games

Some cognitive training helps less-educated older adults more

  • A large study in which older adults underwent various types of cognitive training has found that less-educated adults benefited more from training designed to speed processing.

Data from 2,800 participants (aged 65+) in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study has revealed that one type of cognitive training benefits less-educated people more than it does the more-educated.

While the effects of reasoning and memory training did not differ as a function of how much education the individual had, those older adults with less than a complete high school education experienced a 50% greater benefit from speed of information processing training than college graduates. This advantage was maintained for three years after the end of the training.

The training involved ten 60 to 75-minute sessions over six weeks that focused on visual search and processing information in shorter and shorter times.

Both reasoning and information processing speed training resulted in improved targeted cognitive abilities for 10 years among participants, but memory training did not. Memory training focused on mnemonic strategies for remembering lists and sequences of items, text material, and main ideas and details of stories and other text-based information. Reasoning training focused on improving the ability to solve problems containing a serial pattern.

The researchers speculate that speed of information processing training might help those with less than 12 years of education, who are at greater risk of dementia, close the gap between them and those with more education.

The training modules have been translated into online games delivered by Posit Science.

Less educated study participants were slightly older, less likely to be married, more likely to be African-American, and more likely to have hypertension or diabetes as well as heart disease than the more educated older adults.

http://www.eurekalert.org/pub_releases/2016-01/iu-irs012816.php

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Spatial skills can be improved through training

October, 2012

A review has concluded that spatial training produces significant improvement, particularly for poorer performers, and that such training could significantly increase STEM achievement.

Spatial abilities have been shown to be important for achievement in STEM subjects (science, technology, engineering, math), but many people have felt that spatial skills are something you’re either born with or not.

In a comprehensive review of 217 research studies on educational interventions to improve spatial thinking, researchers concluded that you can indeed improve spatial skills, and that such training can transfer to new tasks. Moreover, not only can the right sort of training improve spatial skill in general, and across age and gender, but the effect of training appears to be stable and long-lasting.

One interesting finding (the researchers themselves considered it perhaps the most important finding) was the diversity in effective training — several different forms of training can be effective in improving spatial abilities. This may have something to do with the breadth covered by the label ‘spatial ability’, which include such skills as:

  • Perceiving objects, paths, or spatial configurations against a background of distracting information;
  • Piecing together objects into more complex configurations, visualizing and mentally transforming objects;
  • Understanding abstract principles, such as horizontal invariance;
  • Visualizing an environment in its entirety from a different position.

The review compared three types of training. Those that used:

  • Video games (24 studies)
  • Semester-long instructional courses on spatial reasoning (42 studies)
  • Practical training, often in a lab, that involved practicing spatial tasks, strategic instruction, or computerized lessons (138 studies).

The first two are examples of indirect training, while the last involves direct training.

On average, taken across the board, training improved performance by well over half a standard deviation when considered on its own, and still almost one half of a standard deviation when compared to a control group. This is a moderately large effect, and it extended to transfer tasks.

It also conceals a wide range, most of which is due to different treatment of control groups. Because the retesting effect is so strong in this domain (if you give any group a spatial test twice, regardless of whether they’ve been training in between the two tests, they’re going to do better on the second test), repeated testing can have a potent effect on the control group. Some ‘filler’ tasks can also inadvertently improve the control group’s performance. All of this will reduce the apparent effect of training. (Not having a control group is even worse, because you don’t know how much of the improvement is due to training and how much to the retesting effect.)

This caution is, of course, more support for the value of practice in developing spatial skills. This is further reinforced by studies that were omitted from the analysis because they would skew the data. Twelve studies found very high effect sizes — more than three times the average size of the remaining studies. All these studies took place in poorly developed countries (those with a Human Development Index above 30 at the time of the study) — Malaysia, Turkey, China, India, and Nigeria. HDI rating was even associated with the benefits of training in a dose-dependent manner — that is, the lower the standard of living, the greater the benefit.

This finding is consistent with other research indicating that lower socioeconomic status is associated with larger responses to training or intervention.

In similar vein, when the review compared 19 studies that specifically selected participants who scored poorly on spatial tests against the other studies, they found that the effects of training were significantly bigger among the selected studies.

In other words, those with poorer spatial skills will benefit most from training. It may be, indeed, that they are poor performers precisely because they have had little practice at these tasks — a question that has been much debated (particularly in the context of gender differences).

It’s worth noting that there was little difference in performance on tests carried out immediately after training ended, within a week, or within a month, indicating promising stability.

