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  • 1.
    Barbera, Mariagnese
    et al.
    Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland; The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom.
    Lehtisalo, Jenni
    Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland; Population Health Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland.
    Perera, Dinithi
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom; FINGERS Brain Health Institute, C/O Stockholms Sjukhem, Box 122 30, Stockholm, Sweden.
    Aspö, Malin
    Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden; Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Karolinska Vägen 37A, Solna, Sweden.
    Cross, Mary
    Imperial Clinical Trials Unit, School of Public Health, Faculty of Medicine, Imperial College London, Imperial College London, Stadium House, 68 Wood Lane, London, United Kingdom.
    De Jager Loots, Celeste A.
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom.
    Falaschetti, Emanuela
    Imperial Clinical Trials Unit, School of Public Health, Faculty of Medicine, Imperial College London, Imperial College London, Stadium House, 68 Wood Lane, London, United Kingdom.
    Friel, Naomi
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom.
    Luchsinger, José A.
    Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, 622 W 168Th St, NY, New York, United States.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Peltonen, Markku
    Population Health Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland; FINGERS Brain Health Institute, C/O Stockholms Sjukhem, Box 122 30, Stockholm, Sweden.
    Price, Geraint
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom.
    Neely, Anna Stigsdotter
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden; Department of Health, Education and Technology, Luleå University of Technology, 971 87, Luleå, Sweden.
    Thunborg, Charlotta
    Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden; Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Karolinska Vägen 37A, Solna, Sweden.
    Tuomilehto, Jaakko
    Population Health Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland; Department of Public Health, University of Helsinki, PO BOX 20, Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
    Mangialasche, Francesca
    FINGERS Brain Health Institute, C/O Stockholms Sjukhem, Box 122 30, Stockholm, Sweden; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden; Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Karolinska Vägen 37A, Solna, Sweden.
    Middleton, Lefkos
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom; Directorate of Public Health, Imperial College NHS Healthcare Trust Hospitals, Praed Street, London, United Kingdom.
    Ngandu, Tiia
    Population Health Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden.
    Solomon, Alina
    Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland; The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden.
    Kivipelto, Miia
    The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan’s Road, London, United Kingdom; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 37A, Solna, Sweden; Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Karolinska Vägen 37A, Solna, Sweden; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland.
    A multimodal precision-prevention approach combining lifestyle intervention with metformin repurposing to prevent cognitive impairment and disability: the MET-FINGER randomised controlled trial protocol2024Ingår i: Alzheimer's Research & Therapy, E-ISSN 1758-9193, Vol. 16, nr 1, artikel-id 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Combining multimodal lifestyle interventions and disease-modifying drugs (novel or repurposed) could provide novel precision approaches to prevent cognitive impairment. Metformin is a promising candidate in view of the well-established link between type 2 diabetes (T2D) and Alzheimer's Disease and emerging evidence of its potential neuro-protective effects (e.g. vascular, metabolic, anti-senescence). MET-FINGER aims to test a FINGER 2.0 multimodal intervention, combining an updated FINGER multidomain lifestyle intervention with metformin, where appropriate, in an APOE ε4-enriched population of older adults (60–79 years) at increased risk of dementia.

    Methods: MET-FINGER is an international randomised, controlled, parallel-group, phase-IIb proof-of-concept clinical trial, where metformin is included through a trial-within-trial design. 600 participants will be recruited at three sites (UK, Finland, Sweden). Participants at increased risk of dementia based on vascular risk factors and cognitive screening, will be first randomised to the FINGER 2.0 intervention (lifestyle + metformin if eligible; active arm) or to receive regular health advice (control arm). Participants allocated to the FINGER 2.0 intervention group at risk indicators of T2D will be additionally randomised to receive metformin (2000 mg/day or 1000 mg/day) or placebo. The study duration is 2 years. The changes in global cognition (primary outcome, using a Neuropsychological Test Battery), memory, executive function, and processing speed cognitive domains; functional status; lifestyle, vascular, metabolic, and other dementia-related risk factors (secondary outcomes), will be compared between the FINGER 2.0 intervention and the control arm. The feasibility, potential interaction (between-groups differences in healthy lifestyle changes), and disease-modifying effects of the lifestyle-metformin combination will be exploratory outcomes. The lifestyle intervention is adapted from the original FINGER trial (diet, physical activity, cognitive training, monitoring of cardiovascular/metabolic risk factors, social interaction) to be consistently delivered in three countries. Metformin is administered as Glucophage®XR/SR 500, (500 mg oral tablets). The metformin/placebo treatment will be double blinded.

