Attentional Control Training in Older Adults: Efficacy, Transfer and Brain Substrates

NCT03532113 | Completed

• 1 other identifier: CRIUGM-005
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Formal education and cognitively stimulating hobbies and profession have a protective effect against age-related cognitive decline and Alzheimer's disease. It is therefore possible that providing cognitively stimulating interventions at a later age increases neuroplasticity and brain resilience. Processes of updating and inhibition are both impaired by aging. Several studies have shown that updating can be improved but very few studies targeted inhibition in spite of the fact that it is impaired in older adults. The aim of this study is to assess the effect of cognitive interventions that will target either of these two components. The investigators will examine the effect on behavior, brain measures and transfer tasks. The investigators will also assess whether the efficacy varies as a function of personal variables such as prior cognitive profile, reserve proxies, genetic polymorphisms and brain markers.

Conditions

Inhibition (Psychology); Updating; General Knowledge; No Training

Keywords

Cognitive intervention; Cognitive training; Aging; Working memory; Cognitive reserve; Brain imaging; Brain plasticity; Polymorphisms; Transfer; Inhibition; Updating

Outcome Measures

Primary Outcomes (2)

• Changes on the updating composite measure (Proximal outcome).

  An updating composite score will be computed by averaging z-scores from the Keep track task and the Running span task.

  within the 2 weeks before intervention starts; 3rd week after intervention starts (after the 6th training session); 6th week (after the 12th training session)

• Changes on the inhibition composite measure (Proximal outcome).

  An inhibition composite score will be computed by averaging z-scores from the Anti-saccade and the Victoria Stroop Test.

  within the 2 weeks before intervention starts; 3rd week after intervention starts (after the 6th training session); 6th week (after the 12th training session)

Secondary Outcomes (7)

• Transfer to complex working memory measure: the Alpha-span task (Distal outcome).

  within the 2 weeks before intervention starts; 1st week after intervention starts (after the 3rd training session); 3rd week (after the 6th training session); 4th week (after the 9th training session); 6th week (after the 12th training session).

• Transfer to complex working memory measure: the Reading span task (Distal outcome).

  within the 2 weeks before intervention starts; 1st week after intervention starts (after the 3rd training session); 3rd week (after the 6th training session); 4th week (after the 9th training session); 6th week (after the 12th training session).

• Transfer to complex working memory measure: the virtual car ride task (Distal outcome).

  within the 2 weeks before intervention starts; 1st week after intervention starts (after the 3rd training session); 3rd week (after the 6th training session); 4th week (after the 9th training session); 6th week (after the 12th training session).

• Brain structure: Regional gray matter volumes in Prefrontal and lateral temporal cortices, Basal ganglia and Hippocampi.

  within the 2 weeks before intervention starts; 3rd week after intervention starts (after the 6th training session); 6th week (after the 12th training session)

• Brain structure: Cortical thickness in Prefrontal regions and lateral temporal cortices.

  within the 2 weeks before intervention starts; 3rd week after intervention starts (after the 6th training session); 6th week (after the 12th training session)

Other Outcomes (8)

• Effect of moderators: Polymorphisms.

  3rd week after intervention starts (after the 6th training session)

• Effect of moderators: Cognitive reserve proxies.

  within the 2 weeks before intervention starts

• Effect of moderators: Intracranial volume.

  within the 2 weeks before intervention starts

Study Arms (3)

Updating

EXPERIMENTAL

The Updating intervention aims to improve the ability to monitor and quickly add or delete of content of working memory.

Behavioral: Updating

Inhibition

EXPERIMENTAL

The Inhibition intervention aims to improve the ability to supersede responses that are prepotent or automatic for a given situation.

Behavioral: Inhibition

General Knowledge

ACTIVE COMPARATOR

The General knowledge intervention allows the learning of information on various topics. It does not involve attentional control but semantic knowledge.

Behavioral: General knowledge

Interventions

Updating BEHAVIORAL

Updating is trained across 12 sessions using N-back-type exercises. Training is performed on a samsung galaxy tab2. Each session lasts 30 minutes. The difficult is reset and the nature of the stimuli (numbers vs. symbols) is changed halfway in each session.

Updating

Inhibition BEHAVIORAL

Inhibition is trained across 12 sessions with Stroop-like exercises. Training is performed on a samsung galaxy tab2. Each session lasts 30 minutes. The difficult is reset and the nature of stimuli (letters vs. numbers) is changed halfway in each session.

