Cognitive Training for Age-Related Distractibility

Overseen By Tae-Ho Lee, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Virginia Polytechnic Institute and State University

Disqualifiers: Metal implants, Pacemaker, Claustrophobia, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

200 Participants Needed

Trial Summary

What is the purpose of this trial?

A growing body of research has highlighted the importance of frontal regions, at both the functional and structural levels, in age-related declines in attentional and cognitive processing. However, the underlying neurobiological pathophysiological changes in the brain that contribute to these declines are still largely unclear. The objective of this proposal is to investigate neural mechanisms of age-related attentional distractibility, focusing on the neural circuit initiated from the locus coeruleus (LC). In the current proposal, the investigators will test the hypothesis that the neural disconnectivity of LC with the salience network (SN) drives failures of ignoring distractors in older adults. The investigators will examine how LC-SN connectivity is associated with selective attention performance, and how improved LC-SN connectivity through a cognitive training program may lead to improved attentional performance.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for age-related distractibility?

Research shows that cognitive training programs, including those delivered via tablets or computers, can improve attention and cognitive performance in older adults. Studies have found that such programs enhance skills like selective focus and coordination, suggesting they may help with age-related distractibility. ^{1 2 3 4 5}

Is cognitive training for age-related distractibility safe for humans?

The research suggests that cognitive training programs, including those delivered online or through computerized methods, are generally safe for older adults. Participants in these studies have reported enjoying the programs, and no adverse effects have been noted in the available data. ^{1 3 6 7 8}

How does the treatment for age-related distractibility differ from other treatments?

This treatment is unique because it uses a tablet-based program to provide adaptive cognitive training, focusing on improving attention by helping older adults suppress irrelevant sensory stimuli. Unlike other treatments, it is specifically designed to enhance selective attention and processing speed through modality-specific exercises, making it accessible and tailored to individual needs. ^{1 3 7 9 10}

Research Team

Tae-Ho Lee, PhD

Principal Investigator

Virginia Polytechnic Institute and State University

Eligibility Criteria

This trial is for healthy adults aged 18-75 who can consent to participate. It's not suitable for those with metal implants, pacemakers, severe claustrophobia, braces, a weight over 250 pounds, pregnancy or severe medical/psychiatric conditions like head trauma.

Inclusion Criteria

Ability to provide written informed consent

I am a healthy adult.

I am between 18 and 75 years old.

Exclusion Criteria

Pregnant or possibility of being pregnant

I have had surgery that involved getting metal implants.

Possible metal fragments in the eyes

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Cognitive Training

Older adult participants complete an attention practice program, preceded and followed by an fMRI scan session featuring an attention task

2 weeks

2 visits (in-person)

Follow-up

Participants are monitored for changes in accuracy on the place-face selective attention task and fMRI LC-SN connectivity

2 weeks

Treatment Details

Interventions

• Tablet based adaptive criterion task practice program
• Tablet based adaptive multimodal attention practice program

Trial Overview The study tests two tablet-based programs aimed at improving attention in older adults by enhancing brain connectivity. One focuses on multimodal attention practice and the other on criterion task practice to reduce age-related distractibility.

Participant Groups

Group I: Older adult participants Experimental Treatment 2 Interventions

Older adult participants in the study will complete one of two variants of an attention practice program and that will be preceded by, and followed by, an fMRI scan session featuring an attention task

Group II: Younger adult participants Active Control 1 Intervention

Younger adult participants in the study will complete one fMRI scan session featuring an attention task

Who Is Running the Clinical Trial?

Virginia Polytechnic Institute and State University

Lead Sponsor

Trials

162

Recruited

26,900+

Findings from Research

The pilot study demonstrated that an online attention training program, ATTENTION WORKOUT™, significantly improved selective focus and coordination of attention in community-dwelling older adults, particularly in the extended practice group (n=17) over a 6-week period.

Participants in the extended practice group showed notable enhancements in various attention tasks, indicating that adaptable cognitive training can effectively target and improve specific cognitive skills in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online Attention Training for Older Adults. Wennberg, A., Kueider, A., Spira, A., et al.[2020]

Attention Process Training (APT) effectively improved attention deficits in four brain-injured individuals over 5 to 10 weeks of intensive cognitive remediation, demonstrating significant gains in attention for all subjects.

The study suggests that focusing specifically on attention training can lead to improvements in attention without affecting other cognitive functions, like visual processing, highlighting the benefits of a targeted rehabilitation approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of an attention-training program. Sohlberg, MM., Mateer, CA.[2015]

Mental Activity Training (MAT) has been shown to positively influence fluid intelligence and everyday activities in elderly individuals without cognitive impairment, suggesting it can help combat cognitive aging.