    Conclusion: MET-FINGER is the first trial combining a multimodal lifestyle intervention with a putative repurposed disease-modifying drug for cognitive impairment prevention. Although preliminary, its findings will provide crucial information for innovative precision prevention strategies and form the basis for a larger phase-III trial design and future research in this field.

    Trial registration: ClinicalTrials.gov (NCT05109169).

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  • 2.
    Bäcklund, Christian
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Elbe, Pia
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Gavelin, Hanna M.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Sörman, Daniel Eriksson
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Ljungberg, Jessica K.
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Gaming motivations and gaming disorder symptoms: A systematic review and meta-analysis2022Ingår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, nr 3, s. 667-688Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background and aims: The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder.

    Method: An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model.

    Results: In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms.

    Discussion and conclusions: The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.

    Registration detail: PROSPERO (CRD42020220050).

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  • 3. Dekker, Joost
    et al.
    Amitami, Marie
    Berman, Anne H.
    Brown, Helen
    Cleal, Bryan
    Figueiras, Maria Joao
    Finney Rutten, Lila J.
    Fors, Egil A.
    Griva, Konstadina
    Gu, Jing
    Keyworth, Chris
    Kleinstauber, Maria
    Lahmann, Claas
    Lau, Joseph T. F.
    Leplow, Bernd
    Li, Li
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Mewes, Ricarda
    Mo, Phoenix K. H.
    Mullan, Barbara
    Penedo, Frank J.
    Prins, Judith
    Rodriguez Rodriguez, Teresa
    Simpson, Sharon A.
    Stauder, Adrienne
    Tuomisto, Martti T.
    Weiss, Deborah Jones
    Nater, Urs M.
    Definition and Characteristics of Behavioral Medicine, and Main Tasks and Goals of the International Society of Behavioral Medicine: an International Delphi Study2021Ingår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 28, nr 3, s. 268-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In the past decades, behavioral medicine has attained global recognition. Due to its global reach, a critical need has emerged to consider whether the original definition of behavioral medicine is still valid, comprehensive, and inclusive, and to reconsider the main tasks and goals of the International Society of Behavioral Medicine (ISBM), as the umbrella organization in the field. The purpose of the present study was to (i) update the definition and scope of behavioral medicine and its defining characteristics; and (ii) develop a proposal on ISBM's main tasks and goals.

    Method: Our study used the Delphi method. A core group prepared a discussion paper. An international Delphi panel rated questions and provided comments. The panel intended to reach an a priori defined level of consensus (i.e., 70%).

    Results: The international panel reached consensus on an updated definition and scope of behavioral medicine as a field of research and practice that builds on collaboration among multiple disciplines. These disciplines are concerned with development and application of behavioral and biomedical evidence across the disease continuum in clinical and public health domains. Consensus was reached on a proposal for ISBM's main tasks and goals focused on supporting communication and collaboration across disciplines and participating organizations; stimulating research, education, and practice; and supporting individuals and organizations in the field.

    Conclusion: The consensus on definition and scope of behavioral medicine and ISBM's tasks and goals provides a foundational step toward achieving these goals.

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  • 4.
    Elbe, Pia
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Sweden.
    Bäcklund, Christian
    Department of Health, Education and Technology, Luleå University of Technology, Sweden.
    Vega-Mendoza, Mariana
    Department of Health, Education and Technology, Luleå University of Technology, Sweden.
    Sörman, Daniel
    Department of Health, Education and Technology, Luleå University of Technology, Sweden.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nyberg, Lars
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Department of Health, Education and Technology, Luleå University of Technology, Sweden; Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway.
    Ljungberg, Jessica K.
    Department of Health, Education and Technology, Luleå University of Technology, Sweden.
    Computerized cognitive interventions for adults with ADHD: a systematic review and meta-analysis2023Ingår i: Neuropsychology, ISSN 0894-4105, E-ISSN 1931-1559, Vol. 37, nr 5, s. 519-530Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective: Treatments for adults with attention-deficit hyperactivity disorder (ADHD) are understudied, compared to children and adolescents with the same condition. In this systematic review and random-effects meta-analysis, we aim to evaluate the outcomes of computerized cognitive training (CCT) interventions in randomized controlled trials (RCTs) including adults with ADHD.

    Method: Cognitive outcomes and ADHD symptom severity were analyzed separately. In addition, the Cattell–Horn–Carroll (CHC) theory of cognitive abilities was used to categorize outcome variables into subdomains, which were analyzed separately in a subsequent analysis.

