None listed
Conditions
Brief summary
Aging slows down our mental abilities. However, some older adults may experience greater decline in their mental abilities than their peers. The study investigates how much age affects older people’s ability to pay attention and remember things. Attention is a core mental ability needed for other mental work and daily functioning. Most studies to date have shown problems with memory in older adults. Few studies have looked at whether a decline in attention affects other mental abilities in older adults. Attention training is not a common therapy for older adults with difficulties in attention and memory. There is also limited information on the effect of such training on older adults. Understanding the usefulness of attention training in older people may help in deciding whether it should be used as a regular form of therapy. 67 older adults aged between 60 and 80 years took part in this study. 63 of the 67 participants were healthy older adults residing in the community and the rest 4 had a diagnosis of Mild Cognitive Impairment (MCI) given by the Memory Clinic, Toowoomba Hospital and/or referred by geriatricians in their private practice. The healthy older adults group were further assigned to two groups. 34 participants received the Attention Training program and 29 participants received the Relaxation training program. Each group of participants received the weekly group training in smaller groups of maximum 8 participants at a time. Interested control group participants were offered the Attention Training program (same training for 10 weeks - 2 hours weekly) after they received their Relaxation Training and have had a minimum wash out period of 2 weeks in between the 2 trainings. The 4 participants with MCI received only the Attention Training program (10 sessions for 2 hours weekly). Pre-post evaluation of data will be completed.
Interventions
This study has a mixed design.
1. A quasi-experimental design (which is an empirical interventional study used to estimate the causal impact of an intervention on target population without random assignment) for data collected pre and post intervention training offered to the sample of participants with Mild Cognitive Impairment (MCI- Group 1).
2. Randomized control trial with data collected pre and post trainings offered to both the treatment and control groups of the sample of healthy olde
This study has a mixed design. 1. A quasi-experimental design (which is an empirical interventional study used to estimate the causal impact of an intervention on target population without random assignment) for data collected pre and post intervention training offered to the sample of participants with Mild Cognitive Impairment (MCI- Group 1). 2. Randomized control trial with data collected pre and post trainings offered to both the treatment and control groups of the sample of healthy older adults (Group 2). For Group 1, participants with a new diagnosis of Mild Cognitive Impairment (MCI) recruited from the Memory Clinic, GARSS, Toowoomba Hospital, and from Geriatricians in their private practises as well as General Practitioners from the community will be recruited. All participants will be aged between 60-80 years. Participants from the community (MCI and Healthy Older Adult participants) will have their assessments and training at the University of Southern Queensland and participants from the Memory Clinic will have their assessments and training at the Toowoomba Hospital. After consent interviews and eligibility assessment with the aid of the Repeatable Battery for the Assessment of Neuropsychological Status- RBANS Update (Form A), the participants will be administered the additional pre-training measure - Test of Everyday Attention (TEA). Eligible participants’ RBANS Update A scores will be included as a pre-training measure. After completion of the pre-training assessments, eligible participants of Group 1 (people with MCI) will be offered the intervention training (Attention Training) individually or in groups of 2-3 participants maximum depending on the number of participants recruited. On the other hand, after completion of pre-training assessments, participants of Group 2 (healthy older adult participants) will be randomly assigned to either the Attention Training group or the Relaxation Training group using a computer-generated randomization numbers available at random.org, with each group receiving equal number of participants (Haahr, M., 1999 and Snippe, et al., 2016). For the healthy older adult population (Group 2), all training programs will be offered in groups of maximum 8 participants. Participants in the treatment groups (both healthy older adults and people with MCI groups) will receive 10 weeks, 2 hrs per week session of structured Attention Training program. Each treatment session will consist of: psychoeducation, an individual attention training task, a group attention training task- both of which primarily targets one or more aspects of attention namely selective, sustained and alternating attention but not divided attention, followed by discussion and feedback. The group facilitator (Principal Researcher) will keep a record of the individual participants’ performance on each individual task completed for the entire 10 weeks program. Participants of the control group of Group 2 (only healthy older adults) will be offered group Relaxation training (10 sessions each 2 hourly) in groups of maximum 8 participants. This comparison group will allow us to understand whether the attention training tasks help improve attention abilities of the treatment groups but not the control groups, keeping other factors constant. After completion of the group or individual training programs (Attention training program for the treatment groups and Relaxation Training program for the control groups), each participant will be re-administered the alternate form of the TEA and the RBANS- Update Form B. Following completion of the relaxation training program, interested healthy older participants will be offered the same 'Attention Training' intervention (10 weekly sessions x 2 hrs each) in groups of 8 participants maximum, after a minimum of 2 weeks washout period. Control group participants for the healthy older adults population (Group 2) who choose to participate in the crossover study will have post outcome assessments taken twice: firstly after completion of the relaxation training (control group) and secondly after completion of the cross over training (Attention Training) thereafter. The same assessment tools (RBANS and TEA) with alternate forms will be used for this purpose.
