Feeling foggy and forgetful? Canadian scientists develop program to help older adults slow down normal deterioration of mental ability

Toronto, CANADA – Canadian psychologists have developed a new approach to cognitive rehabilitation that could one day help healthy older adults slow down the mental deterioration that occurs with normal aging. The program could also be customized for those with head injuries and stroke.

Feeling foggy and forgetful?

Lately Sid finds it harder to pay attention, remember to do things in the right sequence, organize his day, solve problems and plan ahead.

Memory loss and cognitive decline are so gradual that you may not notice their effects until your 50s or 60s.

Baycrest psychologists have developed a new approach to cognitive rehabilitation that could one day help healthy older adults slow down the mental deterioration that comes with normal aging.

“If we can work with people in the early stages of cognitive decline, then we can slow down the rate of this decline and help them maintain a higher level of function for a longer time,” explains Dr. Gordon Winocur, senior scientist at Baycrest's Rotman Research Institute.

As we get older, we experience a certain amount of memory loss and cognitive decline. The changes are so gradual that we might not notice them until we reach our 50s and 60s. The daily tasks that require us to pay attention, remember to do things and in the right sequence, avoid distraction, organize our day, solve problems and plan ahead, become a little harder to do. These are known as strategic abilities, or executive functions, associated with the frontal lobes. Executive functions are often the first to deteriorate with age, and older adults experiencing these memory changes may start to feel frustrated, anxious and less confident in themselves.

Investigators with the Baycrest Research Centre for Aging and the Brain are excited by the results of a clinical-experimental study conducted on 49 healthy older adults with normal cognitive decline. The participants underwent a 12-week cognitive rehabilitation program in a small group setting and showed “significant improvement” in memory, practical task planning and psychosocial function.

"Participants experienced a 15 to 40 per cent improvement in their cognitive functions after taking the program. When we tested them six months later they showed an even higher increase in improvement, which suggests the more they practised using the strategies over time the better they got at it. Their psychological wellbeing -- which includes self-esteem, confidence and feelings of happiness -- improved dramatically in tandem with the improvements in their cognitive functions."
Dr. Gordon Winocur
Study co-coordinator

The study produced five papers which are published in a specially-created section of the January 2007 issue of the Journal of the International Neuropsychological Society (Vol. 13, No. 1). The papers report results from three different rehabilitation modules, and include an introductory paper and overview/ future directions. The online edition will be released Dec. 14 at:
www.journals.cambridge.org/jid_INS.

The Baycrest study is the first to evaluate a comprehensive approach to rehabilitating a wide range of cognitive functions that older adults typically use in their every day lives. The study included a six-month follow-up which found that participants continued to use the strategies long after the training had finished.

While other studies have tested cognitive rehabilitation strategies on larger groups of older adults, they’ve tended to focus more narrowly on improving a few cognitive functions. The benefits documented “in lab” have had limited practical application in the real-life home setting and there hasn’t been long-term follow-up to see if the training sticks.

“Our primary emphasis was on improving the use of general strategic abilities because they are particularly vulnerable to the aging process,” says Dr. Donald Stuss, coordinator of the study and director of the Rotman Research Institute at Baycrest.

While the results of this cognitive rehab program are very promising, it is still a “prototype” and more research is required to refine the approach, says Dr. Stuss. “Our study essentially lays the blueprint for developing a versatile program that can be adapted to different populations, such as adults with normal memory changes, or those with mild cognitive impairment (pre-Alzheimer’s state), traumatic brain injuries, or vascular cognitive impairment associated with stroke.”

He adds that it will be at least four to five years before such a cognitive rehabilitation program would be available to older adults through community clinics.

The study
Study participants ranged in age from 71 to 87 and underwent group training in three distinct modules – memory, goal management, and psychosocial function. Each module involved four weeks of training. In the memory skills training, participants were shown how to use internal and external strategies for learning, retaining and recovering information. Goal-management training emphasized the enhancement of attentional control to reduce everyday memory slips, monitor goal attainment, and simplify cognitively demanding real-life tasks. Psychosocial training was designed to enhance psychological wellbeing and build participants’ confidence in their cognitive abilities.

“We wanted to devise a cognitive rehabilitation program that would produce improvement over a relatively short period of time, so participants could build on that while they’re still functional and slow down the rate of decline,” explains Dr. Gordon Winocur, co-coordinator of the study and a senior scientist at Baycrest’s Rotman Research Institute. He is also a psychology professor at Trent University.

“If we can work with people in the early stages of cognitive decline, then we can slow down the rate of this decline and help them maintain a higher level of function for a longer period of time.”

Lead authors on the five papers include Drs. Donald Stuss, Gordon Winocur (two papers), Fergus Craik, and Brian Levine. The study was funded in large part by the American-based JSF McDonnell Foundation.

Baycrest is an internationally renowned academic health sciences centre affiliated with the University of Toronto. Baycrest provides a spectrum of health care services to older adults, and conducts basic and applied research with a strong focus on brain functioning and mental health.

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For more information on this press release, please contact:
Kelly Connelly
Senior Media Relations Officer
Baycrest Geriatric Health Care System
p.416.785.2432
kconnelly@baycrest.org

Feeling foggy and forgetful? Canadian scientists develop program to help older adults slow down normal deterioration of mental ability

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