psychology and Aging. No Pagination Specified - No Pagination Specified.

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Low levels of omega-3 fatty acids linked to brain aging

April, 2012
  • A large study has found that older adults with low levels of omega-3 fatty acids had greater brain atrophy and more white matter damage.

A study involving 1,575 older adults (aged 58-76) has found that those with DHA levels in the bottom 25% had smaller brain volume (equivalent to about 2 years of aging) and greater amounts of white matter lesions. Those with levels of all omega-3 fatty acids in the bottom quarter also scored lower on tests of visual memory, executive function, and abstract thinking.

The finding adds to the evidence that higher levels of omega-3 fatty acids reduce dementia risk.

For more about omega-3 oils and cognition

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Prevalence of cognitive problems among older adults

April, 2012

A large Swedish twin study reveals the prevalence of age-related cognitive impairment and points to the greater importance of environment over genes. Another very large study points to marked regional variation in mild cognitive impairment.

Data from 11,926 older twins (aged 65+) has found measurable cognitive impairment in 25% of them and subjective cognitive impairment in a further 39%, meaning that 64% of these older adults were experiencing some sort of cognitive impairment.

Although subjective impairment is not of sufficient magnitude to register on our measurement tools, that doesn’t mean that people’s memory complaints should be dismissed. It is likely, given the relative crudity of standard tests, that people are going to be aware of cognitive problems before they grow large enough to be measurable. Moreover, when individuals are of high intelligence or well-educated, standard tests can be insufficiently demanding. [Basically, subjective impairment can be thought of as a step before objective impairment, which itself is a step before mild cognitive impairment (MCI is a formal diagnosis, not simply a descriptive title), the precursor to Alzheimer’s. Note that I am calling these “steps” as a way of describing a continuum, not an inevitable process. None of these steps means that you will inevitably pass to the next step, but each later step will be preceded by the earlier steps.]

Those with subjective complaints were younger, more educated, more likely to be married, and to have higher socio-economic status, compared to those with objective impairment — supporting the idea that these factors provide some protection against cognitive decline.

The use of twins reveals that environment is more important than genes in determining whether you develop cognitive impairment in old age. For objective cognitive impairment, identical twins had a concordance rate of 52% compared to 50% in non-identical same-sex twins and 29% in non-identical different-gender twins. For subjective impairment, the rates were 63%, 63%, and 42%, respectively.

National variation in MCI prevalence

Another very large study, involving 15,376 older adults (65+), has explored the prevalence of amnestic MCI in low- and middle-income countries: Cuba, Dominican Republic, Peru, Mexico, Venezuela, Puerto Rico, China, and India. Differences between countries were marked, with only 0.6% of older adults in China having MCI compared to 4.6% in India (Cuba 1.5%, Dominican Republic 1.3%, Peru 2.6%, Mexico 2.8%, Venezuela 1%, Puerto Rico 3% — note that I have selected the numbers after they were standardized for age, gender, and education, but the raw numbers are not greatly different).

Studies to date have focused mainly on European and North American populations, and have provided prevalence estimates ranging from 2.1%-11.5%, generally hovering around 3-5% (for example, Finland 5.3%, Italy 4.9%, Japan 4.9%, the US 6% — but note South Korea 9.7% and Malaysia 15.4%).

What is clear is that there is considerable regional variation.

Interestingly, considering their importance in Western countries, the effects of both age and education on prevalence of aMCI were negligible. Granted that age and education norms were used in the diagnosis, this is still curious. It may be that there was less variance in educational level in these populations. Socioeconomic status was, however, a factor.

Participants were also tested on the 12-item WHO disability assessment schedule (WHODAS-12), which assesses five activity-limitation domains (communication, physical mobility, self-care, interpersonal interaction, life activities and social participation). MCI was found to be significantly associated with disability in Peru, India, and the Dominican Republic (but negatively associated in China). Depression (informant-rated) was also only associated with MCI in some countries.

All of this, I feel, emphasizes the situational variables that determine whether an individual will develop cognitive impairment.