    Results: The results revealed a small positive change in overall cognitive functioning, a measure of all cognitive outcomes in each study, for individuals who took part in CCT compared to controls (k = 9, Hedge’s g = 0.235, 95% CI [0.002, 0.467], p = 0.048, τ2 = 0.000, I2 = 0.000). However, neither symptom severity nor specific cognitive outcomes (executive functioning, cognitive speed, or working memory) showed a significant improvement.

    Conclusions: We analyzed the risk of bias in the chosen studies and discuss the findings in terms of effect size. It is concluded that CCT has a small positive effect in adults with ADHD. Due to the lack of heterogeneity in intervention designs across the included studies, increased heterogeneity in future studies could help inform clinicians about the aspects of CCT, such as training type and length, that are most beneficial for this group.

  • 5.
    Eskilsson, Therese
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Ek Malmer, Elin
    Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden..
    Stigsdotter Neely, Anna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia.
    Slunga-Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
    Nordin, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Hopeful struggling for health: Experiences of participating in computerized cognitive training and aerobic training for persons with stress-related exhaustion disorder2020Ingår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 61, nr 3, s. 361-368Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is important to understand how people with exhaustion disorder (ED) perceive interventions aiming to facilitate cognitive functioning. Therefore, the overall aim of this study was to explore experiences from persons with ED after participating in a 12-week intervention of either computerized cognitive training or aerobic training. Both interventions were performed in addition to a multimodal rehabilitation programme. Thirteen participants, 11 women and 2 men, were interviewed about pros and cons with participating in the training. The interviews were analysed with Qualitative Content Analysis. The analyses resulted in the theme hopeful struggling for health and the categories support, motivation and sensations. It was hard work recovering from ED. Support from others who are in the same situation, family members, and technology and routines for the training were strongly emphasized as beneficial for recovery. Timing, i.e., matching activities to the rehabilitation programme, getting feedback and perceiving joy in the training were important for motivation. Participants in both interventions experienced positive sensations with improved memory performance, everyday life functioning and increased faith in the prospect of recovery. However, it is important to consider various aspects of support and motivation in both computerized cognitive training and aerobic training to enable participants to pursue their participation.

  • 6.
    Eskilsson, Therese
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap.
    Sturesson, Marine
    Region Västerbotten.
    Elwér, Sofia
    Region Västerbotten.
    Lewis, Charlotte
    Region Västerbotten.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nording, Sofia
    Region Västerbotten.
    Arbetsplatsdialog AD-A: metodstöd för arbetsgivare vid ohälsa och sjukfrånvaro2019Bok (Övrigt vetenskapligt)
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  • 7.
    Eskilsson, Therese
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Stigsdotter Neely, Anna
    Boraxbekk, Carl-Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre.
    Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial2017Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 17, nr 1, artikel-id 322Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program.

    METHODS: In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity.

    RESULTS: In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls.

    CONCLUSION: Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group.

    TRIAL REGISTRATION: ClinicalTrials.gov: NCT03073772 . Retrospectively registered 21 February 2017.

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  • 8.
    Lampit, Amit
    et al.
    Department of Psychiatry, University of Melbourne, Parkville, Australia; Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
    Launder, Nathalie H.
    Department of Psychiatry, University of Melbourne, Parkville, Australia.
    Minkov, Ruth
    Department of Psychiatry, University of Melbourne, Parkville, Australia.
    Rollini, Alice
    Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
    Davey, Christopher G.
    Department of Psychiatry, University of Melbourne, Parkville, Australia.
    Finke, Carsten
    Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
    Lautenschlager, Nicola T.
    Department of Psychiatry, University of Melbourne, Parkville, Australia; NorthWestern Mental Health, Melbourne Health, VIC, Melbourne, Australia.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Department of Psychiatry, University of Melbourne, Parkville, Australia.
    Computerized cognitive training in people with depression: a protocol for a systematic review and meta-analysis2022Ingår i: Systematic Reviews, E-ISSN 2046-4053, Vol. 11, nr 1, artikel-id 6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: People with depression often present with concurrent cognitive impairment. Computerized cognitive training (CCT) is a safe and efficacious strategy to maintain or enhance cognitive performance in a range of clinical populations. However, its efficacy in people with depression and how it varies across populations and design factors are currently unclear.

