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Cognitive Interventions for Neurodegenerative Disease

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Abstract

Purpose of Review

To critically review recent research in the development of non-pharmacological interventions to improve cognitive functioning in individuals with Alzheimer’s disease (AD) or Parkinson’s disease (PD).

Recent Findings

Cognitive interventions can be grouped into three categories: cognitive stimulation (CS), cognitive training (CT), and cognitive rehabilitation (CR). CS confers temporary, nonspecific benefits and might slightly reduce dementia risk for neurologically healthy individuals. CT can improve discrete cognitive functions, but durability is limited and real-world utility is unclear. CR treatments are holistic and flexible and, therefore, most promising but are difficult to simulate and study under rigorous experimental conditions.

Summary

Optimally effective CR is unlikely to be found in a single approach or treatment paradigm. Clinicians must be competent in a variety of interventions and select those interventions best tolerated by the patient and most relevant to their needs and goals. The progressive nature of neurodegenerative disease necessitates that treatment be consistent, open-ended in duration, and sufficiently dynamic to meet the patient’s changing needs as their disease progresses.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. World Alzheimer report. attitudes to dementia Alzheimer’s Disease International. London. 2019;2019:1–160.

    Google Scholar 

  2. Guo J, Wang Z, Liu R, Huang Y, Zhang N, Zhang R. Memantine, donepezil, or combination therapy – what is the best therapy for Alzheimer’s disease? A network meta-analysis. Brain Behav. 2020;10(11):1–13. https://doi.org/10.1002/brb3.1831.

    Article  Google Scholar 

  3. Salomone S, Caraci F, Leggio GM, Fedotova J, Drago F. New pharmacological strategies for treatment of Alzheimer’s disease: focus on disease modifying drugs. Br J Clin Pharmacol. 2012;73(4):504–17.

    Article  CAS  PubMed  Google Scholar 

  4. Walsh S, Merrick R, Milne R, Brayne C. Aducanumab for Alzheimer’s disease? BMJ. 2021;374:1–2.

    Google Scholar 

  5. van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, et al. Lecanemab in early Alzheimer’s disease. N Engl J Med. 2023;388(1):9–21.

    Article  PubMed  Google Scholar 

  6. Voelbel GT, Lindsey HM, Mercuri G, Bushnik T, Rath J. The effects of neuroplasticity-based auditory information processing remediation in adults with chronic traumatic brain injury. NeuroRehabilitation. 2021;49(2):267–78.

    Article  PubMed  Google Scholar 

  7. Cicerone KD, Goldin Y, Ganci K, Rosenbaum A, Wethe JV, Langenbahn DM, et al. Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014. Arch Phys Med Rehabil. 2019;100(8):1515–33.

    Article  PubMed  Google Scholar 

  8. Krellman JW, Tsaousides T, Gordon WA. Neuropsychological interventions following traumatic brain injury. In: Ashley MJ, Hovda DA, editors. Traumatic brain injury rehabilitation, treatment, and case management. Boca Raton (FL): CRC Press; 2017. p. 393–410.

    Chapter  Google Scholar 

  9. Contreras-Somoza LM, Irazoki E, Toribio-Guzmán JM, de la Torre-Díez I, Diaz-Baquero AA, Parra-Vidales E, et al. Usability and user experience of cognitive intervention technologies for elderly people with MCI or dementia: a systematic review. Front Psychol. 2021;12:1–15.

    Article  Google Scholar 

  10. Germain S, Wojtasik V, Lekeu F, Quittre A, Olivier C, Godichard V, et al. Efficacy of cognitive rehabilitation in Alzheimer disease: a 1-year follow-up study. J Geriatr Psychiatry Neurol. 2019;32(1):16–23.

    Article  PubMed  Google Scholar 

  11. Zucchella C, Sinforiani E, Tamburin S, Federico A, Mantovani E, Bernini S, et al. The multidisciplinary approach to Alzheimer’s disease and dementia. A narrative review of non-pharmacological treatment. Front Neurol. 2018;9:1–22.

