The goal of the project presented in this study is to provide a rehabilitation system which is game based in a home environment for elderly people in order to reduce the cognitive decline and halting the progression of memory deficit problems. Recently it has been discovered that cognitive training can initiate brain flexibility and strengthen the neuromodulatory system which controls learning. At the same time we need to consider that elderly people may become stressed while using any type of technology, let alone a video game. That said, another main goal of the project is to reduce the stress level of the player while interacting with the game. The results showed that the stress reducing features used in this study was mostly effective but one of the main problems was most of the participants not having much experience with using a computer which made them more stressed.

There is an established link between exercise, neurogenesis, and memory. Most of this research has been focused on rodent models, with little known about the effects of exercise on cognition in young adults. In rodents, exercise promotes hippocampal neurogenesis by enhancing cell proliferation in the dentate gyrus, while cognitive training promotes hippocampal neurogenesis by enhancing cell survival. Both physical exercise and cognitive training independently induce hippocampal neurogenesis in rodents, suggesting that these different forms of training may work through complimentary neurological pathways to benefit hippocampal memory in young adults. The present study examined the effects of six weeks of physical exercise and cognitive training on hippocampal-mediated memory processes in young adults to determine whether combined training yields enhanced memory benefits. Sixty-six sedentary young adults (32 females; age range 17-30 years) were randomly assigned to one of four groups: 1) Exercise training group (n=15), 2) Cognitive training group (n=16), 3) Combined exercise and cognitive training group (n=18), or 4) No-contact control group (n=17). Memory performance was assessed before and after the intervention on a putative hippocampal neurogenesis-dependent task, the Pattern Separation task. Growth factors that support neuron survival and function, brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1) were measured in blood serum using enzyme-linked immunosorbent assays (ELISA). Based on the literature, the combination of exercise and cognitive training was expected to improve pattern separation performance more than the exercise or cognitive training alone, and display augmented effects for high responders to the exercise training. Additionally, if BDNF and IGF-1 were found to be involved in the mechanisms regulating the observed changes in memory, they too were expected to increase the most from the combined training and be dependent on individual changes in aerobic fitness. Critically, the combination of exercise and cognitive training led to the greatest increase in memory requiring pattern separation [t(16) = 2.91, p < 0.01] , indicating improved hippocampal-mediated memory function. BDNF and IGF-1 were not associated with this change in memory performance but were associated with the individual’s response to the exercise training, such that high responders to exercise had greater BDNF [F(1, 29) = 7.81, p < 0.01] and IGF-1 [F(1, 29) = 5.09, p < 0.05] than low responders to exercise. The results suggest that exercise and cognitive training may work through synergistic mechanisms to enhance hippocampal neurogenesis and support pattern separation processing. However, BDNF and IGF-1 may not be mediating this change in memory function. / Thesis / Master of Science (MSc)

Computerized cognitive training is recognized as an appropriate tool in enhancing working memory in individuals with and without physical limitations. Previous researchers have examined the application of computerized cognitive training in stroke patients, children suffering from ADHD, and older adults. Presently, there is a lack of controlled studies regarding computerized cognitive training in low-achieving primary school students. The goal of this study was to examine the interactions among working memory, computerized cognitive training and academic achievement. Specifically, the study sought to determine whether low-achieving primary school students would significantly improve their mathematics achievement (as measured by the Grade Four Literacy Test) and working memory capacity (as measured by the Automated Working Memory Assessment) through computerized cognitive training on working memory. A random pre-test post-test control-group experimental study was conducted to test the research hypotheses. The experimental group received progressive computerized working memory training. The control group received basic computerized working memory training. Training for both groups of student was conducted the same time each day by the class teacher at the participants' school. The duration for practice was one hour per day, five days per week for five weeks. The working memory capacity of the experimental group was compared to the control group. Both experimental and control groups subjects showed improvements in working memory scores from the baseline pre-test to the post-test. Analysis of the multivariate tests suggests that there was significant difference (Wilks Lambda F = 2.880, p = .045) between the group receiving progressive computerized working memory training compared to the group receiving basic computerized working memory training. The mathematics achievement of the experimental group was compared to the control group immediately after completing training. Both the experimental and control group students showed improvement in post training mathematics scores. However, the difference between control and experimental group improvement was not significant (F = 2.719, p = .085). The end-of-term mathematics (six weeks after completing training) scores of the experimental group was compared to the control group. Both the experimental and control group students showed improvement in their end-of-term mathematics scores. However, the difference between control and experimental group improvement was not significant (F = 2.719, p = .085).

