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5 Brain Exercises to Improve Memory and Concentration - Jim KwikCognitive function improvement programs -
Harvard Medical School has outlined several of these Godman, , including the following:. The supportive factors, exercises, and games cited above remain valid for maintaining cognitive fitness as we grow older, with certain caveats.
For example, a verbal memory task for an older person with encroaching memory problems might be modified to include a 6-item list of words to recall, instead of a item list.
Prompts and cues can spur memory and provide the individual with an experience of success. If it is too hard, you risk overwhelming the person.
Finding the right cognitive challenge for such individuals allows them to exercise their faculties and experience some success, rather than becoming overwhelmed and frustrated.
Neuropsychological testing is one way to assess cognitive health. However, this option can be costly and labor intensive. There are a number of excellent tools available to practitioners for basic screening and tracking of cognitive health.
Many of these tools are designed for use with older people, but some are meant for use with younger people as well. This assessment uses patient history, observations by clinicians, and concerns raised by the patient, family, or caregivers.
These measures include the General Practitioner Assessment of Cognition, Memory Impairment Screen, and the Mini-Cog brief psychometric test. These supplements include B-complex and E vitamins, minerals such as zinc, herbs such as ginkgo biloba, and other botanicals.
The Ginkgo Evaluation of Memory study followed 3, older adult participants over the course of six years, randomly assigned to ginkgo biloba or placebo groups DeKosky et al. The study found no evidence that the supplement slowed cognitive decline or prevented dementia.
B-complex vitamins such as B6, B9, and B12 have not been shown to prevent or slow cognitive decline in older adults McMahon et al. Studies have shown that certain supplements such as zinc can have positive effects on frontal or executive function in children and adults Warthon-Medina et al.
Recently, a large prospective cohort study followed 5, participants for 9. As always, it is best to consult your physician before taking either approved medications or medical supplements. We have a number of resources that specifically apply to strength assessments and a healthy mind.
For some practical resources to get you started, check out some of the following. This handout is a valuable resource you can use to educate children about the benefits of exercise for mental wellness. In particular, it lists several of the emotional and neurochemical benefits of exercise and recommends several forms of exercise children might enjoy.
Use it to facilitate discussion about the link between mind and body when talking about the brain and cognitive health.
This exercise invites clients to illustrate the gap between the extent to which they are currently using their strengths and the extent to which they could. This exercise effectively gives clients immediate visual feedback on their strength use and can facilitate discussion around plans to increase or optimize strengths use.
This measure was created with the help of the Activity Builder at Quenza. Quenza is a platform created by the same team who established PositivePsychology. The Cognitive Fitness Survey can be used for self-reflection. It is designed to assess and track physical and emotional factors that contribute to cognitive health.
It also assesses and tracks specific cognitive health dimensions, including attention; short-term, remote, and prospective memory; and organizational capacity.
Use them to help others flourish and thrive. For much of their history, clinical psychology and related helping professions focused on assessing and treating emotional, social, and cognitive deficits. With the positive psychology movement in the late s came a different emphasis: finding and building upon strengths.
Aspects of health and wellbeing began to be studied more assiduously and became the focus of interventions. Initially, cognitive health was one aspect of overall health and wellbeing that was overlooked by many researchers and practitioners.
Fortunately, more recently, cognitive health has begun to receive the attention it deserves, as both a research topic and focus of intervention Aidman, As with other components of health and wellness, cognitive health, including attentional capacity, memory abilities, and organizational and problem-solving skills, can be enhanced with the right support and exercises.
Staying physically healthy pays large dividends toward such cognitive fitness. Physical health includes maintaining a heart-healthy diet, sleeping well, and exercising regularly. In addition, basic, cost-effective mental activities and exercises can further boost cognitive fitness.
Many of these are enjoyable in their own right and can boost cognitive skills. To be most effective, cognitive activities and exercises should involve as much novelty as possible. To find the right activities, a positive psychology, strengths-based approach might be useful. We hope you enjoyed reading this article.
About the author Dr. Jeffrey Gaines earned a Ph. in clinical psychology from Pennsylvania State University in He sees clinical psychology as a practical extension of philosophy and specializes in neuropsychology — having been board-certified in Jeffrey is currently Clinical Director at Metrowest Neuropsychology in Westborough, MA.
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Save my name, email, and website in this browser for the next time I comment. Have you ever experienced a working state characterized by heightened concentration, a flow-like state, and increased productivity?
Effective time management does not come naturally. For that reason, time management books, techniques, and software are a dime a dozen.