    Article  Google Scholar 

  12. Miller KJ, Geirland J, Gomez ME, Dye RC, Ercoli LM. Memory training and aging. In: Lavretsky H, Sajatovic C, Reynolds C, editors. Complementary and integrative therapies for mental health and aging. New York (NY): Oxford University Press; 2016. p. 321–40.

    Google Scholar 

  13. Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer’s or vascular type: a review. Alzheimer’s Res Ther. 2013;5:1–14.

    Article  Google Scholar 

  14. Xu H, Yang R, Qi X, Dintica C, Song R, Bennett DA, et al. Association of lifespan cognitive reserve indicator with dementia risk in the presence of brain pathologies. JAMA Neurol. 2019;76(10):1184–91.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Stern Y. Cognitive reserve. Neuropsychologia. 2009;47(10):2015–28.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fonte C, Smania N, Pedrinolla A, Munari D, Gandolfi M, Picelli A, et al. Comparison between physical and cognitive treatment in patients with MIC and Alzheimer’s disease. Aging (Albany NY). 2019;11(10):3138–55. Representative RCT of a multifaceted cognitive rehabilitation program.

    Article  CAS  PubMed  Google Scholar 

  17. Tennstedt SL, Unverzagt FW. The ACTIVE study: study overview and major findings. J Aging Health. 2013;25(8S):3S-20S.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sohlberg MM, Avery J, Kennedy M, Ylvisaker M, Coelho C, Turkstra L, et al. Practice guidelines for direct attention training. J Med Speech Lang Pathol. 2003;11(3):19–39.

    Google Scholar 

  19. Kim H, Lee J, Chang SM, Kim BS. Effects of a cognitive rehabilitation program based on mnemonic skills and memory compensatory strategies for older adults: a pilot study. Medicine. 2022;101(31):1–7.

    Article  CAS  Google Scholar 

  20. Luo Y, Lin R, Yan Y, Su J, Lin S, Ma M, et al. Effects of remote expressive arts program in older adults with mild cognitive impairment: a randomized controlled trial. J Alzheimers Dis. 2023;91(2):815–31.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Duff K, Ying J, Suhrie KR, Dalley BC, Atkinson TJ, Porter SM, et al. Computerized cognitive training in amnestic mild cognitive impairment: a randomized clinical trial. J Geriatr Psychiatry Neurol. 2022;35(3):400–9.

    Article  PubMed  Google Scholar 

  22. Gavelin HM, Domellöf ME, Leung I, Neely AS, Launder NH, Nategh L, et al. Computerized cognitive training in Parkinson’s disease: a systematic review and meta-analysis. Ageing Res Rev. 2022;80:1–10. Comprehensive review of computerized cognitive training tools in Parkinson’s disease.

    Article  Google Scholar 

  23. Lasaponara S, Marson F, Doricchi F, Cavallo M. A scoping review of cognitive training in neurodegenerative diseases via computerized and virtual reality tools: what we know so far. Brain Sci. 2021;11(5):1–29. Comprehensive review of computerized cognitive training tools in neurodegenerative disease.

    Article  Google Scholar 

  24. Li BY, He NY, Qiao Y, Xu HM, Lu YZ, Cui PJ, et al. Computerized cognitive training for Chinese mild cognitive impairment patients: a neuropsychological and fMRI study. NeuroImage Clin. 2019;22:1–8.

    Article  CAS  Google Scholar 

  25. Cavallo M, Hunter EM, van der Hiele K, Angilletta C. Computerized structured cognitive training in patients affected by early-stage Alzheimer’s disease is feasible and effective: a randomized controlled study. Arch Clin Neuropsychol. 2016;31(8):868–76.

