Title: Active aging: training to support cognitive functioning in the elderly

Authors: Rossana De Beni, Michela Zavagnin, Erika Borella

Year: 2020

Publisher: Erickson

Premise

Cognitive trainings are, by definition, cognitive enhancement interventions aimed at people of old age, with the aim of improving performance in everyday life. Given the growing aging of the population, publications in the specialist literature on this topic are constantly increasing (Hudes, Rich, Troyer et al. 2019).

In the Italian panorama, several books have been published aimed at operators to structure interventions of cognitive stimulation individual addressed to the elderly with subjective memory deficits (Andreani Dentici, Amoretti and Cavallini, 2004) or to the person with dementia (Bergamaschi, Iannizzi, Mondini, et al. 2007).

Description

As anticipated by the subtitle, it is a training developed for seniors with typical aging o Mild Cognitive Impairment (MCI), to be carried out in groups.


After an introductory part, which briefly explains what cognitive training consists of, it is illustrated how the three different types of training proposed in the volume are structured: metacognitive and strategic training and working memory training. There is also a fourth type that combines the previous ones (combined).

Let's see them briefly one by one.

It defines itself metacognitive that training that works on the beliefs associated with memory and self-monitoring skills. In a course of this type, participants are provided with information on physiological cognitive aging, memory systems and the interaction between cognitive and emotional processes. The goal is to increase self-reflection on the beliefs of each person underlying the functioning of memory and on the strategies automatically adopted to memorize the material, self-monitoring their effectiveness.

In a strategic training participants will be taught mnemonic strategies, that is techniques used more or less consciously to facilitate a deeper coding and a more prompt recall of the material to be memorized (Gross & Rebok, 2011). Usable strategies could be categorizing (serialization or categorization), associating with a mental image (imagery or visualization), or creating stories containing the target words. In most of the studies, several strategies are used jointly, assuming that training that combines several strategies may be more effective in everyday life (Gross, Parisi, Spira et al. 2012). Moreover, in clinical practice, the two interventions (metacognitive and strategic) are often used jointly.

Finally, in a working memory training participants are offered sequences of verbal (e.g. words) and visuospatial material (e.g. positions in a matrix), at predefined time intervals, to be updated in memory from moment to moment, subsequently requesting the recovery of coherent targets with the task requests (eg “what is the third to last word you heard?”). Usually this intervention is proposed in individual ways, but there are experiences (Borella, 2010) experienced in groups. In the training proposed in the volume, participants listen to a list of words and are asked to produce a certain response when they hear the name of a stimulus belonging to the target category (for example, animals). At the end of the presentation of the lists they must recall the target stimuli presented in the correct order.

Each training proposed in the volume includes 5 sessions. Each session is preceded by a short exercise mindfulness: in the intentions of the authors, this proposal could have positive effects on the concentration.

The volume also includes an online extension, with printable and cut-out cards, to build exercise books to be delivered to participants as homework between sessions.

Pro

  • It is the only book currently available in Italian to provide specific training for working memory with a target for the elderly.
  • The literature shows how the combination of strategic and metacognitive trainings is more effective than the use of single trainings: in this sense a combined training, such as the one proposed in the book, could be more useful than single trainings.

Cons

  • Each training is developed in only five sessions, a number that appears too small to expect clear effects with generalization in daily life.
  • Strategic training proposes lists of words and passages as materials. For greater usefulness in everyday life, it would probably be wise to propose ecological word lists (for example, a shopping list) and work on perspective memory. We know that difficulties in prospective memory are among the most common cognitive complaints in the normal elderly (Mc Daniel & Bugg, 2012). In fact, a good percentage of the information that everyone is called to memorize every day concerns this type of memory: it is therefore a very salient and impactful task in everyday life.

Conclusions

This new volume dedicated to cognitive stimulation "Active aging: training to support cognitive functioning in the elderly”Can be useful to the rehabilitator to structure a training focused on working memory and / or to increase the use of strategies to memorize information in everyday life. The training is reduced in the sessions (five per type) and in the type of exercises, but the proposed tasks can constitute a useful basis for structuring a broader training.

References

Andreani Dentici, O., Amoretti, G. & Cavallini, E. (2004). The memory of the elderly: a guide to keep it efficient. Erickson, Trento

Bergamaschi, S., Iannizzi, P., Mondini, S. & Mapelli, D. (2007). Dementia: 100 cognitive stimulation exercises. Raffaello Cortina Publisher, Milan.

Borella, E., Carretti, B., Riboldi, F. & De Beni, R. (2010). Working memory training in older adults: evidence of transfer and maintenance effects. Psychology and Aging, 25 (4), 767-778.

De Beni, R., Zavagnin, M. & Borella, E. (2020). Active aging: training to support cognitive functioning in the elderly. Erickson, Trento.

Gross, AL, Parisi, J., M., Spira, AP, Kueoder, A., Ko, JY, Saczynski, JS et al (2012). Memory training for older adults: a meta-analysis. Aging and Mental Health, 16 (6), 722-734.

Gross & Rebok (2011). Memory training and strategy use in older adults: results from ACTIVE study. Psychology and Aging, 26 (3), 503-517.

Hudes, R., Rich, JB, Troyer, AK, Yusupov, I. & Vandermorris, S. (2019). The impact of memory-strategy training interventions on participant-reported outcomes in healthy older adults: a systematic review and meta-analysis. Psychology and Aging, 34 (4), 587 - 597.

Mc Daniel, MA & Bugg, JM (2012) Memory training interventions: what has been forgotten ?. Journal of Applied Research in Memory and Cognition, 1 (1), 58-60.

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