Older people may be able to boost their working memory with a new approach that couples online therapeutic games with a non-invasive brain stimulation technique. The results of a joint Italian-Canadian-British study were published today in Frontiers in Aging Neuroscience. Sara Assecondi, a biomedical engineer of CIMeC at UniTrento, is the first author of the work
Working memory is volatile, but is critical for people to function well in everyday life as it enables them to interact with their environment in an effective and efficient manner. This form of memory holds and manipulates a finite amount of information over a short time interval. It typically declines with age, with the decline in its capacity causing daily difficulties in people with Parkinson’s disease, dementia, and stroke.
A research team made up of scientists and clinicians from the University of Trento, the University of Birmingham, UK, and Dalhousie University in Nova Scotia, Canada, have devised a new technology to mitigate this decline. The researchers refer to it as “cognitive needs and skills training” in the study that was published today in Frontiers in Ageing Neuroscience, in which they demonstrate it can provide particular benefit to older people who have low working memory capacity (WMC).
The online therapeutic exercises developed to improve working memory, attention and vigilance, are packaged in the type of engaging interface that will be familiar to online game or app users. Brain stimulation is administered via a mobile wireless device that delivers a small (2 milliAmpère) transcranial direct current stimulation (tDCS) during training.
The study involved healthy individuals aged 55 to 76 years old, who were split into two groups. Both groups did the online games for 20 minutes a day, over a five-day period. While one group also received tDCS, the other group wore the tDCS device, which resembles a swimming cap, but did not receive tDCS.
The researchers measured baseline working memory capacity (WMC) before the study, and two days after completion. They found that WMC improved significantly in all participants, regardless of age or whether they received tDCS.
The combination of training games and tDCS showed particular benefit in older people with lower initial working memory. This subset included people aged 69.5 to 76 years. The advantage was evident from the first day of training and became statistically significant by the end of training.
“Approaches used for hospital rehabilitation are difficult to translate to the home setting”, explained Sara Assecondi, a biomedical engineer, formerly at the University of Birmingham but now at the Centre for Mind/Brain Sciences-CIMeC of UniTrento. “But our approach uses online tools, and delivers brain stimulation via a device that can be used anywhere, with the dose determined remotely by the physician”.
The researchers have already shown in a previous study that coupling tDCS with strategy on how to do tasks requiring working memory can help young people with low WMC improve their performance, by helping them put in place strategies that they would not otherwise be able to come up with. “The effects seen in both studies were strong”, Assecondi added, “with the first study indicating that the combination of stimulation and strategy instruction can improve WM performance in younger adults, and the second study showing that strategy use may be facilitated by stimulation in older participants.”
Another co-author of the study is cognitive neuroscientist Kim Shapiro, Professor of the Birmingham’s School of Psychology and the Centre for Human Brain Health, whose research focuses on attention and memory. “Although cognitive decline in the elderly is an inevitability, approaches such as this one, in combination with regular physical exercise, can stem this decline and provide individuals with a higher quality of life”.
The online therapeutic games were developed by Gail Eskes, a neuropsychologist and professor from Dalhousie University, whose clinical practice focuses on training to improve and repair cognitive function. Professor Eskes’ clinical research, which focuses on training to improve and repair cognitive functions, helped design the brain exercises. “Intensive exercises at just the right difficulty are important for increasing brain capacity or efficiency. And the game-like aspects increase motivation and make it easier to stick with the challenging sessions.”
The researchers are now working with technology transfer offices from the University of Birmingham and Dalhousie University, that are seeking commercial partners wishing to collaborate in developing technology using this approach and to take it to market. The researchers are planning further studies to examine other means of brain stimulation that may be even more effective. In particular, they are currently concluding a study evaluating the benefits of their approach in post-stroke patients.