| 1. |
- Gronholm-Nyman, Petra, et al.
(författare)
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Limited Effects of Set Shifting Training in Healthy Older Adults
- 2017
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media S.A.. - 1663-4365. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Our ability to flexibly shift between tasks or task sets declines in older age. As this decline may have adverse effects on everyday life of elderly people, it is of interest to study whether set shifting ability can be trained, and if training effects generalize to other cognitive tasks. Here, we report a randomized controlled trial where healthy older adults trained set shifting with three different set shifting tasks. The training group (n = 17) performed adaptive set shifting training for 5 weeks with three training sessions a week (45 min/session), while the active control group (n = 16) played three different computer games for the same period. Both groups underwent extensive pre-and post-testing and a 1-year follow-up. Compared to the controls, the training group showed significant improvements on the trained tasks. Evidence for near transfer in the training group was very limited, as it was seen only on overall accuracy on an untrained computerized set shifting task. No far transfer to other cognitive functions was observed. One year later, the training group was still better on the trained tasks but the single near transfer effect had vanished. The results suggest that computerized set shifting training in the elderly shows long-lasting effects on the trained tasks but very little benefit in terms of generalization.
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| 2. |
- Kujala, Jan, et al.
(författare)
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Beta-band MEG signal power changes in older adults after physical exercise program with and without additional cognitive training
- 2023
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Ingår i: Brain and Cognition. - : Elsevier. - 0278-2626 .- 1090-2147. ; 165
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Tidskriftsartikel (refereegranskat)abstract
- Physical exercise has been considered to be an efficient mean of preserving cognitive function and it influences both the structural and functional characteristics of the brain. It has especially been shown to increase brain plasticity, the capacity to re-structure brain properties in response to interaction, such as cognitive practice. Studies have also examined the potential additive effect of cognitive training on the documented benefit of physical exercise, commonly, however, not at the neural level. We monitored, using magnetoencephalography (MEG), the brain processes associated with executive functions in older individuals who participated in a 12-month randomized controlled trial including two research arms: physical and cognitive training vs physical training alone. Measurements were conducted at 0 months, 6 months, and 12 months. The addition of cognitive training was associated with better performance in the Stroop test that reflects executive control. The extra benefit of cognitive training was also manifested as decreased modulation of beta frequency band (15–25 Hz) especially to difficult distractors. As beta band activity is associated with attentional control, this indicates fewer resources needed to inhibit irrelevant sensory inputs. These results imply an enhancing role of cognitive elements integrated with physical training in improving or maintaining executive functions in older individuals.
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| 3. |
- Nordvall, Olov, et al.
(författare)
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Self-reported and performance-based measures of executive functions in interned youth
- 2017
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Ingår i: Psychology, Crime and Law. - : Routledge journals, Taylor & Francis ltd. - 1068-316X .- 1477-2744. ; 23:3, s. 240-253
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Tidskriftsartikel (refereegranskat)abstract
- This study address three questions: (a) Do interned adolescents exhibit general or specific deficits in the core executive functions, as compared to an age-matched control group? (b) Do interned adolescents report more executive problems in everyday life, as compared to an age-matched control group? And (c) are performance-based measures of executive functions related to self-reported executive problems? Thirty-one interned youths and 40 non-interned controls participated in the study. To this end, we measured the three constituents (inhibition, shifting, and updating) of the Unity/Diversity model of executive functioning, as well as the participants' self-reported everyday executive functioning using the Behavior Rating Inventory of Executive Functions scale. The interned group performed less well compared to the control group on the majority of performance-based tasks but did not show more pronounced deficits in any one executive function, reflective of a more general deficit. Compared to the controls, the interned adolescents also reported more dysfunction in executive behaviors related to the ability to inhibit action, behavioral flexibility, working memory, and the ability to follow through with tasks. Overall, correlations between self-report and performance-based measures were weak. These findings suggest that performance-based and self-report measures may assess different, albeit important, aspects of executive functioning.
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| 4. |
- Savikangas, Tiina, et al.
(författare)
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The effects of a physical and cognitive training intervention vs. physical training alone on older adults' physical activity : A randomized controlled trial with extended follow-up during COVID-19
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:10, s. 1-20
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Tidskriftsartikel (refereegranskat)abstract
- Background Executive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown. Methods Data from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwelling men and women from Jyvaskyla, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models. Results No significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720-1.614, p<0.001-0.046). Higher baseline Stroop predicted higher physical activity through all subsequent time-points (pooled data: B = 0.011-0.013, p = 0.015-0.030). Higher baseline TMT B-A predicted higher physical activity at 6m (pooled data: B = 0.007, p = 0.006) and during COVID-19 (B = 0.005, p = 0.030). In the PT group, higher baseline Letter Fluency predicted higher physical activity at 12m (B = -0.028, p = 0.030) and follow-up (B = -0.042, p = 0.002). Conclusions Cognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.
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| 5. |
- Sipila, Sarianna, et al.