The added value of the long term intervention was that the participants had significantly improved everyday memory in contrast with the short term intensive programs whose effects decay with time.
For both approaches, boosting sessions or long term training, the training could be, at least partially done, using brain games to maintain the progress obtained during conventional training sessions.
A second important question is to determine the minimum amount of training required to achieve statistical improvement. We do not find any correlation between the total amount of training and progress. Only one study assessed the relationship between the amount of training and the progress but the authors did not find a clear relationship between compliance and improvement According to this review, the median duration of the intervention is 15 h.
We could thus determine this arbitrary as the ideal duration for cognitive training. It must be stressed that the duration of the training may also depend on the cognitive domain trained e.
Another important question is to identify the participants that are most likely to benefit from this kind of intervention. In the ACTIVE study, the authors found that participants with higher education and better self-rated health have greater changes in memory performance after training 47 , younger participants present more gain 48 , racial disparities in training-related gains have also been observed in this study due to variation in the external locus of control We do not have enough information about the characteristics of the participants e.
One study shows that the different variations of APOE also influence the effect of cognitive training in older adults without cognitive impairment It is well known that APOE ε4 is associated with an increased risk of cognitive impairment i.
Cognitive training may attenuate ε4-associated declines in processing speed APOE ε2 carriers, that present lower risk of cognitive impairment, may also benefit from training, particularly on measures of executive function and verbal memory, according to these authors In addition to the issue of clinical efficacy, it is essential to ensure the safety of an intervention.
Only one study reported adverse effects during brain training. In this study participants trained for 40 sessions. Another study mentioned that they did not record any adverse effects during the training The biggest issue with the training is that people are not performing the training.
This drop-out at follow up may lead to potential bias in the studies since, in most of them, the results were not analysed in intention-to-treat. Only a few studies analysed the participants who did not complete the study and did not find differences compared with the other participants 21 , 24 , An important aspect of long-term cognitive training is keeping the participants engaged and adhering to the training over long periods.
In a large study Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability FINGER , including participants with increased dementia risk, the authors indeed reported low adherence to the long term sessions CCT program. This may be addressed by taking into account the level of cognitive functioning and gamification of cognitive training so that it is motivating and fun.
For example, Sahakian et al. Despite the significant results of this meta-analysis, there is a need for large sample size studies to increase the level of evidence of this kind of training.
Several studies have been conducted suggesting that home-based cognitive training was feasible and efficient with older adults 54 , 55 , 56 , Even before the development of brain training apps the efficacy of computer training and internet usage on cognitive abilities in older adults had already been highlighted Indeed compared to traditional brain training computers, smartphones, and virtual environments offer interesting possibilities indeed computerized model could bring more complex environment that will challenge and impact cognition more than traditional exercises Another potential positive aspect of having the training on smartphones is that recent studies underlined the importance of digital devices as platforms for cognitively stimulating activities in delaying cognitive decline in older adults There are several limitations to this review.
First, at the study level, some of the studies referred to have relatively small sample sizes and are likely to be underpowered It would be useful to have more large scale studies to examine the effects of cognitive training.
There are other study-specific limitations i. At the meta-analysis level, the first one is that we limited our analysis to commercially available ccCG while in the research plenty of training programs are being developed and tested but are, currently, not largely available 62 , 63 , 64 , We decided to include only those types of ccCG because we aimed to evaluate the efficacy of training that is available for the general public.
Furthermore, in studies using commercial ccCG all the participants received the same intervention, which is not the case in studies using specific training where the treatment can be adjusted for every participant Additionally, the results from the meta-regression must be interpreted cautiously due to the small number of available studies, with more large scale studies, there may be an effect of age and the amount of training.
However, the results from our meta-analysis do not provide evidence to support an effect of the age of the participants or a dose—response relationship between the amount of training and the outcome.
From the clinical point of view, this is a better approach, but it is more difficult to set-up in real-life situations and in practice not always the case due to restrictions of time and financial means Again this choice has been made in the context of having the most simple solution to use, such kind of training does not require health care professionals to set-up the training and could, therefore, be of particular interest in countries with few healthcare professionals.
We also limited our analysis to published papers and did not include grey literature, which could have led to an increased in the precision of the pooled estimate with narrower confidence interval From a clinical point-of-view, we limited this analysis to purely cognitive interventions while there is a growing body of evidence suggesting than combining cognitive and physical exercises could be an effective solution to prevent cognitive decline and improve cognitive function in older adults 69 , 70 , A few studies also suggest that doing cognitive tasks while doing aerobic physical exercises is feasible and effective in older adults We showed that cognitive training using commercially available ccCG is effective in improving processing speed, working memory, and executive function.