    Methods: We searched MEDLINE, EMBASE, and PsycINFO from inception to 13 July 2021 for randomised controlled trials examining the efficacy of CCT vs any control condition on cognitive, mood, psychiatric symptoms, psychosocial, and daily functioning in adults with depression. Eligible samples include studies specifically targeting people with major depressive disorder as well as those with other diagnoses where at least 50% of the sample meets the clinical criteria for depression, with the exception of major psychiatric disorders or dementia. The primary outcome is change in the overall cognitive performance. Multivariate analyses will be used to examine the effect sizes on each outcome category as well as possible effect modifiers and correlations between categories. The risk of bias will be assessed using the Cochrane risk of bias tool version 2.

    Discussion: To the best of our knowledge, this will be the first systematic review and meta-analysis of narrowly defined CCT across clinical populations with depression. We aim to investigate not only whether CCT is efficacious for cognition, but also how such effects vary across design factors, what other clinically relevant outcomes might respond to CCT, and the extent to which they differ across populations.

    Systematic review registration: PROSPERO CRD42020204209

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  • 9.
    M. Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Domellöf, Magdalena E.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Leung, Isabella
    Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, Australia; Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Camperdown, Australia.
    Neely, Anna Stigsdotter
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Launder, Nathalie H.
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Nategh, Leila
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Finke, Carsten
    Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
    Lampit, Amit
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia; Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
    Computerized cognitive training in Parkinson's disease: A systematic review and meta-analysis2022Ingår i: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 80, artikel-id 101671Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Cognitive impairment is a central non-motor symptom of Parkinson's disease (PD), and there are no established treatments. Computerized cognitive training (CCT) is a safe and efficacious strategy but its efficacy in PD is unclear. We aimed to investigate the efficacy of CCT on cognitive, psychosocial and daily function, and assess potential effect moderators in people with PD without dementia. Randomized controlled trials of CCT were included in multivariate meta-analyses and meta-regressions. Seventeen studies (16 trials) encompassing 679 participants were included. The pooled effect of CCT relative to control was small and statistically significant for overall cognitive function (g=0.16; 95% CI 0.02–0.29). There was robust evidence for benefit on clinical measures of global cognition across 10 trials (g=0.33; 95% CI 0.19–0.48), especially in PD with mild cognitive impairment (PD-MCI), as well as on individual cognitive domains. Greater CCT dose and PD-MCI population were associated with larger effect sizes, but no statistically significant differences were found between subgroups. There was no significant difference in the efficacy of home-based compared to supervised training. Our findings suggest that CCT is associated with cognitive benefits in PD, including when delivered remotely. Larger, well-powered trials are warranted to examine what specific CCT regimens are most likely to promote cognitive and everyday functioning in the long-term.

  • 10.
    M. Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Domellöf, Magdalena E.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Åström, Elisabeth
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nelson, Andreas
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Launder, Nathalie H.
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Stigsdotter Neely, Anna
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden; Department of Social Sciences, Technology and Arts, Luleå University of Technology, Luleå, Sweden; Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Lampit, Amit
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Cognitive function in clinical burnout: a systematic review and meta-analysis2022Ingår i: Work & Stress, ISSN 0267-8373, E-ISSN 1464-5335, Vol. 36, nr 1, s. 86-104Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Clinical burnout has been associated with impaired cognitive functioning; however, inconsistent findings have been reported regarding the pattern and magnitude of cognitive deficits. The aim of this systematic review and multivariate meta-analysis was to assess cognitive function in clinical burnout as compared to healthy controls and identify the pattern and severity of cognitive dysfunction across cognitive domains. We identified 17 studies encompassing 730 patients with clinical burnout and 649 healthy controls. Clinical burnout was associated with impaired performance in episodic memory (g = −0.36, 95% CI −0.57 to −0.15), short-term and working memory (g = −0.36, 95% CI −0.52 to −0.20), executive function (g = −0.39, 95% CI −0.55 to −0.23), attention and processing speed (g = −0.43, 95% CI −0.57 to −0.29) and fluency (g = −0.53, 95% CI −1.04 to −0.03). There were no differences between patients and controls in crystallized (k = 6 studies) and visuospatial abilities (k = 4). Our findings suggest that clinical burnout is associated with cognitive impairment across multiple cognitive domains. Cognitive dysfunction needs to be considered in the clinical and occupational health management of burnout to optimise rehabilitation and support return-to-work.

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  • 11.
    M. Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Stigsdotter Neely, Anna
    Department of Social Sciences, Technology and Arts, Luleå University of Technology, Sweden; Department of Health, Education and Technology, Luleå University of Technology, Sweden; Department of Social and Psychological studies, Karlstad University, Sweden.
    Aronsson, Ingela
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Josefsson, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Andersson, Linus
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Mental fatigue, cognitive performance and autonomic response following sustained mental activity in clinical burnout2023Ingår i: Biological Psychology, ISSN 0301-0511, E-ISSN 1873-6246, Vol. 183, artikel-id 108661Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the effects of sustained mental activity on perceptions of mental fatigue, cognitive performance, and autonomic response in patients with clinical burnout as compared to a healthy control group.