Reference: 

Caracciolo B, Gatz M, Xu W, Pedersen NL, Fratiglioni L. 2012. Differential Distribution of Subjective and Objective Cognitive Impairment in the Population: A Nation-Wide Twin-Study. Journal of Alzheimer's Disease, 29(2), 393-403.

[2801] Sosa, A L., Albanese E., Stephan B. C. M., Dewey M., Acosta D., Ferri C. P., et al.
(2012).  Prevalence, Distribution, and Impact of Mild Cognitive Impairment in Latin America, China, and India: A 10/66 Population-Based Study.
PLoS Med. 9(2), e1001170 - e1001170.

Full text available at http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed....

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Alzheimer's protein may impair mental function even in healthy adults

March, 2012

The protein associated with Alzheimer's disease appears to impair cognitive function many years before symptoms manifest. Higher levels of this protein are more likely in carriers of the Alzheimer’s gene, and such carriers may be more affected by the protein’s presence.

Another study adds to the evidence that changes in the brain that may lead eventually to Alzheimer’s begin many years before Alzheimer’s is diagnosed. The findings also add to the evidence that what we regard as “normal” age-related cognitive decline is really one end of a continuum of which the other end is dementia.

In the study, brain scans were taken of 137 highly educated people aged 30-89 (participants in the Dallas Lifespan Brain Study). The amount of amyloid-beta (characteristic of Alzheimer’s) was found to increase with age, and around a fifth of those over 60 had significantly elevated levels of the protein. These higher amounts were linked with worse performance on tests of working memory, reasoning and processing speed.

More specifically, across the whole sample, amyloid-beta levels affected processing speed and fluid intelligence (in a dose-dependent relationship — that is, as levels increased, these functions became more impaired), but not working memory, episodic memory, or crystallized intelligence. Among the elevated-levels group, increased amyloid-beta was significantly associated with poorer performance for processing speed, working memory, and fluid intelligence, but not episodic memory or crystallized intelligence. Among the group without elevated levels of the protein, increasing amyloid-beta only affected fluid intelligence.

These task differences aren’t surprising: processing speed, working memory, and fluid intelligence are the domains that show the most decline in normal aging.

Those with the Alzheimer’s gene APOE4 were significantly more likely to have elevated levels of amyloid-beta. While 38% of the group with high levels of the protein had the risky gene variant, only 15% of those who didn’t have high levels carried the gene.

Note that, while the prevalence of carriers of the gene variant matched population estimates (24%), the proportion was higher among those in the younger age group — 33% of those under 60, compared to 19.5% of those aged 60 or older. It seems likely that many older carriers have already developed MCI or Alzheimer’s, and thus been ineligible for the study.

The average age of the participants was 64, and the average years of education 16.4.

Amyloid deposits varied as a function of age and region: the precuneus, temporal cortex, anterior cingulate and posterior cingulate showed the greatest increase with age, while the dorsolateral prefrontal cortex, orbitofrontal cortex, parietal and occipital cortices showed smaller increases with age. However, when only those aged 60+ were analyzed, the effect of age was no longer significant. This is consistent with previous research, and adds to evidence that age-related cognitive impairment, including Alzheimer’s, has its roots in damage occurring earlier in life.

In another study, brain scans of 408 participants in the Mayo Clinic Study of Aging also found that higher levels of amyloid-beta were associated with poorer cognitive performance — but that this interacted with APOE status. Specifically, carriers of the Alzheimer’s gene variant were significantly more affected by having higher levels of the protein.

This may explain the inconsistent findings of previous research concerning whether or not amyloid-beta has significant effects on cognition in normal adults.

As the researchers of the first study point out, what’s needed is information on the long-term course of these brain changes, and they are planning to follow these participants.

In the meantime, all in all, the findings do provide more strength to the argument that your lifestyle in mid-life (and perhaps even younger) may have long-term consequences for your brain in old age — particularly for those with a genetic susceptibility to Alzheimer’s.