Initial results indicate that MAT may also be beneficial for patients with severe dementia, highlighting its potential as a treatment method for improving mental performance in those with cognitive decline.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Non-pharmacological intervention strategies on aging processes: Empirical data on mental training in "normal" older people and patients with mental impairment. Cräsel, E.[2019]

The TAPAT training program, designed to improve both sustained and moment-to-moment attention in patients with spatial neglect, has shown promising preliminary results in enhancing cognitive and functional outcomes, indicating its potential efficacy.

The RESPONSE trial will rigorously test TAPAT against an active control in a larger sample of 114 patients over three months, using a randomized controlled trial design to assess the long-term effects of the training on attention deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol. Vleet, TV., DeGutis, J., Dabit, S., et al.[2021]

The study demonstrated that the THINKable computerized cognitive remediation system led to significant improvements in memory and higher cognitive functioning in patients, as assessed after treatment compared to before treatment.

Improvements in cognitive performance were also reflected in the patients' real-world functioning, indicating that this type of structured retraining can be beneficial even for senile patients who had not shown spontaneous recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

THINKable, a computerized cognitive remediation. First results. Giaquinto, S., Fiori, M.[2019]

A 5-week computerized adaptive working memory training program (Cogmed®) did not lead to significant improvements in working memory capacity compared to a non-adaptive training program in 68 adults with mild cognitive impairment (MCI).

The study, which included participants aged 43 to 88 years, found no differences in cognitive function outcomes between the two training methods at both 1 and 4 months post-training, indicating that the adaptive training did not provide additional benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adaptive Computerized Working Memory Training in Patients With Mild Cognitive Impairment. A Randomized Double-Blind Active Controlled Trial. Flak, MM., Hol, HR., Hernes, SS., et al.[2022]

Adaptive working memory training over 5 weeks resulted in greater improvements compared to low-level practice, indicating that adjusting task difficulty can enhance training effectiveness.

Both younger (20-30 years) and older adults (60-70 years) showed maintained training gains and transfer effects after 3 months, suggesting that such training can benefit cognitive functions across age groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Working-memory training in younger and older adults: training gains, transfer, and maintenance. Brehmer, Y., Westerberg, H., Bäckman, L.[2022]

A novel cognitive training program called multi-strategic metamemory training significantly improved long-term delayed free recall and fluency in 66 older adults with mild cognitive impairment compared to a control group of 47 participants.

Participants in the training group also reported a significant decrease in subjective memory complaints, indicating that the program not only enhanced cognitive performance but also improved their perception of everyday memory function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training. Youn, JH., Park, S., Lee, JY., et al.[2020]

A cognitive training intervention over 8 weeks significantly improved selective attention in 66 healthy older adults compared to a control group, indicating its efficacy in enhancing cognitive function.

Participants in the training group not only improved in the targeted attention skills but also showed benefits in other cognitive areas like processing speed and dual-task performance, suggesting broader cognitive enhancements from the training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cognitive training intervention improves modality-specific attention in a randomized controlled trial of healthy older adults. Mozolic, JL., Long, AB., Morgan, AR., et al.[2021]

Age-related distraction is more pronounced in visual tasks compared to auditory tasks, suggesting that the type of sensory modality affects how well older adults can focus on relevant information.

The study proposes that different filtering mechanisms in the brain for visual and auditory information may explain why older adults struggle more with visual distractions, indicating a need to revise theories on cognitive aging to account for these modality-dependent effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of sensory modality in age-related distraction: a critical review and a renewed view. Guerreiro, MJ., Murphy, DR., Van Gerven, PW.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Online Attention Training for Older Adults. [2020]

2. England pubmed.ncbi.nlm.nih.gov

Effectiveness of an attention-training program. [2015]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Non-pharmacological intervention strategies on aging processes: Empirical data on mental training in "normal" older people and patients with mental impairment. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol. [2021]

5. Italy pubmed.ncbi.nlm.nih.gov

THINKable, a computerized cognitive remediation. First results. [2019]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Adaptive Computerized Working Memory Training in Patients With Mild Cognitive Impairment. A Randomized Double-Blind Active Controlled Trial. [2022]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Working-memory training in younger and older adults: training gains, transfer, and maintenance. [2022]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

A cognitive training intervention improves modality-specific attention in a randomized controlled trial of healthy older adults. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

The role of sensory modality in age-related distraction: a critical review and a renewed view. [2019]