A comparison of different types of training did find that some skills were more resistant to training than others, but all types of spatial skill improved. The differences may be because some sorts of skill are harder to teach, and/or because some skills are already more practiced than others.

Given the demonstrated difficulty in increasing working memory capacity through training, it is intriguing to notice one example the researchers cite: experienced video game players have been shown to perform markedly better on some tasks that rely on spatial working memory, such as a task requiring you to estimate the number of dots shown in a brief presentation. Most of us can instantly recognize (‘subitize’) up to five dots without needing to count them, but video game players can typically subitize some 7 or 8. The extent to which this generalizes to a capacity to hold more elements in working memory is one that needs to be explored. Video game players also apparently have a smaller attentional blink, meaning that they can take in more information.

A more specific practical example of training they give is that of a study in which high school physics students were given training in using two- and three-dimensional representations over two class periods. This training significantly improved students’ ability to read a topographical map.

The researchers suggest that the size of training effect could produce a doubling of the number of people with spatial abilities equal to or greater than that of engineers, and that such training might lower the dropout rate among those majoring in STEM subjects.

Apart from that, I would argue many of us who are ‘spatially-challenged’ could benefit from a little training!

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More support for value of cognitive activities in fighting cognitive decline in old age

September, 2012

Two recent conference presentations add to the evidence for the benefits of ‘brain training’, and of mental stimulation, for holding back age-related cognitive decline.

My recent reports on brain training for older adults (see, e.g., Review of working memory training programs finds no broader benefit; Cognitive training shown to help healthy older adults; Video game training benefits cognition in some older adults) converge on the idea that cognitive training can indeed be beneficial for older adults’ cognition, but there’s little wider transfer beyond the skills being practiced. That in itself can be valuable, but it does reinforce the idea that the best cognitive training covers a number of different domains or skill-sets. A new study adds little to this evidence, but does perhaps emphasize the importance of persistence and regularity in training.

The study involved 59 older adults (average age 84), of whom 33 used a brain fitness program 5 days a week for 30 minutes a day for at least 8 weeks, while the other group of 26 were put on a waiting list for the program. After two months, both groups were given access to the program, and both were encouraged to use it as much or as little as they wanted. Cognitive testing occurred before the program started, at two months, and at six months.

The first group to use the program used the program on average for 80 sessions, compared to an average 44 sessions for the wait-list group.

The higher use group showed significantly higher cognitive scores (delayed memory test; Boston Naming test) at both two and six months, while the lower (and later) use group showed improvement at the end of the six month period, but not as much as the higher use group.

I’m afraid I don’t have any more details (some details of the training program would be nice) because it was a conference presentation, so I only have access to the press release and the abstract. Because we don’t know exactly what the training entailed, we don’t know the extent to which it practiced the same skills that were tested. But we may at least add it to the evidence that you can improve cognitive skills by regular training, and that the length/amount of training (and perhaps regularity, since the average number of sessions for the wait-list group implies an average engagement of some three times a week, while the high-use group seem to have maintained their five-times-a-week habit) matters.

Another interesting presentation at the conference was an investigation into mental stimulating activities and brain activity in older adults.

In this study, 151 older adults (average age 82) from the Rush Memory and Aging Project answered questions about present and past cognitive activities, before undergoing brain scans. The questions concerned how frequently they engaged in mentally stimulating activities (such as reading books, writing letters, visiting a library, playing games) and the availability of cognitive resources (such as books, dictionaries, encyclopedias) in their home, during their lifetime (specifically, at ages 6, 12, 18, 40, and now).

Higher levels of cognitive activity and cognitive resources were also associated with better cognitive performance. Moreover, after controlling for education and total brain size, it was found that frequent cognitive activity in late life was associated with greater functional connectivity between the posterior cingulate cortex and several other regions (right orbital and middle frontal gyrus, left inferior frontal gyrus, hippocampus, right cerebellum, left inferior parietal cortex). More cognitive resources throughout life was associated with greater functional connectivity between the posterior cingulate cortex and several other regions (left superior occipital gyrus, left precuneus, left cuneus, right anterior cingulate, right middle frontal gyrus, and left inferior frontal gyrus).

Previous research has implicated a decline in connectivity with the posterior cingulate cortex in mild cognitive impairment and Alzheimer’s disease.

Cognitive activity earlier in life was not associated with differences in connectivity.

The findings provide further support for the idea “Use it or lose it!”, and suggests that mental activity protects against cognitive decline by maintaining functional connectivity in important neural networks.

Reference: 

Miller, K.J. et al. 2012. Memory Improves With Extended Use of Computerized Brain Fitness Program Among Older Adults. Presented August 3 at the 2012 convention of the American Psychological Association.

