Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial.

INTRODUCTION: Cognitive deterioration in older people with mild neurocognitive disorders (mNCD) increases the risk of progress to major NCD. Health professionals worldwide are trying to find strategies for prevention. There is a limited number of studies that deal with cultural conditions in northern Thailand. OBJECTIVES: This study aimed to investigate the effects of a combination of physical movement activity and multifaceted cognitive training on cognitive function in older people with mNCD. METHODS: A randomized control trial involving 70 mNCD people, according to DSM-5 criteria, was conducted on an intervention group and a control group (n = 35 each). The program for the intervention group included 24 sessions (twice a week). The outcome measures on cognitive function were assessed before and after the intervention by means of composite cognitive measures for older people, i.e., the Trail-Making Test (TMT), Digit Span (DS), Verbal Fluency (VF), Word-List Learning (WLL), and Block Design (BD). RESULTS: The combined intervention enhanced cognitive function. TMT-A was significantly improved in the intervention group. There were significant improvements in DS sequence scores, letter verbal fluency (LVF), and category verbal fluency (CVF). Comparing the groups, there were significant differences in LVF including immediate and delayed recall. BD improved significantly in the intervention group. CONCLUSIONS: The combined intervention appeared to be effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with mNCD. Further studies on a variation of treatments suited to cultural conditions and their effects are needed. Trials in other communities are also recommended.

The Development and Psychometric Properties of the Visuospatial Working Memory Assessment (VWMA) for Children.

The visuospatial working memory plays a crucial role in the occupational performance of children including daily living and academic achievement. Unfortunately, relevant visuospatial working memory tests in the occupational therapy setting are lacking. Therefore, it is of clinical interest to develop new assessment tools in this area. The present study is aimed at summarizing the development of the visuospatial working memory assessment (VWMA) and assessing its psychometric properties. The results revealed that the score of item-objective congruence index (IOC) was 1.0 in overall items of assessment. The Cronbach alpha test confirmed that the internal consistency of VWMA showed good reliability in both types of the assessment, with the total score of computerized tests being .88 and the tabletop tests being .81. The computerized test was found to have excellent test-retest reliability with intraclass correlation coefficient (ICC) values ranging from .88 to .99. The tabletop test was found to have a fair to good test-retest reliability with the ICC values ranging from .51 to .63. As regards construct validity, the results revealed that the tasks in the computerized test identified a significant difference between the control group, normal children, and children with attention deficit/hyperactivity disorder (ADHD) group. The exception to this was the N-back task in which the independent sample t-test of computerized test ranged from 1.61 to 6.23. The results of the tabletop test revealed a significant difference between normal children and the children in the ADHD group over all tasks in which the independent sample t-test ranged from 3.05 to 8.40. In conclusion, good psychometric properties established as regards content validity, internal consistency, test-retest reliability, and construct validity provide evidence to support the position that the new VWMA is appropriate for children.

Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics.

INTRODUCTION: Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia. A review showed that 10-15% of those with MCI annually progressed to Alzheimer's disease. OBJECTIVE: This study aimed to investigate the prevalence and risk factors associated with MCI as well as the characteristics of cognitive deficits among older people in rural Thailand. METHODS: A cross-sectional study in 482 people who were 60 years old and over was conducted in northern Thailand. The assessments were administered by trained occupational therapists using demographic and health characteristics, Mental Status Examination Thai 10, Activities of Daily Living - Thai Assessment Scale, 15-item Geriatric Depression Scale and the Montreal Cognitive Assessment-Basic (MoCA-B, Thai version). RESULTS: The mean age of MCI was 68.3 ± 6.82 years, and most had an education ≤4 years. The prevalence of MCI in older people was 71.4% (344 out of 482), and it increased with age. Low education and diabetes mellitus (DM) were the significant risk factors associated with cognitive decline. Older people with MCI were more likely to have an education ≤4 years (RR 1.74, 95% CI 1.21-2.51) and DM (RR 1.19, 95% CI 1.04-1.36) than those who did not. The 3 most common cognitive impairments according to MoCA-B were executive function (86%), alternating attention (33.1%) and delayed recall (31.1%). CONCLUSION: The prevalence of MCI in older Thai people in a rural area is high compared with that in other countries. The explanation might be due to low education and underlying disease associated with MCI. A suitable program that can reduce the prospects of MCI in rural Thailand is needed.

Effectiveness of Information Processing Strategy Training on Academic Task Performance in Children with Learning Disabilities: A Pilot Study.

Learning disabilities (LD) can be associated with problems in the four stages of information processing used in learning: input, throughput, output, and feedback. These problems affect the child's ability to learn and perform activities in daily life, especially during academic activities. This study is a pilot study aimed at investigating the effectiveness of information processing strategy training using a combination of two approaches that address the ability to apply processing strategies during academic activities in children with LD. The two approaches are the Perceive, Recall, Plan, and Perform (PRPP) System of Intervention, which is a strategy training intervention, and the Four-Quadrant Model (4QM) of Facilitated Learning approach, which is a systematic facilitator technique. Twenty children with LD were assigned to two groups: the experimental group (n = 10) and the control group (n = 10). Children in the experimental group received the intervention twice a week for 6 consecutive weeks. Each treatment session took approximately 50 minutes. Children in the control group received traditional intervention twice a week for 6 consecutive weeks. The results indicated that the combination of the PRPP System of Intervention and the 4QM may improve the participants' ability to apply information processing strategies during academic activities.

Home-based interventions improve trained, but not novel, dual-task balance performance in older adults: A randomized controlled trial.

The purpose of this study was to compare the efficacy of four different home-based interventions on dual-task balance performance and to determine the generalizability of the four trainings to untrained tasks. Sixty older adults, aged 65 and older, were randomly assigned to one of four home-based interventions: single-task motor training, single-task cognitive training, dual-task motor-cognitive training, and dual-task cognitive-cognitive training. Participants received 60-min individualized training sessions, 3 times a week for 4 weeks. Prior to and following the training program, participants were asked to walk under two single-task conditions (i.e. narrow walking and obstacle crossing) and two dual-task conditions (i.e. a trained narrow walking while performing verbal fluency task and an untrained obstacle crossing while counting backward by 3s task). A nine-camera motion capture system was used to collect the trajectories of 32 reflective markers placed on bony landmarks of participants. Three-dimensional kinematics of the whole body center of mass and base of support were computed. Results from the extrapolated center of mass displacement indicated that motor-cognitive training was more effective than the single-task motor training to improve dual-task balance performance (p=0.04, ES=0.11). Interestingly, balance performance under both single-task and dual-task conditions can also be improved through a non-motor, single-task cognitive training program (p=0.01, ES=0.13, and p=0.01, ES=0.11, respectively). However, improved dual-task processing skills during training were not transferred to the novel dual task (p=0.15, ES=0.09). This is the first study demonstrating that home-based dual-task training can be effectively implemented to improve balance performance during gait in older adults.