Assessing the Effect of Training on the Cognition and Brain of Older Adults: Protocol for a Three-Arm Randomized Double-Blind Controlled Trial (ACTOP)

Arnaud Boujut, Samira Mellah, Maxime Lussier, Samantha Maltezos, Lynn Valeyry Verty, Louis Bherer, Sylvie Belleville, Arnaud Boujut, Samira Mellah, Maxime Lussier, Samantha Maltezos, Lynn Valeyry Verty, Louis Bherer, Sylvie Belleville

Abstract

Background: To prevent age-related cognitive impairment, many intervention programs offer exercises targeting different central cognitive processes. However, the effects of different process-based training programs are rarely compared within equivalent experimental designs.

Objective: Using a randomized double-blind controlled trial, this project aims to examine and compare the impact of 2 process-based interventions, inhibition and updating, on the cognition and brain of older adults.

Methods: A total of 90 healthy older adults were randomly assigned to 1 of 3 training conditions: (1) inhibition (Stroop-like exercises), (2) updating (N-back-type exercises), and (3) control active (quiz game exercise). Training was provided in 12 half-hour sessions over 4 weeks. First, the performance gain observed will be measured on the trained tasks. We will then determine the extent of transfer of gain on (1) untrained tasks that rely on the same cognitive process, (2) complex working memory (WM) measurements hypothesized to involve 1 of the 2 trained processes, and (3) virtual reality tasks that were designed to mimic real-life situations that require WM. We will assess whether training increases cortical volume given that the volume of the cortex is determined by cortical area and thickness in regions known to be involved in WM or changes task-related brain activation patterns measured with functional magnetic resonance imaging. Dose effects will be examined by measuring outcomes at different time points during training. We will also determine whether individual characteristics moderate the effect of training on cognitive and cerebral outcomes. Finally, we will evaluate whether training reduces the age-related deficit on transfer and brain outcomes, by comparing study participants to a group of 30 younger adults.

Results: The project was funded in January 2017; enrollment began in October 2017 and data collection was completed in April 2019. Data analysis has begun in June 2020 and the first results should be published by the end of 2020 or early 2021.

Conclusions: The results of this study will help understand the relative efficacy of 2 attentional control interventions on the cognition and the brain of older adults, as well as the moderating role of individual characteristics on training efficiency and transfer.

Trial registration: ClinicalTrials.gov NCT03532113; https://ichgcp.net/clinical-trials-registry/NCT03532113.

International registered report identifier (irrid): DERR1-10.2196/20430.

Keywords: aging; brain plasticity; cognitive reserve; cognitive training; working memory.

Conflict of interest statement

Conflicts of Interest: SB has been a consultant for research development on the prevention of Alzheimer disease for the Fondation IUGM (2016) and for Sojecci (2017 to current), and for the development of a cognitive stimulation program for the Centre de promotion de la Santé AvantÂge (2015). She has intellectual property rights on the "Programme de Stimulation pour une santé cognitive, Memoria, Batterie d’évaluation de la mémoire Côte-des-Neiges" and "MEMO, Méthode d’Entrainement pour une Mémoire Optimale". She collaborates and receives funding from Mind Maze and Beam Me Up. The remaining authors declare that they have no competing interests.

©Arnaud Boujut, Samira Mellah, Maxime Lussier, Samantha Maltezos, Lynn Valeyry Verty, Louis Bherer, Sylvie Belleville. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.11.2020.

Figures

Figure 1
Figure 1
Illustration of the training exercises used to train attentional control: (A) in this Neuropeak updating exercise, the task consisted of indicating whether the current symbol (eg, a star) matches (or does not match) the previously displayed symbol in 1-, 2-, or 3-back position. (B) In this Neuropeak inhibition exercise (incongruent trials), the task consisted of indicating the number of copies (eg, 5) of the digit displayed in the center of the screen (eg, 2). (C) In this general knowledge quiz game, the task consisted of indicating the number of the correct answer (eg, 4) to the question displayed in the upper part of the screen.
Figure 2
Figure 2
Illustration of a graph showing the progress of a fictive participant from the inhibition training group through each session. The score is the IES (Inverse Efficiency Score).

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