Han, S.D. et al. 2012. Cognitive Activity and Resources Are Associated With PCC Functional Connectivity in Older Adults. Presented August 3 at the 2012 convention of the American Psychological Association.

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Video games and impaired attention: a vicious circle

April, 2012

A large, long-running study suggests both that children with attention difficulties tend to spend more time playing video games, and that extensive video game playing is bad for attention.

A three-year study involving 3,034 Singaporean children and adolescents (aged 8-17) has found that those who spent more time playing video games subsequently had more attention problems, even when earlier attention problems, sex, age, race, and socioeconomic status were statistically controlled. Those who were more impulsive or had more attention problems subsequently spent more time playing video games, even when initial video game playing was statistically controlled. These findings suggest that the cause-effect relationship between video game playing and attention problems/impulsiveness goes both ways.

While the particular content may have an effect on attention problems and impulsiveness (violent games appeared to be an additional, independent, factor in attention problems), it was the total time spent that was more important.

Participants completed questionnaires about their video game playing habits annually for three years running. They also completed questionnaires aimed to measure attention and impulsiveness (the Current ADHD Symptoms Scale Self-Report, and the Barratt Impulsiveness Scale-11, respectively). Regarding attention, the children answered questions such as how often they "fail to give close attention to details or make careless mistakes" in their work or "blurt out answers before questions have been completed." For the impulsivity test, they selected points they felt described themselves, such as "I often make things worse because I act without thinking" or "I concentrate easily."

How does this finding relate to other evidence showing that playing video games can improve visual attention for rapid and accurate recognition of information from the environment? The answer lies in the different nature of attention — the attention needed for visual search differs in important ways from the attention necessary for sustained concentration in contexts that are often effortful and/or boring.

The example of many attention-challenged individuals makes this more understandable. Many parents of children with ADHD find that the only thing their child can concentrate on for a lengthy period is video games. The answer to that riddle is the rapidly changing nature of video games, and the way they are designed to grab the attention, with flashing lights and loud noises and moving images etc. The young person is not, therefore, improving their ability to focus in a way that is helpful for the school environment, or indeed for everyday life.

Unfortunately, this study suggests that it is precisely those people who are most in need of such ‘external supports’ for attention (‘grabbing’ stimuli such as lights and sounds and movement) — that is, those individuals who are least able to control their own attention — who are most likely to spend a lot of time playing such games. The games then weaken their attentional control even more, and so the cycle continues.

So this research answers the question ADHD parents tend to have: should I encourage my child to play video games a lot (given that it’s the only thing that holds their attention) or not? The answer, unfortunately, would seem to be: not. However, all is not lost. There are computer ‘games’ that are designed to help those with ADHD learn to concentrate in a way that is more useful (see the Topic collection on ADHD for more on this).

The American Academy of Pediatrics recommends one hour per day of total media screen time (including TV, DVDs, video games, Internet, iPad, etc.) for children in elementary school, and two hours for children in secondary school.

Reference: 

Gentile, D.A., Swing, E.L., Lim, C.G. & Khoo, A. 2012. Video game playing, attention problems, and impulsiveness: Evidence of bidirectional causality. Psychology of Popular Media Culture, Vol 1(1), Jan 2012, 62-70. doi: 10.1037/a0026969

Full text available at http://www.apa.org/pubs/journals/releases/ppm-1-1-62.pdf

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'Exergames' may provide greater cognitive benefit for older adults

February, 2012

An intriguing pilot study finds that regular exercise on a stationary bike enhanced with a computer game-type environment improves executive function in older adults more than ordinary exercise on a stationary bike.

We know that physical exercise greatly helps you prevent cognitive decline with aging. We know that mental stimulation also helps you prevent age-related cognitive decline. So it was only a matter of time before someone came up with a way of combining the two. A new study found that older adults improved executive function more by participating in virtual reality-enhanced exercise ("exergames") that combine physical exercise with computer-simulated environments and interactive videogame features, compared to the same exercise without the enhancements.

The Cybercycle Study involved 79 older adults (aged 58-99) from independent living facilities with indoor access to a stationary exercise bike. Of the 79, 63 participants completed the three-month study, meaning that they achieved at least 25 rides during the three months.

Unfortunately, randomization was not as good as it should have been — although the researchers planned to randomize on an individual basis, various technical problems led them to randomize on a site basis (there were eight sites), with the result that the cybercycle group and the control bike group were significantly different in age and education. Although the researchers took this into account in the analysis, that is not the same as having groups that match in these all-important variables. However, at least the variables went in opposite directions: while the cybercycle group was significantly younger (average 75.7 vs 81.6 years), it was significantly less educated (average 12.6 vs 14.8 years).