    Methods: Patients with clinical burnout (n = 30) and healthy control participants (n = 30) completed a 3-hour test session, in which they were administered a set of cognitive tests before and after an effortful cognitive task with concurrent sound exposure. Perceptions of mental fatigue and task demands (mental effort and concentration difficulties) were assessed repeatedly over the course of the test session. Heart rate variability was recorded to index autonomic response.

    Results: In comparison with controls, perceived mental fatigue increased earlier in the session for the clinical burnout group and did not recover following a short rest period. Throughout the session, patients rated the tasks as more demanding and showed less improvement on measures of attention and processing speed, inhibition and working memory. While autonomic responses were initially comparable, there was a unique decrease in high-frequency heart rate variability in the clinical burnout group after extended testing and exposure.

    Conclusion: Patients with clinical burnout are affected differently than healthy controls by sustained mental activity, as reflected by ratings of perceived mental fatigue, aspects of cognitive performance and autonomic response. Further investigation into the role of autonomic regulation in relation to cognitive symptoms in clinical burnout is warranted.

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  • 12.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Rehabilitation for improved cognition in stress-related exhaustion: cognitive, neural and clinical perspectives2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Stress-related exhaustion disorder (ED) has been associated with concomitant cognitive impairment, perceived by patients to have large impact on everyday life. However, little is known about how to address cognition in stress rehabilitation and how this could influence stress recovery over time. The aim of this thesis was to evaluate the efficacy of additional cognitive and aerobic training for patients with ED who participated in a multimodal stress rehabilitation program. A further aim was to explore the neural correlates of ED. The main focus of this thesis was on cognitive training, the effects of which were studied from a cognitive, neural, and clinical perspective (Study I-III). The final part of this thesis (Study III) broadened the perspective and investigated the long-term effects of cognitive and aerobic training on cognitive and clinical outcomes.

    Study I and II evaluated the effects of process-based cognitive training immediately following the intervention. The results from Study I showed that generalization of training effects following cognitive training was selective and restricted to tasks similar to those trained. The cognitive training group showed a greater reduction in burnout symptoms, and partial support was given for fewer subjective cognitive complaints compared to stress rehabilitation alone. Study II used functional neuroimaging to explore the neural effects of cognitive training, showing training-related activation increases at high working memory load; however, conclusions were restricted due to the small sample.

    Study II additionally explored the neural correlates of ED by investigating within-group associations between burnout level and functional neural response during working memory updating. The results revealed that patients with higher levels of burnout showed greater recruitment of working memory-related regions during task execution, potentially reflecting a compensatory mechanism serving to uphold task performance.

    Study III evaluated the clinical utility of addressing cognitive impairments in stress rehabilitation. Here, the effects of cognitive and aerobic training on several ED-related variables were investigated 1 year after the intervention. Cognitive training was associated with a small and lasting improvement in cognitive performance. Aerobic training yielded improvements in episodic memory immediately following the intervention, but no significant difference was found between the aerobic training group and the control group at 1-year follow-up. For psychological health and work ability, no additional benefits were seen for the added interventions relative to stress rehabilitation alone. However, a long-term improvement in burnout symptoms favouring cognitive training was observed when restricting the analysis to only include patients who had completed the intervention. This highlights the importance of supporting patients in adhering to added treatments.

    In sum, the papers in this thesis provide initial evidence of neurocognitive plasticity in patients with ED and tentatively suggest that cognitive improvements following cognitive training may translate into alleviated clinical symptoms. These results support the argument that interventions targeting cognitive impairments holds a place in the effective rehabilitation of ED.