The total amount of training does not seem to influence the results. In addition, the age of the participants does not influence the results, indicating that the ability to learn is preserved in healthy older adults. Only one study reported some minor adverse effects, suggesting that ccCG is safe.
Therefore, in support of the findings from a previous systematic review 17 , the results of this meta-analysis support the use of ccCG to challenge the brain and improve cognitive functions. ccCG training should be combined with other methods of brain training and a healthy life-style 73 to maintain optimal cognition and fight against the decline of cognitive functions in older adults.
Other work should focus on the use of such training to improve or slow down the cognitive decline in MCI patients as the level of evidence supporting such kind of intervention is still sparse 74 , There are not enough studies available to determine if ccCG can prevent clinical dementia or improve or maintain cognitive function in patients We searched the PubMed electronic database, Web of Sciences, Embase, Scopus, and Sciences Direct for relevant articles published up to the 31st of December The details of the search strategies are presented in Supplementary Table S1.
References from selected papers and from other relevant articles were screened for potential additional studies in accordance with the snowball principle.
The search was limited to journal articles published in English. The inclusion and exclusion criteria were as follows. No time period threshold was used because ccCG training is a fairly recent paradigm. A PICOS approach Population, Intervention, Control, Outcome, and Study design was used inclusion and exclusion criteria, which was predetermined and assessed by the study team Intervention Studies using mobile devices or gaming consoles and using commercially available ccCG to perform cognitive training.
The duration of the training must be a minimum of 1 month. Studies using action-video games or a combination of cognitive and physical rehabilitation exercises were not included. Outcome Outcomes included performance on one or more cognitive tests that were not included in the training program i.
This review is limited to the changes in performance from baseline to immediately post-training. The primary outcomes are cognitive tests not included in the training program, administered before and after training, that provides any validated measure of on tests of verbal memory, working memory, processing speed, attention, visuospatial abilities, and executive functions.
The list of the different tests used to assess the different cognitive functions in the studies is presented in Supplementary Table S2. A flow diagram of the study selection with the screened articles and the selection process is shown in Fig.
A positive SMD implies better therapeutic effects over time in the intervention group compared to the control group. To detect an extreme effect size outliers in the different cognitive functions, two methods were used.
We first checked the confidence interval of the individual studies and defined a study as an outlier if the confidence interval did not overlap with the confidence interval of the pooled effect.
We then performed an influence analysis using leave-one-out method to confirm the results of the first method We assessed the heterogeneity in stratified analyses by type of control active or passive. We prespecified a tau 2 of 0. Finally, trim-and-fill method to adjust for funnel plot asymmetry and publication biases were applied Random-effects meta-regression analysis quantified the association of the outcome and the amount of training and the age of the participants.
Studies were weighted by the inverse of the sum of the within- and between-study variance Statistical analyses were performed at an overall significance level of 0.
Statistics were conducted in STATA The protocol of the present study was registered in the international prospective register of systematic reviews PROSPERO registration number CRD This systematic review and meta-analysis were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA recommendations For the present study, no ethics committee approval was necessary.
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Network connectivity of motor control in the ageing brain. In this trial, neurofeedback sessions were conducted by trained EEG technicians, under the supervision of the neurologist and the co-director of the program who had certification from Biofeedback Certification International Alliance, BCIA.
Each patient received a personalized neurofeedback protocol based on their symptoms e. The baseline Q-EEG and neurofeedback interventions were applied with the latest version of the Brain Master hardware and software programs www. The performance scores on the neurocognitive tests were recorded as raw scores and then converted to standardized z-scores.
Repeated measures non-parametric t-tests, with significance at 0. The overall effectiveness for the Brain Fitness Program for each participant was the sum of the component tests with significant positive change.
We also performed a Spearman correlational analysis of our data to determine if there were relationships between the changes in the volume of hippocampus and the changes in cognitive function. In this single-arm intervention trial, elderly patients with an average age of Upon completing the program, patients on average improved in 4.
The post-program cognitive tests Fig. Figure 1. The battery of the neurocognitive evaluation used in this trial assessed 10 areas of cognitive function. A random subset of 17 patients received a brain MRI after they completed the program. An example of a patient who had 8. Three of the 17 patients had no evidence of the expected hippocampal atrophy no change and five patients experienced the usual expected atrophy in the hippocampal volume.