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Severe, rapid memory loss linked to future, fatal strokes

March, 2012

A large, long-running study has revealed that older adults who suffered a fatal stroke showed significantly faster cognitive decline in the years preceding the stroke compared to stroke survivors and stroke-free adults.

A ten-year study following 12,412 middle-aged and older adults (50+) has found that those who died after stroke had more severe memory loss in the years before stroke compared to those who survived stroke and those who didn't have a stroke.

Participants were tested every two years, using a standard word-recall list to measure memory loss (or caregiver assessment for those whose memory loss was too severe). During the decade of the study, 1,027 participants (8.3%) survived a stroke, 499 (4%) died after stroke, and 10,886 (87.7%) remained stroke-free over the study period.

Before having a stroke, those who later survived a stroke had worse average memory than similar individuals who never had a stroke, however their rate of memory decline was similar (0.034 and 0.028 points per year, respectively). Those who later died after a stroke, on the other hand, showed significantly faster memory decline (0.118 points per year).

Whether this is because those who die after stroke have a more compromised brain prior to the stroke, or because greater memory impairment makes people more vulnerable in the wake of a stroke, cannot be told from this data (and indeed, both factors may be involved).

Among survivors, stroke had a significant effect on memory decline, with memory scores dropping an average of 0.157 points at the time of the stroke — an amount equivalent to around 5.6 years of memory decline in similarly-aged stroke-free adults. However, in subsequent years, decline was only a little greater than it had been prior to the stroke (0.038 points per year).

(You can see a nice graph of these points here.)

Reference: 

Wang, Q., Capistrant, B.D., Ehntholt, A. & Glymour, M.M. 2012. Abstract 31: Rate of Change in Memory Functioning Before and After Stroke Onset. Presented at the American Stroke Association's International Stroke Conference 2012. http://stroke.ahajournals.org/cgi/content/meeting_abstract/43/2_MeetingAbstracts/A31?sid=960f2015-06d1-478f-8c03-c00994d35f2c

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More evidence linking poor sleep to Alzheimer’s risk

March, 2012

Two recent studies add to the evidence linking sleep disorders to the later development of Alzheimer’s disease.

A small study of the sleep patterns of 100 people aged 45-80 has found a link between sleep disruption and level of amyloid plaques (characteristic of Alzheimer’s disease). The participants were recruited from the Adult Children Study, of whom half have a family history of Alzheimer’s disease.

Sleep was monitored for two weeks. Those who woke frequently (more than five times an hour!) and those who spent less than 85% of their time in bed actually asleep, were more likely to have amyloid plaques. A quarter of the participants had evidence of amyloid plaques.

The study doesn’t tell us whether disrupted sleep leads to the production of amyloid plaques, or whether brain changes in early Alzheimer's disease lead to changes in sleep, but evidence from other studies do, I think, give some weight to the first idea. At the least, this adds yet another reason for making an effort to improve your sleep!

The abstract for this not-yet-given conference presentation, or the press release, don’t mention any differences between those with a family history of Alzheimer’s and those without, suggesting there was none — but since the researchers made no mention either way, I wouldn’t take that for granted. Hopefully we’ll one day see a journal paper providing more information.

The main findings are supported by another recent study. A Polish study involving 150 older adults found that those diagnosed with Alzheimer’s after a seven-year observation period were more likely to have experienced sleep disturbances more often and with greater intensity, compared to those who did not develop Alzheimer’s.

Reference: 

Ju, Y., Duntley, S., Fagan, A., Morris, J. & Holtzman, D. 2012. Sleep Disruption and Risk of Preclinical Alzheimer Disease. To be presented April 23 at the American Academy of Neurology's 64th Annual Meeting in New Orleans.