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  • 13.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Boraxbekk, Carl-Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Stenlund, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Lisbeth, Slunga Järvholm
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stigsdotter Neely, Anna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Karlstad University.
    Effects of a process-based cognitive training intervention for patients with stress-related exhaustion2015Ingår i: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 18, nr 5, s. 578-588Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Stress-related exhaustion has been linked to a pattern of selective cognitive impairments, mainly affecting executive functioning, attention and episodic memory. Little is known about potential treatments of these cognitive deficits. The purpose of the present study was to evaluate the effects of a process-based cognitive training intervention, designed to target the specific cognitive impairments associated with stress-related exhaustion. To this end, patients diagnosed with exhaustion disorder (ED) were randomized to either a multimodal stress rehabilitation program with the addition of a process-based cognitive training intervention (training group, n = 27) or a treatment-as-usual control condition, consisting of multimodal stress rehabilitation with no additional training (control group, n = 32). Treatment effects were evaluated through an extensive cognitive test battery, assessing both near- and far transfer effects, as well as self-report forms regarding subjective cognitive complaints and burnout levels. Results showed pronounced training-related improvements on the criterion updating task (p < 0.001). Further, evidence was found of selective near transfer effects to updating (p = 0.01) and episodic memory (p = 0.04). Also, the trained group reported less subjective memory complaints (p = 0.02) and levels of burnout decreased for both groups, but more so for the trained group (p = 0.04), following the intervention. These findings suggest that process-based cognitive training may be a viable method to address the cognitive impairments associated with ED.

  • 14.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Stenlund, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stigsdotter Neely, Anna
    Karlstad University.
    Effects of a process-based cognitive training intervention for patients with stress-related exhaustion: a randomized clinical trial2015Ingår i: International Convention of Psychological Science, Amsterdam, 2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    The present study evaluated whether a computerized process-based cognitive training program improves cognitive function in patients with stress-related exhaustion (n=59). Results showed training effects that were generalizable beyond the specific training tasks, suggesting that cognitive training may be a viable part of the rehabilitation of stress-related exhaustion.

  • 15.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.
    Domellöf, Magdalena E.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Leung, Isabella
    Stigsdotter Neely, Anna
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden..
    Finke, Carsten
    Lampit, Amit
    Computerised cognitive training in Parkinson's disease: a protocol for a systematic review and updated meta-analysis2020Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 10, nr 11, artikel-id e040656Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Cognitive impairment is recognised as an important non-motor symptom in Parkinson's disease (PD) and there is a need for evidence-based non-pharmacological interventions that may prevent or slow cognitive decline in this patient group. One such intervention is computerised cognitive training (CCT), which has shown efficacious for cognition across older adult populations. This systematic review aims to investigate the efficacy of CCT across cognitive, psychosocial and functional domains for people with PD and examine study and intervention design factors that could moderate CCT effects on cognition.

    METHODS AND ANALYSIS: Randomised controlled trials investigating the effects of CCT in patients with PD without dementia, on cognitive, psychosocial or functional outcomes, will be included. The primary outcome is overall cognitive function. Secondary outcomes are domain-specific cognitive function, psychosocial functioning and functional abilities. We systematically searched MEDLINE, Embase and PsycINFO through 14 May 2020 to identify relevant literature. Risk of bias will be assessed using the revised Cochrane Risk of Bias tool. Effect sizes will be calculated as standardised mean difference of baseline to postintervention change (Hedges' g) with 95% CI for each eligible outcome measure. Pooling of outcomes across studies will be conducted using random-effects models, accounting for dependency structure of effect sizes within studies. Heterogeneity will be assessed using τ2 and I2 statistic. Potential moderators, based on key study and intervention design factors, will be investigated using mixed-effects meta-regression models.

    ETHICS AND DISSEMINATION: No ethical approval is required. The findings will be disseminated in a peer-reviewed scientific journal.

    PROSPERO REGISTRATION NUMBER: CRD42020185386.

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  • 16.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.
    Dong, Christopher
    Minkov, Ruth
    Bahar-Fuchs, Alex
    Ellis, Kathryn A.
    Lautenschlager, Nicola T.
    Mellow, Maddison L.
    Wade, Alexandra T.
    Smith, Ashleigh E.
    Finke, Carsten
    Krohn, Stephan
    Lampit, Amit
    Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials2020Ingår i: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 66, artikel-id 101232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges' g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.

  • 17.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Eskilsson, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Boraxbekk, Carl-Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark..
    Josefsson, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Stigsdotter Neely, Anna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden..
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO – a randomized clinical trial2018Ingår i: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 21, nr 4, s. 279-291Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47) or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.

