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  • 1.
    Malmberg Gavelin, Hanna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology. Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia.
    Lampit, Amit
    University of Melbourne, Australia.
    Hallock, Harry
    Charité–Universitätsmedizin Berlin, Germany.
    Sabatés, Julieta
    University of Melbourne, Australia.
    Bahar-Fuchs, Alex
    University of Melbourne, Australia.
    Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews2020In: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660, Vol. 30, no 2, p. 167-193Article, review/survey (Refereed)
    Abstract [en]

    Cognition-oriented treatments - commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation - are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of cognition-oriented treatments on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR). We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (mean Hedges' g = 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (mean Hedges' g = 0.40, range 0.32-0.60, five reviews), and dementia (mean Hedges' g = 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (mean Hedges' g = 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of cognition-oriented treatments improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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  • 2.
    Papenberg, Goran
    et al.
    Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden.
    Salami, Alireza
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden.
    Persson, Jonas
    Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden.
    Lindenberger, Ulman
    Berlin, Germany; London, UK.
    Bäckman, Lars
    Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden.
    Genetics and Functional Imaging: Effects of APOE, BDNF, COMT, and KIBRA in Aging2015In: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660, Vol. 25, no 1, p. 47-62Article, review/survey (Refereed)
    Abstract [en]

    Increasing evidence from cross-sectional and longitudinal molecular-genetic studies suggests that effects of common genetic variations on cognitive functioning increase with aging. We review the influence of candidate genes on brain functioning in old age, focusing on four genetic variations that have been extensively investigated: APOE, BDNF, COMT, and KIBRA. Similar to the behavioral evidence, there are reports from age-comparative studies documenting stronger genetic effects on measures of brain functioning in older adults compared to younger adults. This pattern suggests disproportionate impairments of neural processing among older individuals carrying disadvantageous genotypes. We discuss various factors, including gene-gene interactions, study population characteristics, lifestyle factors, and diseases, that need to be considered in future studies and may help understand inconsistent findings in the extant literature.

  • 3. Rieckmann, Anna
    et al.
    Bäckman, Lars
    Implicit learning in aging: extant patterns and new directions.2009In: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660, Vol. 19, no 4, p. 490-503Article in journal (Refereed)
    Abstract [en]

    Research suggests that the striatum plays an important role in implicit learning (IL). The striatum exhibits marked age-related morphological and neurochemical losses. Yet, behavioral studies suggest that IL is generally well preserved in old age, and that age-related differences emerge only when highly complex IL tasks are used. In this review, we integrate behavioral and neuroimaging evidence on IL in aging. We suggest that relative stability of IL in old age may reflect neural reorganization that compensates for age-related losses in striatal functions. Specifically, there may be an age-related increase in reliance on extrastriatal regions (e.g., medial-temporal, frontal) during IL. This reorganization of function may be beneficial under less taxing performance conditions, but not when task demands become more challenging.

  • 4.
    Sabates, Julieta
    et al.
    The University of Melbourne, VIC, Carlton, Australia.
    Chiu, Wei-Hsuan
    The University of Melbourne, VIC, Carlton, Australia.
    Loi, Samantha
    The University of Melbourne, VIC, Carlton, Australia; Royal Melbourne Hospital, Parkville, Australia.
    Lampit, Amit
    The University of Melbourne, VIC, Carlton, Australia.
    M. Gavelin, Hanna
    Umeå University, Faculty of Social Sciences, Department of Psychology. The University of Melbourne, VIC, Carlton, Australia.
    Chong, Terence
    The University of Melbourne, VIC, Carlton, Australia; Royal Melbourne Hospital, Parkville, Australia; St Vincent’s Hospital, Melbourne, Australia.
    Launder, Nathalie
    The University of Melbourne, VIC, Carlton, Australia.
    Goh, Anita M. Y.
    National Ageing Research Institute &, The University of Melbourne, Parkville, Australia.
    Brodtmann, Amy
    Central Clinical School, Cognitive Health Initiative, Monash University, Melbourne, Australia.
    Lautenschlager, Nicola
    The University of Melbourne, VIC, Carlton, Australia.
    Bahar-Fuchs, Alex
    The University of Melbourne, VIC, Carlton, Australia; Deakin University, Melbourne, Australia.
    The associations between neuropsychiatric symptoms and cognition in people with dementia: a systematic review and meta-analysis2023In: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660Article, review/survey (Refereed)
    Abstract [en]

    Most people with dementia experience neuropsychiatric symptoms (NPS), including anxiety, depression or disinhibition. There is growing interest in the relationship between NPS and cognitive impairment, but data is still limited. This study aimed to investigate the specific associations between NPS and cognition in people with dementia. MEDLINE, EMBASE and PsycINFO were searched for published, peer-reviewed studies of associations between at least one NPS and one cognitive ability in people with dementia. The quality of the studies was assessed with the NIH National Heart, Lung and Blood Institute’s quality assessment tools. A meta-analysis was conducted using Robumeta package for R. Ninety studies were included. We found significant associations between NPS, global cognition and cognitive domains, e.g. apathy was associated with global cognitive and memory impairment; dysphoria was associated with worse attention; delusions with executive dysfunction. Increased NPS in people with dementia are associated with worse cognitive performance. There were few studies looking at associations between some neuropsychiatric clusters and cognitive abilities, and there was little research on causal relationships. Our review was limited by the inclusion of studies that reported associations in specific formats, and most included people with a diagnosis of Alzheimer’s disease (AD). However, given the large number of studies, this is unlikely to have biased results. More research is needed that includes diverse people with different dementia syndromes.

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