Bidzan L, Grabowski J, Dutczak B, Bidzan M. 2011. [Sleep disorders in the preclinical period of the Alzheimer's disease]. Psychiatria Polska, 45(6), 851-60. http://www.ncbi.nlm.nih.gov/pubmed/22335128

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Identifying those with cognitive impairment

March, 2012

A brief questionnaire designed to identify those with Alzheimer’s has been found to be useful in also identifying those with MCI. A large study confirms the value of such tools but also points to their limitations

New data from the ongoing validation study of the Alzheimer's Questionnaire (AQ), from 51 cognitively normal individuals (average age 78) and 47 aMCI individuals (average age 74), has found that the AQ is effective in identifying not only those with Alzheimer’s but also those older adults with mild cognitive impairment.

Of particular interest is that four questions were strong indicators of aMCI. These related to:

  • repeating questions and statements,
  • trouble knowing the date or time,
  • difficulties managing finances, and
  • decreased sense of direction.

The AQ consists of 21 yes/no questions designed to be answered by a relative or carer. The questions fall into five categories: memory, orientation, functional ability, visuospatial ability, and language. Six of these questions are known to be predictive of AD and are given extra weighting, resulting in a score out of 27. A score above 15 was indicative of AD, and between 5 and 14 of aMCI. Scores of 4 or lower indicate that the person does not have significant memory problems.

The questionnaire is not of course definitive, but is intended as an indicator for further testing. Note, too, that all participants in this study were Caucasian.

The value and limitations of brief cognitive screenings

The value of brief cognitive screenings combined with offering further evaluation is demonstrated in a recent large VA study, which found that, of 8,342 Veterans aged 70+ who were offered screening (the three-minute Mini-Cog), 8,063 (97%) accepted, 2,081 (26%) failed the screen, and 580 (28%) agreed to further evaluation. Among those accepting further evaluation, 93% were found to have cognitive impairment, including 75% with dementia.

Among those who declined further evaluation, 17% (259/1,501) were diagnosed with incident cognitive impairment through standard clinical care. In total, the use of brief cognitive screenings increased the numbers with cognitive impairment to 11% (902/8,063) versus 4% (1,242/28,349) in similar clinics without this program.

Importantly, the limits of such questionnaires were also demonstrated: 118 patients who passed the initial screen nevertheless requested further evaluation, and 87% were found to have cognitive impairment, including 70% with dementia.

This should not be taken as a reason not to employ such cognitive tests! There are two points that should, I think, be taken from this:

  • Routine screening of older adults is undoubtedly an effective strategy for identifying those with cognitive impairment.
  • Individuals who pass such tests but nevertheless believe they have cognitive problems should be taken seriously.

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Negative stereotypes about aging affect how well older adults remember

March, 2012

Another study has come out supporting the idea that negative stereotypes about aging and memory affect how well older adults remember. In this case, older adults reminded of age-related decline were more likely to make memory errors.

In the study, 64 older adults (60-74; average 70) and 64 college students were compared on a word recognition task. Both groups first took a vocabulary test, on which they performed similarly. They were then presented with 12 lists of 15 semantically related words. For example, one list could have words associated with "sleep," such as "bed," "rest," "awake," "tired" and "night" — but not the word “sleep”. They were not told they would be tested on their memory of these, rather they were asked to rate each word for pleasantness.

They then engaged in a five-minute filler task (a Sudoku) before a short text was read to them. For some, the text had to do with age-related declines in memory. These participants were told the experiment had to do with memory. For others, the text concerned language-processing research. These were told the experiment had to do with language processing and verbal ability.

They were then given a recognition test containing 36 of the studied words, 48 words unrelated to the studied words, and 12 words related to the studied words (e.g. “sleep”). After recording whether or not they had seen each word before, they also rated their confidence in that answer on an 8-point scale. Finally, they were given a lexical decision task to independently assess stereotype activation.

While young adults showed no effects from the stereotype manipulation, older adults were much more likely to falsely recognize related words that had not been studied if they had heard the text on memory. Those who heard the text on language were no more likely than the young adults to falsely recognize related words.

Note that there is always quite a high level of false recognition of such items: young adults, and older adults in the low-threat condition falsely recognized around half of the related lures, compared to around 10% of unrelated words. But in the high-threat condition, older adults falsely recognized 71% of the related words.

