Cognitive Training for Age-Related Distractibility
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Virginia Polytechnic Institute and State University
Disqualifiers: Metal implants, Pacemaker, Claustrophobia, Pregnancy, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
A growing body of research has highlighted the importance of frontal regions, at both the functional and structural levels, in age-related declines in attentional and cognitive processing. However, the underlying neurobiological pathophysiological changes in the brain that contribute to these declines are still largely unclear. The objective of this proposal is to investigate neural mechanisms of age-related attentional distractibility, focusing on the neural circuit initiated from the locus coeruleus (LC). In the current proposal, the investigators will test the hypothesis that the neural disconnectivity of LC with the salience network (SN) drives failures of ignoring distractors in older adults. The investigators will examine how LC-SN connectivity is associated with selective attention performance, and how improved LC-SN connectivity through a cognitive training program may lead to improved attentional performance.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment for age-related distractibility?
Research shows that cognitive training programs, including those delivered via tablets or computers, can improve attention and cognitive performance in older adults. Studies have found that such programs enhance skills like selective focus and coordination, suggesting they may help with age-related distractibility.12345
Is cognitive training for age-related distractibility safe for humans?
How does the treatment for age-related distractibility differ from other treatments?
This treatment is unique because it uses a tablet-based program to provide adaptive cognitive training, focusing on improving attention by helping older adults suppress irrelevant sensory stimuli. Unlike other treatments, it is specifically designed to enhance selective attention and processing speed through modality-specific exercises, making it accessible and tailored to individual needs.137910
Eligibility Criteria
This trial is for healthy adults aged 18-75 who can consent to participate. It's not suitable for those with metal implants, pacemakers, severe claustrophobia, braces, a weight over 250 pounds, pregnancy or severe medical/psychiatric conditions like head trauma.Inclusion Criteria
Ability to provide written informed consent
I am a healthy adult.
I am between 18 and 75 years old.
Exclusion Criteria
Pregnant or possibility of being pregnant
I have had surgery that involved getting metal implants.
Possible metal fragments in the eyes
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Cognitive Training
Older adult participants complete an attention practice program, preceded and followed by an fMRI scan session featuring an attention task
2 weeks
2 visits (in-person)
Follow-up
Participants are monitored for changes in accuracy on the place-face selective attention task and fMRI LC-SN connectivity
2 weeks
Treatment Details
Interventions
- Tablet based adaptive criterion task practice program (Behavioural Intervention)
- Tablet based adaptive multimodal attention practice program (Behavioural Intervention)
Trial OverviewThe study tests two tablet-based programs aimed at improving attention in older adults by enhancing brain connectivity. One focuses on multimodal attention practice and the other on criterion task practice to reduce age-related distractibility.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Older adult participantsExperimental Treatment2 Interventions
Older adult participants in the study will complete one of two variants of an attention practice program and that will be preceded by, and followed by, an fMRI scan session featuring an attention task
Group II: Younger adult participantsActive Control1 Intervention
Younger adult participants in the study will complete one fMRI scan session featuring an attention task
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Virginia Polytechnic Institute and State UniversityBlacksburg, VA
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Who Is Running the Clinical Trial?
Virginia Polytechnic Institute and State UniversityLead Sponsor
References
Online Attention Training for Older Adults. [2020]Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention- coordination, allocation, and selective focus -in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p=.02) and blanks (U=26.5; Z=-3.05; p=.002) as well as a matching attributes task (U=49.5; Z=-2.33; p=.02). The extended practice group significantly improved on three tasks of coordinating attention - radio-tuning (U=30; Z=-2.73; p=.01), circuit-breaker resetting (U=46; Z=-2.24; p=.03), and the combination of the two tasks (U=15; Z=-3.51; p<.0001) - as well as a memory generalization task (U=20; Z=-3.27; p=.001). A post-test satisfaction survey found both groups enjoyed the program, but the abbreviated practice group felt the tasks were more difficult. These findings suggest online attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults.
Effectiveness of an attention-training program. [2015]Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed.
Non-pharmacological intervention strategies on aging processes: Empirical data on mental training in "normal" older people and patients with mental impairment. [2019]A wide variety of measures and methods are applied to conduct cognitive training. Of these, "Mental Activity Training" (MAT) is used in order to train basic parameters of information-processing directly, i.e., information flow to short-term storage and duration of presence. Here the results of three studies are discussed in which MAT was implemented. They examine the influence on fluid intelligence abilities and everyday activities of elderly people without cognitive impairment. Furthermore, the first results of investigations on patients with severe dementia are discussed. An overview of recent publications on the topics shows that cognitive training is an appropriate mean of combatting cognitive aging as well as of providing a method of treatment for illness-related reduced mental performance.
Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol. [2021]Spatial neglect is a frequent and debilitating consequence of acquired brain injury and currently has no widely accepted standard of care. While previous interventions for spatial neglect have targeted patients' overt spatial deficits (e.g., reduced contralesional visual scanning), far fewer have directly targeted patients' non-spatial deficits (e.g., sustained attention deficits). Considering that non-spatial deficits have shown to be highly predictive of long-term disability, we developed a novel computer based training program that targets both sustained (tonic) and moment-to-moment (phasic) aspects of non-spatial attention (Tonic and Phasic Alertness Training, TAPAT). Preliminary studies demonstrate that TAPAT is safe and effective in improving both spatial and non-spatial attention deficits in the post-acute recovery phase in neglect patients. The purpose of the current trial (referred to as the REmediation of SPatial Neglect or RESPONSE trial) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes.
