Title:Mental Training for Cognitive Improvement in Elderly People: What have We Learned from Clinical and Neurophysiologic Studies?
VOLUME: 12 ISSUE: 6
Author(s):Bin-Yin Li, Hui-Dong Tang, Yuan Qiao and Sheng-Di Chen
Affiliation:Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Keywords:Alzheimer`s disease, Mental training, Mild cognitive impairment, Neural plasticity, Neurogenesis.
Abstract:Cognitive impairment is a major concern in elderly people, and a variety of nonpharmacological
therapies (NPTs) have been developed to help with cognitive decline. One of the
most popular therapies is cognitive training, which includes pencil-and-paper puzzles, computerized
games, or the combination of the two. Training is designed to have participants perform diverse exercises
in one or more cognitive domains. Most clinical training trials indicate that well-organized tasks
are clinically effective for cognitive improvement. Neural plasticity is a probable explanation for positive
training effects. EEG and fMRI research show that the electrical activity and metabolism of specific
brain areas are changed, and these changes are retained for a long period after training. Studies on mice to uncover
the cellular and molecular changes underlying neural connectivity have found effective changes in brain networks after
learning or training. Rac1 and NMDA receptors are thought to be involved in hippocampal neurogenesis, which is induced
by learning. Here we review clinical trials of cognitive training, published during the last five years, and summarized
some important characteristics of training tasks design. The probable role of neuronal plasticity and molecular
mechanisms in training effects also are discussed. Most importantly, we discuss key ways to modifying the design of tasks
based on studies we review. This review mainly identifies and discusses the reasons for positive training effects on cognition
from clinical and neurophysiological perspectives. Based on the findings and their related mechanisms, further studies
should design more effective and specific training tasks.