The thesis explores the influence of cognitive training carried out in a second language on the elderly suffering from dementia. Having described the basic anatomy of the nervous system, neurolinguistic theories as well as ageing and having dealt with cognitive aspects in relation to language learning, the thesis aims at performing an experiment that should help dementia clients to broaden their vocabulary in a second language. This is to be achieved through individual therapy- like units using worksheets created specifically for these purposes. The results indicate that cognitive training in a second language is beneficial to dementia clients and could be used more extensively. Key words ageing, dementia, language, cognitive training, neurolinguistics

No description available.

Thesis advisor: Barbara E. Wolfe / Postoperative cognitive dysfunction (POCD) is characterized by a decline in cognitive performance following anesthesia and surgery and is a major cause of morbidity and mortality in the postoperative period. Moreover, studies suggest that patients who develop POCD may be at higher risk for cognitive decline later in life. POCD is of critical importance in relation to independent living, need for care, personal and economic cost, and quality of life. The majority of studies to date examine risk factors, prevalence, and complications associated with POCD. There is a lack of effective intervention strategies being developed to promote improved cognitive processing in this patient population. The primary aim of this study was to examine the feasibility and acceptability of a cognitive training intervention (CTI) for postoperative cardiac surgical patient. Feasibility was examined by conducting an attrition analysis to compare percent of attrition between intervention and control groups. A chi-square was conducted to answer the research question examining the difference between groups on attrition from study. Acceptability was examined by the administration of a "feasibility and acceptability" questionnaire, which was a 15-item questionnaire specific to the intervention. Fifteen one-sample t tests were used to determine acceptability of the intervention in the treatment population. The secondary purpose of the study was to investigate the preliminary effect of the CTI on cognitive outcomes following cardiac surgery. A randomized controlled, single-blind, repeated measures design was used to test the hypothesis that following cardiac surgery, patients who receive a 6-week CTI when compared with those who receive usual care will demonstrate a significantly greater improvement in cognitive status when comparing discharge scores to scores at 6 weeks and 3 months postoperatively. Collection of data from 53 patients who underwent cardiac surgery was conducted from May 2008 to January 2010 at Catholic Medical Center in Manchester, NH. Factorial Analyses of Variance were conducted to answer the research question assessing the effectiveness of a cognitive training intervention (CTI) on cognitive outcomes following cardiac surgery. However given assumptions of ANOVA were violated and non parametric statistics including two Kruskall Wallis H tests for independent samples at each assessment period as well as two Wilcoxon's signed ranks tests for related samples for each group were conducted. The results of the chi-square were not significant, x2(1) = 0.95, p = .329, suggesting no relationship exists between withdrawn participants and group. After Bonferroni adjustment the results of the fifteen one-sample t tests on the feasibility questionnaire (Q1-Q15) for the intervention group reveal questions 2-8, 10, 14 and 15 have a larger mean compared to the neutral median value of 3.0, suggesting that participants tended toward a high level of acceptability over neutrality. Wilcoxon signed rank test on TICS scores by control group and time period (posttest vs. six week follow up and posttest vs. three month follow up) revealed a significant main effect by time period, p< .01 at both time periods. Wilcoxon signed rank test on TICS scores by experimental group and time period (posttest vs. six week follow up and posttest vs. three month follow up) revealed a significant main effect by time period, p< .01 at both time periods. Kruskall Wallis test at six week follow up and three month follow up by group (control vs. experimental) was not significant, x2 (1) = 0.01, p = .934, and x2 (1) = 0.02, p = .891 respectively suggesting no statistical difference at six week follow up by group. The Wilcoxon signed rank on TICS by group and time period (six week follow up vs. 3 month follow up) was not significant (p=.274) and the Kruskall Wallis test at three month follow up by group (control vs. experimental) was not significant, x2 (1) = 0.02, p = .891, suggesting no statistical difference at three month follow up by group. The results of this study suggest that a CTI is feasible to conduct and acceptable to patients following cardiac surgery. Results of the preliminary effect of the CTI suggest that cognitive performance improves over a six-week period following cardiac surgery independent of the CTI and there are no significant changes from the six-week to the three-month period. Preliminary findings yield further inquiry into cognitive enhancing interventions in the cardiac surgical patient. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

