Improvement in Motor Skills, Attention, and Working Memory in Mild Cognitive Impairment and Alzheimer’s Disease Patients Using COSMA Cognitive App

There are a rapid growth of adults with cognitive impairments and an increasing need for cognitive stimulation and rehabilitation to delay cognitive deterioration. COSMA, a cognitive gaming app, was developed to assist cognitive stimulation in people with cognitive decline and dementia. Therefore, the study was conducted to investigate the effectiveness of COSMA in people with mild cognitive impairment (MCI) and early Alzheimer’s disease (AD). The study involved a treatment group who played COSMA at home and during laboratory visits for 28 days and a control group who played only during laboratory visits. Each group was measured on days 1–14–28, where recordings of playing COSMA and Cambridge Neuropsychological Test Automated Battery (CANTAB) tests were taken. The results showed that the MCI treatment group improved sensorimotor skills in 14 days, sustained attention, spatial planning, working and visual memory, and learning in 28 days. The AD treatment group improved in sustained attention in 14 and 28 days and showed a lower cognitive decline in working memory compared to the AD control group in 28 days. Both control groups did not show any level of improvement. Even though the progression of the MCI was faster than that of the early AD, the study showed inspired results of cognitive improvement in both groups. COSMA showed evidence that cognitive stimulation and rehabilitation are possible in MCI and AD and that it is an effective and efficient non-pharmacological therapeutic tool in these groups of patients

Effects of aging on the association between cerebrovascular responses to visual stimulation, hypercapnia and arterial stiffness

Aging is associated with decreased vascular compliance and diminished neurovascular- and hypercapnia-evoked cerebral blood flow (CBF) responses. However, the interplay between arterial stiffness and reduced CBF responses is poorly understood. It was hypothesized that increased cerebral arterial stiffness is associated with reduced evoked responses to both, a flashing checkerboard visual stimulation (i.e., neurovascular coupling), and hypercapnia. To test this hypothesis, 20 older (64 ± 8 year; mean ± SD) and 10 young (30 ± 5 year) subjects underwent a visual stimulation (VS) and a hypercapnic test. Blood velocity through the posterior (PCA) and middle cerebral (MCA) arteries was measured concurrently using transcranial Doppler ultrasound (TCD). Cerebral and systemic vascular stiffness were calculated from the cerebral blood velocity and systemic blood pressure waveforms, respectively. Cerebrovascular (MCA: young = 76 ± 15%, older = 98 ± 19%, p = 0.004; PCA: young = 80 ± 16%, older = 106 ± 17%, p < 0.001) and systemic (young = 59 ± 9% and older = 80 ± 9%, p < 0.001) augmentation indices (AI) were higher in the older group. CBF responses to VS (PCA: p < 0.026) and hypercapnia (PCA: p = 0.018; MCA: p = 0.042) were lower in the older group. A curvilinear model fitted to cerebral AI and age showed AI increases until ~60 years of age, after which the increase levels off (PCA: R2 = 0.45, p < 0.001; MCA: R2 = 0.31, p < 0.001). Finally, MCA, but not PCA, hypercapnic reactivity was inversely related to cerebral AI (MCA: R2 = 0.28, p = 0.002; PCA: R2 = 0.10, p = 0.104). A similar inverse relationship was not observed with the PCA blood flow response to VS (R2 = 0.06, p = 0.174). In conclusion, older subjects had reduced neurovascular- and hypercapnia-mediated CBF responses. Furthermore, lower hypercapnia-mediated blood flow responses through the MCA were associated with increased vascular stiffness. These findings suggest the reduced hypercapnia-evoked CBF responses through the MCA, in older individuals may be secondary to vascular stiffening.ISSN:1664-042