Roheger, Mandy
(2019).
Cognitive Plasticity in Healthy Older Adults:
Effects of Nonpharmacological Interventions and Predictors of Intervention Success.
PhD thesis, Universität zu Köln.
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Abstract
Background: Even in the absence of health problems, the ageing process is associated with deficits in cognitive functioning. One way to maintain cognitive abilities in healthy older adults is the participation in cognitive training (CT) interventions or combined cognitive and physical training (CPT) interventions. However, so far it is unclear, which of these non-pharmacological interventions is the most efficient. Furthermore, one question that also has not been properly investigated is: Who benefits most from these non-pharmacological interventions? So far, data is rare and inconsistent regarding which specific characteristics of individuals predict success of CT and CPT. Yet, this knowledge is highly relevant as it would facilitate the design of new, optimally tailored programs for subgroups to ensure individual-centered prevention of cognitive decline in the age of personalized medicine. Aims: The overall aims of this thesis were (i) to investigate whether CT and CPT can help healthy older individuals to maintain or even improve their cognitive functions and (ii) to identify possible factors that determine who benefits most from CT and/or CPT directly after an intervention and at follow-up one year later. Methods: The thesis comprises four studies. Study I was a partly randomized controlled trial comparing the effectiveness of a structured CT (n = 35 healthy older individuals) with an unstructured CT (n = 35) and a passive control group (n = 35) directly after the intervention. This study identifies predictors of CT success. Study II investigates the effectiveness of a CT (n = 23 healthy older individuals) compared to a CPT (n = 28) and a CPT plus counselling (n = 30) one year after the intervention. Furthermore, possible predictors for CPT success one year after the intervention were investigated. Study III focuses on predictors of short- and long-term CT success. Analyses of Study II and Study III were based on the same data. Study IV is a systematic review of studies (n = 28) investigating predictors of memory training success in healthy older individuals. Results: The main results of Study I showed that attending a structured CT was more effective than attending an unstructured CT and no intervention (the control group) to improve verbal short-term memory. Results of Study II showed a significant effect favouring the CPT in comparison to CPT plus counselling in the domains overall cognition and verbal long-term memory. Also, within-group comparisons showed cognitive improvements for all types of training. Regarding predictors of CT and CPT success in healthy older individuals, results of Studies I, II and III show that “more vulnerable” groups (i.e., individuals with less education, at an older age, and with worse performance on neuropsychological tests at training entry) can benefit more from CT as well as from CPT both directly after the training and one year later. The systematic review conducted in Study IV revealed that the statistical analyses and dependent variables used to calculate predictors of memory training success differ greatly and may explain the partly conflicting results regarding predictors of training success in the existing literature. Conclusion: The present thesis contributes to the research into the effectiveness of CT and CPT interventions by showing that both CT and CPT interventions are suitable for maintaining and improving cognitive functions in healthy older adults. Furthermore, substantial contributions were made to the investigation of possible predictors of CT and CPT success, thus taking an important step toward an individualized prevention approach to maintaining cognitive abilities in healthy older ageing. Moreover, the identification of methodological shortcomings in prediction research so far will contribute to the establishment of guidelines and a higher methodological quality of future prediction research.
| Item Type: | Thesis (PhD thesis) | ||||||||
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| Corporate Creators: | Humanwissenschaftliche Fakultät, Universität zu Köln, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln | ||||||||
| URN: | urn:nbn:de:hbz:38-105126 | ||||||||
| Date: | 19 December 2019 | ||||||||
| Language: | English | ||||||||
| Faculty: | Faculty of Human Sciences | ||||||||
| Divisions: | Faculty of Human Sciences > Department Psychologie | ||||||||
| Subjects: | Psychology General statistics |
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| Date of oral exam: | 19 December 2019 | ||||||||
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| Refereed: | Yes | ||||||||
| URI: | http://kups.ub.uni-koeln.de/id/eprint/10512 |
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