Moreover, older adults’ confidence was also affected. While young adults’ confidence in their false memories was unaffected by threat condition, older adults in the high-threat condition were more confident of their false memories than older adults in the low-threat condition.

The idea that older adults were affected by negative stereotypes about aging was supported by the results of the lexical decision task, which found that, in the high-threat condition, older adults responded more quickly to words associated with negative stereotypes than to neutral words (indicating that they were more accessible). Young adults did not show this difference.

Reference: 

Thomas, A. K., & Dubois, S. J. (2011). Reducing the burden of stereotype threat eliminates age differences in memory distortion. Psychological science, 22(12), 1515-7. doi:10.1177/0956797611425932

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Why eating less may keep the brain young

February, 2012

Two animal studies add to our understanding of why calorie restriction might help prevent cognitive impairment and dementia and how to accrue cognitive benefits from it. A human study adds to the evidence for the benefits of eating less.

I have reported often on studies pointing to obesity as increasing your risk of developing dementia, and on the smaller evidence that calorie restriction may help fight age-related cognitive decline and dementia (and help you live longer). A new mouse study helps explain why eating less might help the brain.

It turns out that a molecule called CREB-1 is triggered by calorie restriction (defined as only 70% of normal consumption). cAMP Response Element Binding (CREB) protein is an essential component of long-term memory formation, and abnormalities in the expression of CREB have been reported in the brains of Alzheimer’s patients. Restoring CREB to Alzheimer’s mice has been shown to improve learning and memory impairment.

Animal models have also indicated a role for CREB in the improvements in learning and memory brought about by physical exercise. CREB seems to be vital for adult neurogenesis.

The current study found that, when CREB1 was missing (in mice genetically engineered to lack this molecule), calorie restriction had no cognitive benefits. CREB deficiency in turn drastically reduced the expression of Sirt-1. These proteins have been implicated in cardiac function, DNA repair and genomic stability (hence the connection to longevity). More recently, Sirt-1 has also been found to modulate synaptic plasticity and memory formation — an effect mediated by CREB. This role in regulating normal brain function appears to be quite separate from its cell survival functions.

The findings identify a target for drugs that could produce the same cognitive (and longevity) benefits without the need for such strict food reduction.

Reducing your eating and drinking to 70% of normal intake is a severe reduction. Recently, researchers at the National Institute on Ageing in Baltimore have suggested that the best way to cut calories to achieve cognitive benefits was to virtually fast (down to around 500 calories) for two days a week, while eating as much as you want on the other days. Their animal experiments indicate that timing is a crucial element if cognitive benefits are to accrue.

Another preliminary report, this time from the long-running Mayo Clinic study of aging, adds to the evidence that lower consumption reduces the risk of serious cognitive impairment. The first analysis of data has revealed that the risk of developing mild cognitive impairment more than doubled for those in the highest food consumption group (daily calorie consumption between 2,143 and 6,000) compared to those in the lowest (between 600 and 1,526 calories).

Calorie consumption was taken from food questionnaires in which respondents described their diets over the previous year, so must be taken with a grain of salt. Additionally, the analysis didn’t take into account types of food and beverages, or other lifestyle factors, such as exercise. Further analysis will investigate these matters in more depth.

The study involved 1,233 older adults, aged 70 to 89. Of these, 163 were found to have MCI.

None of this should be taken as a recommendation for severely restricting your diet. Certainly such behavior should not be undertaken without the approval of your doctor, but in any case, calorie restriction is only part of a much more complex issue concerning diet. I look forward to hearing more from the Mayo Clinic study regarding types of foods and interacting factors.

Reference: 

[2681] Fusco, S., Ripoli C., Podda M V., Ranieri S C., Leone L., Toietta G., et al.
(2012).  A role for neuronal cAMP responsive-element binding (CREB)-1 in brain responses to calorie restriction.
Proceedings of the National Academy of Sciences. 109(2), 621 - 626.