Perhaps also partly off-setting the age advantage, the cybercycle group was in poorer shape than the control group (higher BMI, glucose levels, lower physical activity level, etc), although these differences weren’t statistically significant. IQ was also lower for the cybercycle group, if not significantly so (but note the high averages for both groups: 117.6 vs 120.6). One of the three tests of executive function, Color Trails, also showed a marked group difference, but the large variability in scores meant that this difference was not statistically significant.

Although participants were screened for disorders such as Alzheimer’s and Parkinson’s, and functional disability, many of both groups were assessed as having MCI — 16 of the 38 in the cybercycle group and 14 of the 41 in the control bike group.

Participants were given cognitive tests at enrolment, one month later (before the intervention began), and after the intervention ended. The stationary bikes were identical for both groups, except the experimental bike was equipped with a virtual reality display. Cybercycle participants experienced 3D tours and raced against a "ghost rider," an avatar based on their last best ride.

The hypothesis was that cybercycling would particularly benefit executive function, and this was borne out. Executive function (measured by the Color Trails, Stroop test, and Digits Backward) improved significantly more in the cybercycle condition, and indeed was the only cognitive task to do so (other cognitive tests included verbal fluency, verbal memory, visuospatial skill, motor function). Indeed, the control group, despite getting the same amount of exercise, got worse at the Digits Backward test, and failed to show any improvement on the Stroop test.

Moreover, significantly fewer cybercyclists progressed to MCI compared to the control group (three vs nine).

There were no differences in exercise quantity or quality between the two groups — which does argue against the idea that cyber-enhanced physical activity would be more motivating. However, the cybercycling group did tend to comment on their enjoyment of the exercise. While the enjoyment may not have translated into increased activity in this situation, it may well do so in a longer, less directed intervention — i.e. real life.

It should also be remembered that the intervention was relatively short, and that other cognitive tasks might take longer to show improvement than the more sensitive executive function. This is supported by the fact that levels of the brain growth factor BDNF, assessed in 30 participants, showed a significantly greater increase of BDNF in cybercyclists.

I should also emphasize that the level of physical exercise really wasn't that great, but nevertheless the size of the cybercycle's effect on executive function was greater than usually produced by aerobic exercise (a medium effect rather than a small one).

The idea that activities that combine physical and mental exercise are of greater cognitive benefit than the sum of benefits from each type of exercise on its own is not inconsistent with previous research, and in keeping with evidence from animal studies that physical exercise and mental stimulation help the brain via different mechanisms. Moreover, I have an idea that enjoyment (in itself, not as a proxy for motivation) may be a factor in the cognitive benefits derived from activities, whether physical or mental. Mere speculation, derived from two quite separate areas of research: the idea of “flow” / “being in the zone”, and the idea that humor has physiological benefits.

Of course, as discussed, this study has a number of methodological issues that limit its findings, but hopefully it will be the beginning of an interesting line of research.  

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The right sort of video game can increase your intelligence

June, 2011

Games that use the n-back task, designed to challenge working memory, may improve fluid intelligence, but only if the games are at the right level of difficulty for the individual.

It has been difficult to train individuals in such a way that they improve in general skills rather than the specific ones used in training. However, recently some success has been achieved using what is called an “n-back” task, a task that involves presenting a series of visual and/or auditory cues to a subject and asking the subject to respond if that cue has occurred, to start with, one time back. If the subject scores well, the number of times back is increased each round.

In the latest study, 62 elementary and middle school children completed a month of training on a computer program, five times a week, for 15 minutes at a time. While the active control group trained on a knowledge and vocabulary-based task, the experimental group was given a demanding spatial task in which they were presented with a sequence of images at one of six locations, one at a time, at a rate of 3s. The child had to press one key whenever the current image was at the same location as the one n items back in the series, and another key if it wasn’t. Both tasks employed themed graphics to make the task more appealing and game-like.

How far back the child needed to remember depended on their performance — if they were struggling, n would be decreased; if they were meeting the challenge, n would be increased.

Although the experimental and active control groups showed little difference on abstract reasoning tasks (reflecting fluid intelligence) at the end of the training, when the experimental group was divided into two subgroups on the basis of training gain, the story was different. Those who showed substantial improvement on the training task over the month were significantly better than the others, on the abstract reasoning task. Moreover, this improvement was maintained at follow-up testing three months later.