Inhibition

General knowledge BEHAVIORAL

General Knowledge is trained across 12 sessions. Participants complete four-choice questions relating to general knowledge and vocabulary and are provided with the correct answer and a short explanation. Questions are displayed one by one on a computer screen with a maximum of 20 seconds per question. Each session lasts 30 minutes and includes 2 blocks of 40 new questions each (about 220 seconds per block). Questions with wrong answers are displayed again at the end of each block.

General Knowledge

Eligibility Criteria

• Age: 60 Years - 85 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• French-speaking
• Right-handed
• Sufficient visual and auditory acuity to undergo neuropsychological tests and to do the interventions.
• Sufficient delayed recall score above the education-adjusted cut-offs (≥9 for 16+ years of education; ≥5 for 8-15 years of education; ≥3 for 0-7 years of education) at the Logical Memory test (Wechsler Memory Scale, maximum score 25).

You may not qualify if:

• Answer 'Yes' to the two following questions: "Do you feel like your memory is becoming worse?" "Does this worry you?" (to exclude subjective cognitive decline).
• The presence of a disease or injury of the central nervous system: moderate to severe chronic static leukoencephalopathy (including previous traumatic injury), multiple sclerosis, a serious developmental handicap, subdural hematoma (past or current), subarachnoid haemorrhage (past or current), primary cerebral tumour or cerebral metastases, epilepsy (current), dementia or another neurodegenerative disease, and other rarer brain illnesses.
• Symptomatic stroke within the previous year.
• Alcoholism or substance abuse
• History of intracranial surgery.
• Major surgery within last 2 months.
• General anesthesia in the past 6 months.
• Serious comorbid condition that, in the opinion of the study investigator, is likely to result in death within a year.
• Major depression or anxiety.
• Schizophrenia or other major psychiatric disorder (e.g., bipolar disorder).
• Individuals where French is not sufficiently proficient for clinical assessment and neuropsychological testing.
• Unable to undergo MRI scan due to medical contraindications or inability to tolerate the procedure.
• Plans on moving outside the province within the next 2 months.

Sponsors & Collaborators

• Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal: lead
• Natural Sciences and Engineering Research Council, Canada: collaborator

Study Sites (1)

CRIUGM

Montreal, Quebec, H3W 1W4, Canada

Location

Related Publications (3)

• Verty LV, Mellah S, Maltezos S, Boujut A, Lussier M, Bherer L, Belleville S. Youth-like brain activation linked with greater cognitive training gains in older adults: Insights from the ACTOP study. Cortex. 2024 Jul;176:221-233. doi: 10.1016/j.cortex.2024.04.013. Epub 2024 May 17.

  PMID: 38805784 DERIVED

• Boujut A, Verty LV, Maltezos S, Lussier M, Mellah S, Bherer L, Belleville S. Effects of Computerized Updating and Inhibition Training in Older Adults: The ACTOP Three-Arm Randomized Double-Blind Controlled Trial. Front Neurol. 2020 Dec 3;11:606873. doi: 10.3389/fneur.2020.606873. eCollection 2020.

  PMID: 33343503 DERIVED

• Boujut A, Mellah S, Lussier M, Maltezos S, Verty LV, Bherer L, Belleville S. Assessing the Effect of Training on the Cognition and Brain of Older Adults: Protocol for a Three-Arm Randomized Double-Blind Controlled Trial (ACTOP). JMIR Res Protoc. 2020 Nov 24;9(11):e20430. doi: 10.2196/20430.

  PMID: 33231556 DERIVED

MeSH Terms

Conditions

Inhibition, Psychological

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Sylvie Belleville, PhD

  Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: The experimenters are blind in the clinical trials. Participants know that there are different training programs but they ignore the purpose of each one.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research director of CRIUGM and full professor at University of Montreal

Model Details: Older participants are randomly assigned to one of three intervention conditions (Inhibition ; Updating ; General knowledge). Young participants only complete the initial assessment.

Study Record Dates

• First Submitted: April 18, 2018
• First Posted: May 22, 2018
• Study Start: October 19, 2017
• Primary Completion: December 20, 2019
• Study Completion: December 20, 2019
• Last Updated: January 23, 2020

Record last verified: 2020-01

Locations

CA (1)