The findings from the National Institute on Aging were presented at the annual meeting of the American Association for the Advancement of Science in Vancouver.

Geda, Y., Ragossnig, M., Roberts, L.K., Roberts, R., Pankratz, V., Christianson, T., Mielke, M., Boeve, B., Tangalos, E. & Petersen, R. 2012. Caloric Intake, Aging, and Mild Cognitive Impairment: A Population-Based Study. To be presented April 25 at the American Academy of Neurology's 64th Annual Meeting in New Orleans.

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Cognitive training for older adults can also change a personality trait

February, 2012

A program designed to improve reasoning ability in older adults also increased their openness to new experiences.

Openness to experience – being flexible and creative, embracing new ideas and taking on challenging intellectual or cultural pursuits – is one of the ‘Big 5’ personality traits. Unlike the other four, it shows some correlation with cognitive abilities. And, like them, openness to experience does tend to decline with age.

However, while there have been many attempts to improve cognitive function in older adults, to date no one has tried to increase openness to experience. Naturally enough, one might think — it’s a personality trait, and we are not inclined to view personality traits as amenable to ‘training’. However, recently there have been some indications that personality traits can be changed, through cognitive interventions or drug treatments. In this new study, a cognitive training program for older adults also produced increases in their openness to experience.

The study involved 183 older adults (aged 60-94; average age 73), who were randomly assigned to a 16-week training program or a waiting-list control group. The program included training in inductive reasoning, and puzzles that relied in part on inductive reasoning. Most of this activity was carried out at home, but there were two 1-hour classroom sessions: one to introduce the inductive reasoning training, and one to discuss strategies for Sudoku and crosswords.

Participants came to the lab each week to hand in materials and pick up the next set. Initially, they were given crossword and Sudoku puzzles with a wide range of difficulty. Subsequently, puzzle sets were matched to each participant’s skill level (assessed from the previous week’s performance). Over the training period, the puzzles became progressively more difficult, with the steps tailored to each individual.

The inductive reasoning training involved learning to recognize novel patterns and use them to solve problems. In ‘basic series problems’, the problems required inference from a serial pattern of words, letters, or numbers. ‘Everyday serial problems’ included problems such as completing a mail order form and answering questions about a bus schedule. Again, the difficulty of the problems increased steadily over the training period.

Participants were asked to spend at least 10 hours a week on program activities, and according to the daily logs they filled in, they spent an average of 11.4 hours a week. In addition to the hopefully inherent enjoyment of the activities, those who recorded 10 hours were recognized on a bulletin board tally sheet and entered into a raffle for a prize.

Cognitive and personality testing took place 4-5 weeks prior to the program starting, and 4-5 weeks after program end. Two smaller assessments also took place during the program, at week 6 and week 12.

At the end of the program, those who had participated had significantly improved their pattern-recognition and problem-solving skills. This improvement went along with a moderate but significant increase in openness. Analysis suggested that this increase in openness occurred independently of improvement in inductive reasoning.

The benefits were specific to inductive reasoning and openness, with no significant effects on divergent thinking, processing speed, verbal ability, or the other Big 5 traits.

The researchers suggest that the carefully stepped training program was important in leading to increased openness, allowing the building of a growing confidence in their reasoning abilities. Openness to experience contributes to engagement and enjoyment in stimulating activity, and has also been linked to better health and decreased mortality risk. It seems likely, then, that increases in openness can be part of a positive feedback cycle, leading to greater and more sustained engagement in mentally stimulating activities.

The corollary is that decreases in openness may lead to declines in cognitive engagement, and then to poorer cognitive function. Indeed it has been previously suggested that openness to experience plays a role in cognitive aging.

Clearly, more research is needed to tease out how far these findings extend to other activities, and the importance of scaffolding (carefully designing cognitive activities on an individualized basis to support learning), but this work reveals an overlooked aspect to the issue of mental stimulation for preventing age-related cognitive decline.

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