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  • 18.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. 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 Reviews2020Ingår i: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660, Vol. 30, nr 2, s. 167-193Artikel, forskningsöversikt (Refereegranskat)
    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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  • 19.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Stigsdotter Neely, Anna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Andersson, Micael
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Fysiologi.
    Eskilsson, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
    Neural activation in stress-related exhaustion: cross-sectional observations and interventional effects2017Ingår i: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 269, s. 17-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary purpose of this study was to investigate the association between burnout and neural activation during working memory processing in patients with stress-related exhaustion. Additionally, we investigated the neural effects of cognitive training as part of stress rehabilitation. Fifty-five patients with clinical diagnosis of exhaustion disorder were administered the n-back task during fMRI scanning at baseline. Ten patients completed a 12-week cognitive training intervention, as an addition to stress rehabilitation. Eleven patients served as a treatment-as-usual control group. At baseline, burnout level was positively associated with neural activation in the rostral prefrontal cortex, the posterior parietal cortex and the striatum, primarily in the 2-back condition. Following stress rehabilitation, the striatal activity decreased as a function of improved levels of burnout. No significant association between burnout level and working memory performance was found, however, our findings indicate that frontostriatal neural responses related to working memory were modulated by burnout severity. We suggest that patients with high levels of burnout need to recruit additional cognitive resources to uphold task performance. Following cognitive training, increased neural activation was observed during 3-back in working memory-related regions, including the striatum, however, low sample size limits any firm conclusions.

  • 20.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Academic Unit for Psychiatry of Old Age, University of Melbourne, Australia.
    Stigsdotter Neely, Anna
    Department for Social and Psychological Studies, Karlstad University.
    Dunås, Tora
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Eskilsson, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
    Mental fatigue in stress-related exhaustion disorder: structural brain correlates, clinical characteristics and relations with cognitive functioning2020Ingår i: NeuroImage: Clinical, E-ISSN 2213-1582, Vol. 27, artikel-id 102337Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Emerging evidence suggests that mental fatigue is a central component of the cognitive and clinical characteristics of stress-related exhaustion disorder (ED). Yet, the underlying mechanisms of mental fatigue in this patient group are poorly understood. The aim of this study was to investigate cortical and subcortical structural neural correlates of mental fatigue in patients with ED, and to explore the association between mental fatigue and cognitive functioning. Fifty-five patients with clinical ED diagnosis underwent magnetic resonance imaging. Mental fatigue was assessed using the Concentration subscale from the Checklist Individual Strength. Patients with high levels of mental fatigue (n = 30) had smaller caudate and putamen volumes compared to patients with low-moderate levels of mental fatigue (n = 25). No statistically significant differences in cortical thickness were observed between the groups. Mediation analysis showed that mental fatigue mediated the relationship between caudate volume and working memory; specifically, smaller caudate volume was associated with higher level of mental fatigue and mental fatigue was positively associated with working memory performance. Our findings demonstrate that the structural integrity of the striatum is of relevance for the subjective perception of mental fatigue in ED, while also highlighting the complex relationship between mental fatigue, cognitive performance and its neural underpinnings.

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  • 21.
    Malmberg Gavelin, Hanna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Stigsdotter Neely, Anna
    Institutionen för sociala och psykologiska studier, Karlstads Universitet.
    Stenlund, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Slunga-Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Boraxbekk, Carl-Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Effects of a Process-based Cognitive Training Intervention for Patients With Stress-related Exhaustion - an fMRI study2016Ingår i: Cognitive Neuroscience Society: 2016 Annual Meeting Program, 2016, s. 161-161, artikel-id D59Konferensbidrag (Övrigt vetenskapligt)
  • 22. Nelson, Andreas
    et al.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Andersson, Micael
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).
    Josefsson, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Eskilsson, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Slunga-Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Stigsdotter Neely, Anna
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
    Subjective cognitive complaints and its associations to response inhibition and neural activation in patients with stress-related exhaustion disorder2023Ingår i: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 26, nr 1, artikel-id 2188092Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Stress-related exhaustion is associated with cognitive deficits, measured subjectively using questionnaires targeting everyday slips and failures or more objectively as performance on cognitive tests. Yet, only weak associations between subjective and objective cognitive measures in this group has been presented, theorized to reflect recruitment of compensational resources during cognitive testing. This explorative study investigated how subjectively reported symptoms of cognitive functioning and burnout levels relate to performance as well as neural activation during a response inhibition task. To this end, 56 patients diagnosed with stress-related exhaustion disorder (ED; ICD-10 code F43.8A) completed functional magnetic resonance imaging (fMRI) using a Flanker paradigm. In order to investigate associations between neural activity and subjective cognitive complaints (SCCs) and burnout, respectively, scores on the Prospective and retrospective memory questionnaire (PRMQ) and the Shirom-Melamed burnout questionnaire (SMBQ) were added as covariates of interest to a general linear model at the whole-brain level. In agreement with previous research, the results showed that SCCs and burnout levels were largely unrelated to task performance. Moreover, we did not see any correlations between these self-report measures and altered neural activity in frontal brain regions. Instead, we observed an association between the PRMQ and increased neural activity in an occipitally situated cluster. We propose that this finding may reflect compensational processes at the level of basic visual attention which may go unnoticed in cognitive testing but are reflected in the experience of deficits in everyday cognitive functioning.