The goal of this study is to assess the far-transfer effects of strategy-based working memory (WM) training to a novel problem solving task. Far-transfer refers to the application of trained skills to an untrained situation and is especially important because it deals with the generalization of learning to novel contexts. However, previous working memory training studies have produced little evidence for far-transfer. In the current study, children were trained in two strategies, phonological rehearsal and semantic categorization. These strategies have been suggested to increase the efficiency in processing and encoding of information and are invoked to explain developmental increases in WM capacity. Sixteen 6-to 9-year-olds were randomly assigned to each of four training conditions: semantic and rehearsal training, semantic training only, rehearsal training only, and treated control group. The treated control group performed significantly worse on the problem solving task compared to the three training groups. Surprisingly, the treatment groups did not differ significantly from each other. There was no statistically significant difference in receiving combined training of both strategies compared to only one strategy and furthermore, neither strategy resulted in better performance compared to the other strategy. Future directions for WM training and the implications for cognitive interventions are discussed. / Graduate / 0620 / 0633 / sharonc@uvic.ca

Background Some degree of cognitive decline is a normal, non-clinical part of aging. Physical exercise has been suggested as one strategy which may improve cognition in nondemented older adults. The findings of randomised, controlled trials conducted since the 1980s have been promising, but not unequivocal, and much remains to be understood about the relationship between exercise and cognition in older adults. There have also been suggestions that combining exercise and cognitive training may be beneficial. There has, however, been only one reported study comparing the benefits of exercise training, and combined exercise and cognitive training (Fabre, Chamari, Mucci, Masse-Biron, & Prefaut, 2002). While combined training was reported to be even more effective than exercise training alone for improving cognition in older adults, the study had some substantial limitations. Aims The overall aims of this thesis were to further explore the effect of exercise training on cognition in older adults, and to compare exercise training alone with combined exercise and cognitive training. Following a narrative review of the relevant literature, this thesis is presented in two parts. In Part One a randomized, controlled trial comparing the impact of exercise training, and combined exercise and cognitive training, on the cognitive functioning, physical functioning, functional performance, and psychological well-being of communitydwelling older adults is presented. For Part One, there were three specific aims: (1) To assess the efficacy of a 16 week exercise program (relative to control), on measures of cognitive functioning, physical functioning, functional performance, and psychological well-being; (2) To compare the efficacy of the 16 week exercise program with that of a 16 week combined exercise and cognitive training program; and (3) To identify the physical, psychological and training factors associated with changes in cognitive and physical functioning from baseline to post-test. In Part Two a qualitative evaluation of older adults’ experiences and perceptions of exercise training, and combined exercise and cognitive training, is presented. Methods Thirty-nine community dwelling, older adults (aged between 60 and 80 years) were randomly allocated to one of three groups: Exercise, Combination or Control. Participants in the Exercise group attended three aerobic and strength training sessions per week for 16 weeks. Participants in the Combination group attended two aerobic and strength training sessions, and one cognitive training session, per week for 16 weeks. Participants in the Control group were contacted every four weeks. Assessments were conducted at baseline, post-test (16 weeks) and six-month follow-up (40 weeks). Measures of physical function, cognitive function, functional performance, and psychological wellbeing were collected, along with anthropometric and physiological measures. For the qualitative evaluation, participants from the Exercise and Combination groups provided written feedback to questions about their experiences of the two training programs and their perceptions of the outcomes. These qualitative data were collected after post-test. Results Significant within-group improvements in physical and cognitive function, from baseline to post-test, were seen in Exercise and Combination participants. Combination participants also showed significant within-group reductions in symptoms of anxiety and depression. There were, however, only a few significant between-group differences among Exercise and Control participants, and among Exercise and Combination participants. There were no significant within-group improvements in functional performance, from baseline to post-test, among Exercise or Combination participants. Six-month follow-up data were difficult to interpret, due to the paucity of between-group differences at post-test and the small sample size. There were several significant associations between physical, psychological and training factors, and changes in cognitive and physical functioning. The most pertinent finding was that baseline functioning was consistently associated with change, such that participants with low baseline scores were most likely to improve from baseline to posttest. In the qualitative evaluation participants reported positive experiences of the training programs and reported improvements in physical, cognitive, functional and psychological wellbeing. Participants also highlighted components of the programs which require improvement and made recommendations for future programs. Conclusions The results of this thesis provide some cautious support for the notion that exercise, and combined exercise and cognitive training, may result in small improvements in cognition, physical functioning, and psychological well-being in older adults. Some of the findings must be interpreted with caution, however, given the small sample size. More research is required into the functional (or ‘real world’) impact of this type of training, the long-term effects of training, and the factors associated with changes in cognitive and physical function. Based on these findings, recommendations for the development and implementation of future research were made. As the population ages and the public health burden attributable to aging increases, research into the development and efficacy of programs to enhance well-being and independence in older adults is of great importance.