    PubMed  Google Scholar 

  26. Cavallo M, Angilletta C. Long-lasting neuropsychological effects of a computerized cognitive training in patients affected by early stage Alzheimer’s disease: are they stable over time? J Appl Gerontol. 2019;38(7):1035–44.

    Article  PubMed  Google Scholar 

  27. van Balkom TD, Berendse HW, van der Werf YD, Twisk JW, Peeters CF, Hoogendoorn AW, et al. Effect of eight-week online cognitive training in Parkinson’s disease: a double-blind, randomized, controlled trial. Parkinsonism Relat Disord. 2022;96:80–7.

    Article  PubMed  Google Scholar 

  28. Leung IH, Walton CC, Hallock H, Lewis SJ, Valenzuela M, Lampit A. Cognitive training in Parkinson disease: a systematic review and meta-analysis. Neurol. 2015;85(21):1843–51.

    Article  Google Scholar 

  29. Orgeta V, McDonald KR, Poliakoff E, Hindle JV, Clare L, Leroi I. Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev. 2020;2:1–63. Comprehensive review of cognitive training in Parkinson’s disease.

    Google Scholar 

  30. Katz B, Shah P, Meyer DE. How to play 20 questions with nature and lose: reflections on 100 years of brain-training research. Proc Natl Acad Sci U S A. 2018;115(40):9897–904.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Redick TS, Shipstead Z, Harrison TL, Hicks KL, Fried DE, Hambrick DZ, et al. No evidence of intelligence improvement after working memory training: a randomized, placebo-controlled study. J Exp Psychol Gen. 2013;142(2):359–79.

    Article  PubMed  Google Scholar 

  32. Owen AM, Hampshire A, Grahn JA, Stenton R, Dajani S, Burns AS, et al. Putting brain training to the test. Nat. 2010;465(7299):775–8.

    Article  CAS  Google Scholar 

  33. Zhang H, Huntley J, Bhome R, Holmes B, Cahill J, Gould RL, et al. Effect of computerised cognitive training on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis. BMJ. 2019;9(8):1–10.

    Google Scholar 

  34. Kim H, Jung J, Lee S. Therapeutic application of virtual reality in the rehabilitation of mild cognitive impairment: a systematic review and meta-analysis. Vision. 2022;6(4):1–10.

    Article  Google Scholar 

  35. Yu D, Li X, Lai FH. The effect of virtual reality on executive function in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health. 2023;27(4):663–73.

    Article  PubMed  Google Scholar 

  36. White PJ, Moussavi Z. Neurocognitive treatment for a patient with Alzheimer’s disease using a virtual reality navigational environment. J Exp Neurosci. 2016;10:129–35.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Foloppe DA, Richard P, Yamaguchi T, Etcharry-Bouyx F, Allain P. The potential of virtual reality-based training to enhance the functional autonomy of Alzheimer’s disease patients in cooking activities: a single case study. Neuropsychol Rehabil. 2018;28(5):709–33.

    Article  PubMed  Google Scholar 

  38. Park JH. Does the virtual shopping training improve executive function and instrumental activities of daily living of patients with mild cognitive impairment? Asian J Psychiatry. 2022;69:102977.

    Article  Google Scholar 

  39. Son C, Park JH. Ecological effects of VR-based cognitive training on ADL and IADL in MCI and AD patients: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(23):1–10. Comprehensive systematic review and meta-analysis examining training in daily living skills for individuals with Alzheimer’s disease.

    Article  Google Scholar 

  40. Clay F, Howett D, FitzGerald J, Fletcher P, Chan D, Price A. Use of immersive virtual reality in the assessment and treatment of Alzheimer’s disease: a systematic review. J Alzheimers Dis. 2020;75(1):23–43.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Zhong D, Chen L, Feng Y, Song R, Huang L, Liu J, et al. Effects of virtual reality cognitive training in individuals with mild cognitive impairment: a systematic review and meta-analysis. Int J Geriatr Psychiatry. 2021;36(12):1829–47. Comprehensive systematic review and meta-analysis of virtual reality-based cognitive training for individuals with mild cognitive impairment.

