Lower cognitive baseline scores predict cognitive training success after 6 months in healthy older adults: Results of an online RCT

Background: Identifying predictors for general cognitive training (GCT) success in healthy older adults has many potential uses, including aiding intervention and improving individual dementia risk prediction, which are of high importance in health care. However, the factors that predict training improvements and the temporal course of predictors (eg, do the same prognostic factors predict training success after a short training period, such as 6 weeks, as well as after a longer training period, such as 6 months?) are largely unknown. Methods: Data (N = 4,184 healthy older individuals) from two arms (GCT vs. control) of a three-arm randomized controlled trial were reanalyzed to investigate predictors of GCT success in five cognitive tasks (grammatical reasoning, spatial working memory, digit vigilance, paired association learning, and verbal learning) at three time points (after 6 weeks, 3 months, and 6 months of training). Possible investigated predictors were sociodemographic variables, depressive symptoms, number of training sessions, cognitive baseline values, and all interaction terms (group*predictor). Results: Being female was predictive for improvement in grammatical reasoning at 6 weeks in the GCT group, and lower cognitive baseline scores were predictive for improvement in spatial working memory and verbal learning at 6 months. Conclusion: Our data indicate that predictors seem to change over time; remarkably, lower baseline performance at study entry is only a significant predictor at 6 months training. Possible reasons for these results are discussed in relation to the compensation hypothesis. J Am Geriatr Soc 68:-, 2020.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.Alzheimer's Society UKpublished version, accepted version (12 month embargo), submitted versio

Task based profiles of language impairment in Parkinson’s Disease

This study aimed to add to our understanding of language impairment in people with Parkinson's Disease (PwPD). Language difficulties are increasingly reported in PD. However, there are contradictory reports on how they relate to motor and cognitive impairment. In addition, the link between various language deficits or the same deficits across task modalities is not well understood. This lack of understanding impacts on clinicians’ ability to assess and effectively treat language impairment in PD. Our study therefore aimed to investigate language performance across a number of task structures and correlate this performance with cognitive skills, as well as motor and speech performance. The study included 22 German speaking PwPD and 22 matched healthy control participants. 18 participants in each group were cognitively healthy and four had mild cognitive impairment. They performed a number of executive function and language tasks of different complexity and structure. The linguistic investigation focused on grammatical accuracy and complexity, linguistic content as well as articulatory features. There were few cognitive differences between the two groups, with only set-shifting as an executive function being significantly reduced in PwPD, but grammatical error rate was higher in PwPD than in their healthy controls across all language tasks. This was linked to set shifting skills but only for the complex grammar condition, not for more naturalistic language tasks. Furthermore, there was no correlation of language performance across the task levels, i.e. error rates in the structured task did not predict naturalistic performance. Motor and dysarthria severity could not predict language impairment either. This study confirms the presence of language problems in PwPD in the absence of global cognitive impairment or only MCI, and at the same time establishes a task based relationship between the two skills. From a clinical perspective the data indicate that structured tests are unable to accurately predict naturalistic language performance, highlighting the need for functional assessments rather than relying on fast scoring structured tests, at least at early disease stages. In addition, the impact of the individual language difficulties needs to be explored to establish appropriate and effective treatment pathways

Stimulation of the Social Brain Improves Perspective Selection in Older Adults: A HD-tDCS Study

There is evidence for dissociable, causal roles for two key social brain regions in young adults. Specifically, the right temporoparietal junction (rTPJ) is associated with embodied perspective taking, whereas the dorsomedial prefrontal cortex (dmPFC) is associated with the integration of social information. However, it is unknown whether these causal brain-behaviour associations are evident in older adults. Fifty-two healthy older adults were stratified to receive either rTPJ or dmPFC anodal high-definition transcranial direct current stimulation in a sham-controlled, double-blinded, repeated-measures design. Self-other processing was assessed across implicit and explicit level one (line-of-sight) and level two (embodied rotation) visual perspective taking (VPT) tasks, and self-other encoding effects on episodic memory. Both rTPJ and dmPFC stimulation reduced the influence of the alternate perspective during level one VPT, indexed by a reduced congruency effect (difference between congruent and incongruent perspectives). There were no stimulation effects on level two perspective taking nor self-other encoding effects on episodic memory. Stimulation to the rTPJ and dmPFC improved perspective selection during level one perspective taking. However, dissociable effects on self-other processing, previously observed in young adults, were not identified in older adults. The results provide causal evidence for age-related changes in social brain function that requires further scrutinization

Syntactic impairment in Parkinson's Disease : cross-task differences and relationship to cognitive impairment

The presence of language difficulties in Parkinson's Disease (PD) is increasingly recognised. Less is known about the exact manifestation of these problems, their relationship to other cognitive domains, and how they vary across different task complexities. Particularly the latter is important in order to establish sensitive and clinically useful assessment procedures, which can then serve as the basis for developing effective treatment strategies. This study aimed to contribute to this knowledge base by investigating language performance in people with PD (PwPD) across a number of speaking tasks and to correlate this performance with cognitive skills. 22 PwPD and 22 healthy matched control participants performed a range of executive function and linguistic tasks. Four participants in each group presented with mild cognitive impairment (MCI), the rest were cognitively healthy. Language tasks ranged from complex grammar tasks to less structured sentence generation and picture description tasks. The investigation focused on grammatical accuracy and complexity in all three tasks, as well as speech characteristics (sentence generation and picture description) and information content (picture description only). Results indicated that PwPD produced more grammatical errors than their healthy controls across all language tasks. No significant differences were evident for other parameters such as grammatical complexity, false starts, pauses, concepts, etc. Error rate in the complex grammar was linked to set shifting ability whereas performance in the other tasks was independent of cognition. Syntactic performance did not correlate across the three tasks, indicating that each task presented with its own difficulties and error patterns. Our study highlights that language problems can occur at early stages of PD before speech or cognitive problems arise. In addition, the data demonstrate that at this stage only highly complex grammatical tasks depend on cognitive performance, whereas more natural language production appears to be decoupled from this skill. The findings that result from structured language tests cannot predict day to day communication performance highlighting that clinicians should focus on functional assessment in order to provide early effective intervention

Self-disclosure and Interpersonal Input in Psychodynamic Group Psychotherapy - An Explorative Study

In the present explorative data analysis, for the first time possible, coherences were identified for interpersonal input and self-disclosure, - two factors which are highly important in the context of psychodynamic group research. 51 videotapes, each documenting 90 minutes of a total of three outpatient psychodynamic group therapy sessions, were analyzed with the help of SYMLOG. Results may show the tendency of the importance of receiving statements that promote mentalization as well as directly received speeches as predictors for both factors