Sponsors
Mousumi Singh
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
60 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Group 1: Participants will be recruited from the Memory Clinic, Geriatric Adult Rehabilitation and Stroke Services, GARSS, Toowoomba Hospital, from Geriatricians in their private practise as well as General Practitioners (GPs) from the community. All participants will have a confirmed diagnosis of MCI. MCI status need to be recent within 3 months of recruitment to this study. The MCI status in GARSS is determined by the consultant geriatrician after the patient goes through a thorough clinical assessment by the Memory Clinic team formed of the consultant geriatrician, psychologist, pharmacist and the geriatric clinical nurse consultant. Additional to their MCI status, all MCI participants, within 3 months of recruitment to this study, will be screened by the research assistant for their eligibility by using RBANS (Update form A). Their RBANS score should be between 1 and 2 SD below the mean or between 3rd and 16 percentiles for their age and education matched peers on culturally appropriate normative data (American Psychiatric Association, 2013). Cognitive impairment maybe seen in one or more cognitive domains measured by the RBANS. However, participants will be independent with all their activities of daily living as reported by them, significant others or their GP. Participants of this group will be assessed with the RBANS at regular intervals of 3 months during their participation period, to ensure that they continue to hold their eligibility status. Age of the sample population was determined to be between 60-80 years. Group 2: Healthy Older Adults (without MCI diagnosis): Participants will be recruited from the community and should be aged between 60 years and 80 years, do not hold a diagnosis of Mild Cognitive Impairment (MCI) and/or Dementia in the last 3 months prior to recruitment. Their general cognition as measured by the total RBANS score should be at least equal or above the mean, for their age and education matched peers on culturally appropriate normative data (APA, 2013). If they qualify for this study, this RBANS measure obtained will be used as one of the primary outcome measure administered before delivering intervention. No reports of functional or cognitive decline as noted by client, significant other or GP. Participants will be re-assessed of their eligibility status by using RBANS, if they or their significant other or their GP report any rapid cognitive decline, during their participation period. For both groups 1 and 2 other inclusion criteria include -age of the sample population, which is between 60-80 years and participants must be able to read and write..
Exclusion criteria
Exclusion criteria: Exclusion criteria for participants of Group 1 (participants with a MCI status)- exclusion will be if these participants have a current diagnosis of Dementia or they progress to having Dementia while they are a participant in this study. Exclusion criteria for Group 2 (healthy older adults)- exclusion criteria will be if they have a diagnosis of MCI or Dementia or they progress to having MCI or Dementia during the course of their participation in this study. Other exclusion criteria for both MCI and Healthy older adults groups include severe sensory impairment that could potentially impact on their performance, acute medical condition or a severe medical condition needing intensive treatment, and intellectual impairment. These people are excluded as such conditions will hinder their ability to participate in the interventions.
Outcome results
None listed