Abstract By 2020 the World Health Organisation has predicted that depression will be the largest cause of disease burden in the world (Ellen, 2002). This study investigated the effects of three interventions (Explanatory Style, Conflict Resolution, and Exercise) on the level of well-being of adolescents from the middle years of schooling. The research consisted of three studies. Study 1 involved the design of a Student Perception Questionnaire. The 28¬–item Student Perception Questionnaire was created to measure the outcomes of the three interventions and was trialled on 215 Middle School students. A Principal Components analysis with Varimax rotation was performed on the data retrieved from the respondents, and all items were retained on the questionnaire, although four factors did not show a .30 loading. Study 2, a Pilot Study, was conducted with three students to trial the interventions and measures in preparation for the final study. It included the collection of qualitative and quantitative data. The qualitative data was gained from interviews held with the students, parents, and teachers. Study 2 revealed that the interventions and the measures used to determine the effectiveness of the interventions would be suitable for Study 3. Study 3 was the full intervention that involved 25 students in an intervention group and six students in a no-intervention group. The 25 students were allocated to six groups that were engaged in a counterbalanced design study using the Explanatory Style, Conflict Resolution, and Exercise interventions. The group of six students was used as a comparison group. The results showed that students in the intervention group experienced a reduction of internalising behaviours such as withdrawal and depressive symptoms following all three interventions. The program as a whole was successful in reducing depressive symptoms and the interventions individually also significantly reduced depressive symptoms. The intervention group developed more optimistic thinking styles following the explanatory style intervention. Analysis of parent data revealed that parents of the intervention group were experiencing significant feelings of incompetence and guilt towards themselves as parents. In the members of the no-intervention group, having good social skills and a strong support network of friends and family were protective factors against depressive symptoms. The thesis showed that interventions can be used with adolescents that are effective in reducing depressive symptoms and do not have negative side effects, such as those associated with medications.

Abstract By 2020 the World Health Organisation has predicted that depression will be the largest cause of disease burden in the world (Ellen, 2002). This study investigated the effects of three interventions (Explanatory Style, Conflict Resolution, and Exercise) on the level of well-being of adolescents from the middle years of schooling. The research consisted of three studies. Study 1 involved the design of a Student Perception Questionnaire. The 28¬–item Student Perception Questionnaire was created to measure the outcomes of the three interventions and was trialled on 215 Middle School students. A Principal Components analysis with Varimax rotation was performed on the data retrieved from the respondents, and all items were retained on the questionnaire, although four factors did not show a .30 loading. Study 2, a Pilot Study, was conducted with three students to trial the interventions and measures in preparation for the final study. It included the collection of qualitative and quantitative data. The qualitative data was gained from interviews held with the students, parents, and teachers. Study 2 revealed that the interventions and the measures used to determine the effectiveness of the interventions would be suitable for Study 3. Study 3 was the full intervention that involved 25 students in an intervention group and six students in a no-intervention group. The 25 students were allocated to six groups that were engaged in a counterbalanced design study using the Explanatory Style, Conflict Resolution, and Exercise interventions. The group of six students was used as a comparison group. The results showed that students in the intervention group experienced a reduction of internalising behaviours such as withdrawal and depressive symptoms following all three interventions. The program as a whole was successful in reducing depressive symptoms and the interventions individually also significantly reduced depressive symptoms. The intervention group developed more optimistic thinking styles following the explanatory style intervention. Analysis of parent data revealed that parents of the intervention group were experiencing significant feelings of incompetence and guilt towards themselves as parents. In the members of the no-intervention group, having good social skills and a strong support network of friends and family were protective factors against depressive symptoms. The thesis showed that interventions can be used with adolescents that are effective in reducing depressive symptoms and do not have negative side effects, such as those associated with medications.