TY - JOUR
T1 - Protocols for cognitive enhancement. A user manual for Brain Health Services—part 5 of 6
AU - Brioschi Guevara, Andrea
AU - Bieler, Melanie
AU - Altomare, Daniele
AU - Berthier, Marcelo
AU - Csajka, Chantal
AU - Dautricourt, Sophie
AU - Démonet, Jean-François
AU - Dodich, Alessandra
AU - Frisoni, Giovanni B.
AU - Miniussi, Carlo
AU - Molinuevo, José Luis
AU - Ribaldi, Federica
AU - Scheltens, Philip
AU - Chételat, Gael
N1 - Funding Information: GBF received funding by: the EU-EFPIA Innovative Medicines Initiatives 2 Joint Undertaking (IMI 2 JU) “European Prevention of Alzheimer’s Dementia consortium” (EPAD, grant agreement number: 115736) and “Amyloid Imaging to Prevent Alzheimer’s Disease” (AMYPAD, grant agreement number: 115952); the Swiss National Science Foundation: “Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): correlation with clinical features and in vivo neuropathology” (grant number: 320030_182772). Funding Information: European Task Force for Brain Health Services (in alphabetical order): Marc ABRAMOWICZ, Daniele ALTOMARE, Frederik BARKHOF, Marcelo BERTHIER, Melanie BIELER, Kaj BLENNOW, Carol BRAYNE, Andrea BRIOSCHI GUEVARA, Emmanuel CARRERA, Gael CH?TELAT, Chantal CSAJKA, Jean-Fran?ois DEMONET, Alessandra DODICH, Bruno DUBOIS, Giovanni B. FRISONI, Valentina GARIBOTTO, Jean GEORGES, Samia HURST, Frank JESSEN, Miia KIVIPELTO, David LLEWELLYN, Laura McWHIRTER, Richard MILNE, Carolina MINGUILL?N, Carlo MINIUSSI, Jos? Luis MOLINUEVO, Peter M NILSSON, Janice RANSON, Federica RIBALDI, Craig RITCHIE, Philip SCHELTENS, Alina SOLOMON, Cornelia VAN DUIJN, Wiesje VAN DER FLIER, Bruno VELLAS, Leonie VISSER. Funding Information: GBF reports grants from Alzheimer Forum Suisse, Académie Suisse des Sciences Médicales, Avid Radiopharmaceuticals, Biogen, GE International, Guerbert, Association Suisse pour la Recherche sur l’Alzheimer, IXICO, Merz Pharma, Nestlé, Novartis, Piramal, Roche, Siemens, Teva Pharmaceutical Industries, Vifor Pharma, and Alzheimer’s Association; he has received personal fees from AstraZeneca, Avid Radiopharmaceuticals, Elan Pharmaceuticals, GE International, Lundbeck, Pfizer, and TauRx Therapeutics. Funding Information: This paper was the product of a workshop funded by the Swiss National Science Foundation entitled “Dementia Prevention Services” (grant number: IZSEZ0_193593). Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques. We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence. CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory. We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs (“smart drugs”, acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment. Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.
AB - Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques. We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence. CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory. We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs (“smart drugs”, acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment. Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.
KW - Brain Health Service
KW - Cognitive enhancement
KW - Cognitive intervention
KW - Drugs
KW - Mindfulness meditation
KW - Non-invasive brain stimulation
KW - Physical training
KW - Subjective cognitive decline
UR - http://www.scopus.com/inward/record.url?scp=85116870228&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s13195-021-00844-1
DO - https://doi.org/10.1186/s13195-021-00844-1
M3 - Review article
C2 - 34635149
SN - 1758-9193
VL - 13
JO - Alzheimer's Research and Therapy
JF - Alzheimer's Research and Therapy
IS - 1
M1 - 172
ER -