Figure 2. Before and after MRI results in one of the patients who completed the Brain Fitness Program. Post-program MRI with NeuroQuant showed an 8. A : Baseline Brain MRI. B : Post-program Brain MRI. C : Higher magnification of baseline hippocampal volume.
D : Higher magnification of the post-program hippocampal volume. A Spearman correlational analysis showed a correlation of 0. Results from the MCI patients who completed the week Brain Fitness Program reveal that elderly patients with objective cognitive impairment have the capacity to improve their brain performance with an intensive set of treatments.
Post-program MRI in a small subset of 17 patients showed that 12 patients experienced a reversal of hippocampal atrophy or an actual growth above its baseline volume.
The main strength of the Brain Fitness Program is its multi-faceted interventions. It appears that when protective factors such as cognitive stimulation, stress reduction, improved diet, better fitness, and treatment of sleep issues are combined, patients do experience a reversal of their cognitive decline and can increase the volume of their hippocampus.
Another strength of the Brain Fitness Program is the personalized nature of its interventions. Patients are first asked to describe their symptoms, concerns, fears, and motivations for their desire to enhance their brain performance as well as the degree of their commitment for completing this intensive 3-month program.
The limitations of the current trial are its small size, lack of randomization, the absence of a control group, and the challenge to establish which of the interventions provided is most effective in treating patients with MCI. Patients had variable degrees of different comorbid medical conditions such as depression, sleep deficits, or cardiovascular disease.
They also had variable degree of compliance with following instruction for treatment of their medical and neurological conditions. The level of family support to help them follow through with the program was also variable. However, given these limitations, the fact that a program in a real-life clinical setting can produce measurable results is quite encouraging.
It is possible that the results may have been more significant if more patients were enrolled in this trial and they were randomized to either an active group or a control group.
A large multicenter trial of the Brain Fitness Program may be able to answer which interventions would yield the most benefits for any individual patient in the shortest amount of time, and what dose of treatment would be sufficient to obtain clinically meaningful and long-lasting results.
An interesting observation in our trial is the fact that patients with a younger age and higher baseline MMSE seem to gain the most benefits with completing the Brain Fitness Program.
These patients may have strong baseline brain reserve that can be rehabilitated and rebuilt 1, 2. Patients with advanced age and severe cognitive deficits may already have lost a significant portion of their brain reserve 1, 2.
Such individuals may require increased frequency and magnitude of interventions for a much longer period of time, though it is not clear if they would ever rebound significantly. To quantify and monitor change in hippocampal volume as a function of disease progression and biomarker of response to prevention and treatment trials, quantitative tools for hippocampal volume assessment are needed.
Only two such programs are FDA cleared for use in patients: NeuroQuant and Neuroreader. In this paper, we used NeuroQuant which was the first FDA cleared software for this purpose. Neuroreader is a newer software program that has been validated against Delphi Consensus Criteria for manual segmentations of the hippocampus Additionally, Neuroreader has an FDA cleared normative database that improves reliability of its Z-score calculations Applying such tools in clinical practice for prevention purposes such as described in this paper is part of a larger goal of utilizing quantitative neuroimaging in brain aging and cognitive decline A unique feature of the Brain Fitness Program is its use of neurofeedback training for enhancing cognitive function and mood in elderly 6.
In this intervention, patients undergo continuous EEG monitoring during a typical minute session and receive auditory and visual feedback to move their brain wave activity toward the normal range. Through repeated neurofeedback sessions, with a protocol aimed to reward a reduction in high-beta activity, the patient gradually becomes calmer and more focused Given the growing evidence for the long-lasting benefits of this non-pharmaceutical intervention 15 , neurofeedback therapy has the potential to become an important tool for treatment of elderly with MCI.
In summary, these results for our Brain Fitness Program for patients with MCI further support the fact that a multi-disciplinary set of interventions has the potential to enhance cognitive function in elderly 4.
It provides an additional incentive to initiate large placebo-controlled randomized clinical trials to evaluate the possibility that we can slow the rate of cognitive decline with aging, and grow the size of hippocampus, through an emphasis on diet, exercise, cognitive stimulation, neurofeedback, meditation, and counseling for stress reduction and having a purpose in life.
Acknowledgements: The authors would like to express their gratitude to the members of the Brain Fitness Program team which included Dr. Amy Cunningham, Rebekah Banerjee, Michelle Battaglia, Corissa Fanning, Dr.
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