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  • 23. Nelson, Andreas
    et al.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, University of Melbourne, Australia.
    Boraxbekk, Carl-Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Denmark.
    Eskilsson, Therese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Josefsson, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Neely, Anna Stigsdotter
    Subjective cognitive complaints in patients with stress-related exhaustion disorder: a cross sectional study2021Ingår i: BMC Psychology, E-ISSN 2050-7283, Vol. 9, nr 1, artikel-id 84Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Stress-related exhaustion is associated with cognitive impairment as measured by both subjective cognitive complaints (SCCs) and objective cognitive test performance. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress.

    Methods: We compared a group of patients with stress-related exhaustion disorder (n = 103, female = 88) with matched healthy controls (n = 58, female = 47) cross-sectionally, concerning the type and magnitude of self-reported SCCs. We furthermore explored the association between SCCs and cognitive test performance as well as with self-reported depression, anxiety and burnout levels, in the patient and the control group, respectively.

    Results: Patients reported considerably more cognitive failures and were more likely than controls to express memory failures in situations providing few external cues and reminders in the environment. In both groups, SCCs were associated with demographic and psychological factors, and not with cognitive test performance.

    Conclusion: Our findings underline the high burden of cognitive problems experienced by patients with exhaustion disorder, particularly in executively demanding tasks without external cognitive support. From a clinical perspective, SCCs and objective cognitive test performance may measure different aspects of cognitive functioning, and external cognitive aids could be of value in stress rehabilitation.

    Trial registration: Participants were recruited as part of the Rehabilitation for Improved Cognition (RECO) study (ClinicalTrials.gov: NCT03073772). Date of registration: 8 March 2017

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  • 24.
    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 universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. 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-analysis2023Ingår i: Neuropsychology Review, ISSN 1040-7308, E-ISSN 1573-6660Artikel, forskningsöversikt (Refereegranskat)
    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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  • 25.
    Stratton, Elizabeth
    et al.
    Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia.
    Lampit, Amit
    Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Choi, Isabella
    Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia.
    Malmberg Gavelin, Hanna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia.
    Aji, Melissa
    Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia.
    Taylor, Jennifer
    Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia.
    Calvo, Rafael A.
    Dyson School of Design Engineering, Imperial College London, London, United Kingdom.
    Harvey, Samuel B.
    School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia.
    Glozier, Nick
    Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia.
    Trends in effectiveness of organizational ehealth interventions in addressing employee mental health: systematic review and meta-analysis2022Ingår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, nr 9, artikel-id e37776Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    BACKGROUND: Mental health conditions are considered the leading cause of disability, sickness absence, and long-term work incapacity. eHealth interventions provide employees with access to psychological assistance. There has been widespread implementation and provision of eHealth interventions in the workplace as an inexpensive and anonymous way of addressing common mental disorders.

    OBJECTIVE: This updated review aimed to synthesize the literature on the efficacy of eHealth interventions for anxiety, depression, and stress outcomes in employee samples in organizational settings and evaluate whether their effectiveness has improved over time.

    METHODS: Systematic searches of relevant articles published from 2004 to July 2020 of eHealth intervention trials (app- or web-based) focusing on the mental health of employees were conducted. The quality and bias of all studies were assessed. We extracted means and SDs from publications by comparing the differences in effect sizes (Hedge g) in standardized mental health outcomes. We meta-analyzed these data using a random-effects model.

    RESULTS: We identified a tripling of the body of evidence, with 75 trials available for meta-analysis from a combined sample of 14,747 articles. eHealth interventions showed small positive effects for anxiety (Hedges g=0.26, 95% CI 0.13-0.39; P<.001), depression (Hedges g=0.26, 95% CI 0.19-0.34; P<.001), and stress (Hedges g=0.25, 95% CI 0.17-0.34; P<.001) in employees' after intervention, with similar effects seen at the medium-term follow-up. However, there was evidence of no increase in the effectiveness of these interventions over the past decade.

    CONCLUSIONS: This review and meta-analysis confirmed that eHealth interventions have a small positive impact on reducing mental health symptoms in employees. Disappointingly, we found no evidence that, despite the advances in technology and the enormous resources in time, research, and finance devoted to this area for over a decade, better interventions are being produced. Hopefully, these small effect sizes do not represent optimum outcomes in organizational settings.

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