THINKable, a computerized cognitive remediation. First results. [2019]We have carried out the first study in Italy on the cognitive remediation by a new computerized system developed by IBM and called THINKable. Statistical analyses revealed that on some measures there was a significant improvement in the level of performance of the subjects at the time of the posttreatment assessment compared with the pretreatment assessment. Disorders of memory and higher cognitive functioning improved by structured retraining, independently of attention. Improvement has been matched by changes in the patients real-word functioning. Senile patients also took advantage from cognitive training. They were already followed before as outpatients and had no spontaneous recovery. The role of personal computers in neuropsychological training is discussed.
Adaptive Computerized Working Memory Training in Patients With Mild Cognitive Impairment. A Randomized Double-Blind Active Controlled Trial. [2022]Label="OBJECTIVE" NlmCategory="OBJECTIVE">We investigated if a 5-week computerized adaptive working memory training program (Cogmed®) of 20 to 25 sessions would be effective in improving the working memory capacity and other neuropsychological functions compared to a non-adaptive working memory training program (active-controlled) in adult patients with mild cognitive impairment (MCI).
Working-memory training in younger and older adults: training gains, transfer, and maintenance. [2022]Working memory (WM), a key determinant of many higher-order cognitive functions, declines in old age. Current research attempts to develop process-specific WM training procedures, which may lead to general cognitive improvement. Adaptivity of the training as well as the comparison of training gains to performance changes of an active control group are key factors in evaluating the effectiveness of a specific training program. In the present study, 55 younger adults (20-30 years of age) and 45 older adults (60-70 years of age) received 5 weeks of computerized training on various spatial and verbal WM tasks. Half of the sample received adaptive training (i.e., individually adjusted task difficulty), whereas the other half-worked on the same task material but on a low task difficulty level (active controls). Performance was assessed using criterion, near-transfer, and far-transfer tasks before training, after 5 weeks of intervention, as well as after a 3-month follow-up interval. Results indicate that (a) adaptive training generally led to larger training gains than low-level practice, (b) training and transfer gains were somewhat greater for younger than for older adults in some tasks, but comparable across age groups in other tasks, (c) far-transfer was observed to a test on sustained attention and for a self-rating scale on cognitive functioning in daily life for both young and old, and (d) training gains and transfer effects were maintained across the 3-month follow-up interval across age.
Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training. [2020]Intervention programs to relieve memory impairment and memory-related complaints in older adults with mild cognitive impairment are needed. Objective: The purpose of the current study was to assess the efficacy of a novel cognitive training approach-named multi-strategic metamemory training-in older adults with amnestic mild cognitive impairment. Among a total of 113 older adults with mild cognitive impairment, 66 participated in the memory training program (training group) and 47 did not (control group). Repeated measures of analysis of variance revealed that compared with the control group, the training group experienced: i) a significantly greater increase in cognitive test scores of long-term delayed free recall (Finteraction = 6.04, p = .016) and fluency (Finteraction = 4.11, p = .045) and ii) significantly greater decrease in their subjective memory complaints for everyday memory (Finteraction = 7.35, p = .009). These results suggest that the training program can improve verbal memory (i.e., delayed free recall), language processing (i.e., categorical fluency) and limit complaints in everyday instrumental memory activities of mildly impaired older adults.
A cognitive training intervention improves modality-specific attention in a randomized controlled trial of healthy older adults. [2021]Age-related deficits in cognitive and sensory function can result in increased distraction from background sensory stimuli. This randomized controlled trial investigated the effects of a cognitive training intervention aimed at helping healthy older adults suppress irrelevant auditory and visual stimuli. Sixty-six participants received 8 weeks of either the modality-specific attention training program or an educational lecture control program. Participants who completed the intervention program had larger improvements in modality-specific selective attention following training than controls. These improvements also correlated with reductions in bimodal integration during selective attention. Further, the intervention group showed larger improvements than the control group in non-trained domains such as processing speed and dual-task completion, demonstrating the utility of modality-specific attention training for improving cognitive function in healthy older adults.
The role of sensory modality in age-related distraction: a critical review and a renewed view. [2019]Selective attention requires the ability to focus on relevant information and to ignore irrelevant information. The ability to inhibit irrelevant information has been proposed to be the main source of age-related cognitive change (e.g., Hasher & Zacks, 1988). Although age-related distraction by irrelevant information has been extensively demonstrated in the visual modality, studies involving auditory and cross-modal paradigms have revealed a mixed pattern of results. A comparative evaluation of these paradigms according to sensory modality suggests a twofold trend: Age-related distraction is more likely (a) in unimodal than in cross-modal paradigms and (b) when irrelevant information is presented in the visual modality, rather than in the auditory modality. This distinct pattern of age-related changes in selective attention may be linked to the reliance of the visual and auditory modalities on different filtering mechanisms. Distractors presented through the auditory modality can be filtered at both central and peripheral neurocognitive levels. In contrast, distractors presented through the visual modality are primarily suppressed at more central levels of processing, which may be more vulnerable to aging. We propose the hypothesis that age-related distractibility is modality dependent, a notion that might need to be incorporated in current theories of cognitive aging. Ultimately, this might lead to a more accurate account for the mixed pattern of impaired and preserved selective attention found in advancing age.