    Article  PubMed  Google Scholar 

  42. Cheng TC, Huang SF, Wu SY, Lin FG, Lin WS, Tsai PY. Integration of virtual reality into transcranial magnetic stimulation improves cognitive function in patients with Parkinson’s disease with cognitive impairment: a proof-of-concept study. J Parkinson’s Dis. 2022;12(2):723–36.

    Article  Google Scholar 

  43. Levy SA, Smith G, De Wit L, DeFeis B, Ying G, Amofa P, et al. Behavioral interventions in mild cognitive impairment (MCI): lessons from a multicomponent program. Neurotherapeutics. 2022;19(1):117–31.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Straubmeier M, Behrndt EM, Seidl H, Özbe D, Luttenberger K, Graessel E. Non-pharmacological treatment in people with cognitive impairment: results from the randomized controlled German day care study. Dtsch Arztebl Int. 2017;114(48):815–21.

    PubMed  PubMed Central  Google Scholar 

  45. Graessel E, Stemmer R, Eichenseer B, Pickel S, Donath C, Kornhuber J, et al. Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomized, controlled trial. BMC Med. 2011;9(1):1–11.

    Article  Google Scholar 

  46. Li B, Tang H, He G, Jin Z, He Y, Huang P, et al. Tai chi enhances cognitive training effects on delaying cognitive decline in mild cognitive impairment. Alzheimers Dement. 2023;19(1):136–49.

    Article  PubMed  Google Scholar 

  47. Liu X, Wang G, Cao Y. Association of nonpharmacological interventions for cognitive function in older adults with mild cognitive impairment: a systematic review and network meta-analysis. Aging Clin Exp Res. 2023;35:463–78.

    Article  PubMed  Google Scholar 

  48. Yang C, Moore A, Mpofu E, Dorstyn D, Li Q, Yin C. Effectiveness of combined cognitive and physical interventions to enhance functioning in older adults with mild cognitive impairment: a systematic review of randomized controlled trials. Gerontologist. 2020;60(8):e633–42.

    Article  Google Scholar 

  49. Lin M, Ma C, Zhu J, Gao J, Huang L, Huang J, et al. Effects of exercise interventions on executive function in old adults with mild cognitive impairment: a systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev. 2022;82:1–14.

    Article  Google Scholar 

  50. Wang R, Zhang H, Li H, Ren H, Sun T, Xu L, et al. The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: a systematic review and meta-analysis. Front Public Health. 2022;10:1–15.

    Google Scholar 

  51. Shao Z, Hu M, Zhang D, Zeng X, Shu X, Wu X, et al. Dose-response relationship in non-pharmacological interventions for individuals with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. J Clin Nurs. 2022;31(23–24):3390–401.

    Article  PubMed  Google Scholar 

  52. Prigatano GP. A history of cognitive rehabilitation. In: Halligan PW, Wade DT, editors. The effectiveness of rehabilitation for cognitive deficits. USA: Oxford University Press; 2005. p. 3–10.

    Chapter  Google Scholar 

  53. Marks S. Psychotherapy in historical perspective. Hist Hum Sci. 2017;30(2):3–16.

    Article  Google Scholar 

  54. Pettman E. A history of manipulative therapy. J Man Manip Ther. 2007;15(3):165–74.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Columbia University Irving Medical Center, 710 West 168Th Street, New York, NY, 10032-3784, USA

    Jason W. Krellman & Giulia Mercuri

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  1. Jason W. Krellman
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Correspondence to Jason W. Krellman.

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Krellman, J.W., Mercuri, G. Cognitive Interventions for Neurodegenerative Disease. Curr Neurol Neurosci Rep 23, 461–468 (2023). https://doi.org/10.1007/s11910-023-01283-1

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