(författare)
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Effects of physical and cognitive training on gait speed and cognition in older adults : A randomized controlled trial
- 2021
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 31:7, s. 1518-1533
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Tidskriftsartikel (refereegranskat)abstract
- Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the PT and computer training (CT) on EFs 15-20 min, 3-4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6-min walking distance, dual-task cost in gait speed, and EF (Stroop and Trail Making B-A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59%-72% in PT and 62%-77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT-PT, 0.02; 95%CI -0.03, 0.08), walking distance (-3.8; -16.9, 9.3) or dual-task cost (-0.22; -1.74, 1.30). Stroop improvement was greater after PTCT than PT (-6.9; -13.0, -0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF's, complementing physical training with targeted cognitive training provides additional benefit.
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| 6. |
- Sipilä, Sarianna, et al.
(författare)
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Promoting safe walking among older people : the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial
- 2018
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women.Methods: Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyvaskyla will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics.Discussion: The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.
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| 7. |
- Thorgeirsdottir, Lilja, et al.
(författare)
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Study protocol: establishment of a multicentre pre-eclampsia database and biobank in Sweden: GO PROVE and UP MOST, a prospective cohort study
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Pre-eclampsia, a multisystem disorder in pregnancy, is one of the most common causes of maternal morbidity and mortality worldwide. However, we lack methods for objective assessment of organ function in pre-eclampsia and predictors of organ impairment during and after pre-eclampsia. The women’s and their partners’ experiences of pre-eclampsia have not been studied in detail. To phenotype different subtypes of the disorder is of importance for prediction, prevention, surveillance, treatment and follow-up of pre-eclampsia.The aim of this study is to set up a multicentre database and biobank for pre-eclampsia in order to contribute to a safer and more individualised treatment and care.Methods and analysis This is a multicentre cohort study. Prospectively recruited pregnant women ≥18 years, diagnosed with pre-eclampsia presenting at Sahlgrenska University Hospital, Uppsala University Hospital and at Södra Älvsborgs Hospital, Sweden, as well as normotensive controls are eligible for participation. At inclusion and at 1-year follow-up, the participants donate biosamples that are stored in a biobank and they are also asked to participate in various organ-specific evaluations. In addition, questionnaires and interviews regarding the women’s and partner’s experiences are distributed at follow-up.Ethics and dissemination By creating a database and biobank, we will provide the means to explore the disorder in a broader sense and allow clinical and laboratory discoveries that can be translated to clinical trials aiming at improved care of women with pre-eclampsia. Further, to evaluate experiences and the psychological impact of being affected by pre-eclampsia can improve the care of pregnant women and their partners. In case of incidental pathological findings during examinations performed, they will be handled in accordance with clinical routine. Data are stored in a secure online database. Biobank samples are identified through the women’s personal identification number and pseudonymised after identification in the biobank before analysis.This study was approved by the regional ethical review board in Gothenburg on 28 December 2018 (approval number 955-18) and by the Swedish Ethical Review Authority on 27 February 2019 (approval number 2019-00309).
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| 8. |
- Thunborg, Charlotta, 1965-, et al.
(författare)
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Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial
- 2024
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Ingår i: Alzheimer's Research & Therapy. - : Springer Nature. - 1758-9193. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer’s disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear.Methods: MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60–85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale.Results: During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions.Conclusions: The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial.
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| 9. |
- Tirkkonen, Anna, et al.
(författare)
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Associations Between Physical and Executive Functions Among Community-Dwelling Older Men and Women
- 2022
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Ingår i: Journal of Aging and Physical Activity. - : Human Kinetics. - 1063-8652 .- 1543-267X. ; 30:2, s. 332-339
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Tidskriftsartikel (refereegranskat)abstract
- Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had intact cognition. Our results showed that, while executive functions were associated with gait and lower extremity functioning, the associations depended partly on the executive process measured and the nature of the physical task. Moreover, the associations did not differ between the sexes.
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| 10. |
- Tirkkonen, Anna, et al.
(författare)
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Participant characteristics associated with the effects of a physical and cognitive training program on executive functions
- 2022
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media S.A.. - 1663-4365. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions. Methods: Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical and cognitive training (PTCT) intervention. Measurements of executive functions related to inhibition (Stroop), set shifting (Trail Making Test B) and updating (Verbal Fluency) were performed at baseline and 12 months. Data were analyzed using a longitudinal linear path model for the two measurements occasion. Results: Stroop improved significantly more in women and participants in the low compliance subgroup who received PTCT than in counterparts in the PT subgroup (difference –8.758, p = 0.001 and difference –8.405, p = 0.010, respectively). In addition, TMT B improved after the intervention in the low compliance PTCT subgroup and worsened in the corresponding PT subgroup (difference –15.034, p = 0.032). No other significant associations were observed. Conclusion: Executive functions in women and in the participants, who only occasionally engaged in training showed greater improvement after the PTCT than PT intervention. However, the additional extra benefit gained from the PTCT intervention was uniquely expressed in each executive function measured in this study.
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