The key to success seems to be whether or not the games hit the “sweet spot” for the individual — fun and challenging, but not so challenging as to be frustrating. Those who showed the least improvement rated the game as more difficult, while those who improved the most found it challenging but not overwhelming.

You can try this task yourself at http://brainworkshop.sourceforge.net/.

Reference: 

Jaeggi, Susanne M, Martin Buschkuehl, John Jonides, and Priti Shah. “Short- and long-term benefits of cognitive training.” Proceedings of the National Academy of Sciences of the United States of America 2011 (June 13, 2011): 2-7. http://www.ncbi.nlm.nih.gov/pubmed/21670271.

[1183] Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. From the Cover: Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences [Internet]. 2008 ;105(19):6829 - 6833. Available from: http://www.pnas.org/content/early/2008/04/25/0801268105.abstract

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Brain fitness program produces working memory improvement in older adults

August, 2010

A new study shows improvement in visual working memory in older adults following ten hours training with a commercial brain training program. The performance gains correlated with changes in brain activity.

While brain training programs can certainly improve your ability to do the task you’re practicing, there has been little evidence that this transfers to other tasks. In particular, the holy grail has been very broad transfer, through improvement in working memory. While there has been some evidence of this in pilot programs for children with ADHD, a new study is the first to show such improvement in older adults using a commercial brain training program.

A study involving 30 healthy adults aged 60 to 89 has demonstrated that ten hours of training on a computer game designed to boost visual perception improved perceptual abilities significantly, and also increased the accuracy of their visual working memory to the level of younger adults. There was a direct link between improved performance and changes in brain activity in the visual association cortex.

The computer game was one of those developed by Posit Science. Memory improvement was measured about one week after the end of training. The improvement did not, however, withstand multi-tasking, which is a particular problem for older adults. The participants, half of whom underwent the training, were college educated. The training challenged players to discriminate between two different shapes of sine waves (S-shaped patterns) moving across the screen. The memory test (which was performed before and after training) involved watching dots move across the screen, followed by a short delay and then re-testing for the memory of the exact direction the dots had moved.

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Those less motivated to achieve will excel on tasks seen as fun

January, 2010

Telling students to strive for excellence may not always be the best strategy.

You may think that telling students to strive for excellence is always a good strategy, but it turns out that it is not quite as simple as that. A series of four experiments looking at how students' attitudes toward achievement influenced their performance on various tasks has found that while those with high achievement motivation did better on a task when they also were exposed to subconscious "priming" that related to winning, mastery or excellence, those with low achievement motivation did worse. Similarly, when given a choice, those with high achievement motivation were more likely to resume an interrupted task which they were told tested their verbal reasoning ability. However, those with high achievement motivation did worse on a word-search puzzle when they were told the exercise was fun. The findings point to the fact that people have different goals (e.g., achievement vs enjoyment), and that effective motivation requires this to be taken account of.

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Video games help stroke victims recover motor function

March, 2010

A pilot study suggests that video games for the Nintendo Wii could help stroke victims recover fine and gross motor function after a stroke.

A pilot study suggests that video games for the Nintendo Wii could help stroke victims recover fine motor function (such as finger dexterity) and gross motor function (such as arm movements) two months after a stroke. The ten patients randomly assigned to playing these games for about six hours over the course of two weeks showed significantly better recovery, and none of the adverse effects (like nausea or dizziness) that were reported in the other group assigned to recreational games such as cards or the block-stacking game Jenga. A clinical trial is now underway.

Reference: 

The research was presented February 25 at the American Stroke Association's International Stroke Conference.

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Study claims brain games don't make you smarter

April, 2010

The recent report splashed all over the press that supposedly found playing online brain games makes you no smarter than surfing the Internet demonstrated no more than we already know: that transfer beyond the specific tasks you practise is very rare, and that well-educated people who are not deprived of mental stimulation and have no health or disability problems are not the people likely to be helped by such games.

A six-week study got a lot of press last month. The study involved some 11,000 viewers of the BBC's science show "Bang Goes the Theory", and supposedly showed that playing online brain games makes you no smarter than surfing the Internet to answer general knowledge questions. In fact, the main problem was the media coverage. The researchers acknowledged that previous research has found some types of individuals benefit from such games (older adults, preschool children, and I would add, children with some learning disabilities such as ADHD), and that video gamers show improved skills in some areas. What they found was that, across this general, mostly well-educated group, the amount of training on these tasks didn't improve performance beyond those specific tasks. This is neither a surprise, nor news. I'll talk more about this in the newsletter coming out early next month.

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