OBJECTIVE: The aim of these secondary analyses was to examine cognitive speed of processing training (SPT) gains in cognitive and everyday functioning among older adults with psychometrically defined mild cognitive impairment (MCI). METHOD: A subgroup of participants from the Staying Keen in Later Life (SKILL) study with psychometrically defined MCI ( N = 49) were randomized to either the SPT intervention or an active control group of cognitive stimulation. Outcome measures included the Useful Field of View (UFOV), Road Sign Test, and Timed Instrumental Activities of Daily Living (IADL) Test. A 2 × 2 repeated-measures MANOVA revealed an overall effect of training, indicated by a significant group (SPT vs. control) by time (baseline vs. posttest) interaction. RESULTS: Effect sizes were large for improved UFOV, small for the Road Sign test, and medium for Timed IADL. DISCUSSION: Results indicate that further investigation of cognitive intervention strategies to improve everyday functioning in patients with MCI is warranted.

• MeSH
• činnosti denního života MeSH
• kognitivně behaviorální terapie metody   MeSH
• kognitivní dysfunkce terapie   MeSH
• lidé MeSH
• neuropsychologické testy MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH
• randomizované kontrolované studie MeSH
• Research Support, N.I.H., Extramural MeSH

BACKGROUND: The prevalence of dementia, the most expensive medical condition (Kirschstein, 2000 and Hurd et al., 2013 [1,2]), and its precursor, mild cognitive impairment (MCI) are increasing [3]. Finding effective intervention strategies to prevent or delay dementia is imperative to public health. Prior research provides compelling evidence that central auditory processing (CAP) deficits are a risk factor for dementia [4-6]. Grounded in the information degradation theory [7, 8], we hypothesize that improving brain function at early perceptual levels (i.e., CAP) may be optimal to attenuate cognitive and functional decline and potentially curb dementia prevalence. Piano training is one avenue to enhance cognition [9-13] by facilitating CAP at initial perceptual stages [14-18]. OBJECTIVES: The Keys To Staying Sharp study is a two arm, randomized clinical trial examining the efficacy of piano training relative to music listening instruction to improve CAP, cognition, and everyday function among older adults. In addition, the moderating effects of MCI status on piano training efficacy will be examined and potential mediators of intervention effects will be explored. HYPOTHESES: We hypothesize that piano training will improve CAP and cognitive performance, leading to functional improvements. We expect that enhanced CAP will mediate cognitive gains. We further hypothesize that cognitive gains will mediate functional improvements. METHOD: We plan to enroll 360 adults aged 60 years and older who will be randomized to piano training or an active control condition of music listening instruction and complete pre- and immediate post- assessments of CAP, cognition, and everyday function.

• MeSH
• činnosti denního života MeSH
• kognice MeSH
• kognitivní dysfunkce terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• muzikoterapie metody   MeSH
• neuropsychologické testy MeSH
• sebeuplatnění MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sluchová percepce MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH
• protokol klinické studie MeSH
• randomizované kontrolované studie MeSH
• Research Support, N.I.H., Extramural MeSH

INTRODUCTION: Recent research indicated that cognitive speed of processing training (SPT) improved Useful Field of View (UFOV) among individuals with Parkinson's disease (PD). The effects of SPT in PD have not been further examined. The objectives of the current study were to investigate use, maintenance and dose effects of SPT among individuals with PD. METHODS: Participants who were randomized to SPT or a delayed control group completed the UFOV at a six-month follow-up visit. Use of SPT was monitored across the six-month study period. Regression explored factors affecting SPT use. Mixed effect models were conducted to examine the durability of training gains among those randomized to SPT (n = 44), and training dose effects among the entire sample (n = 87). RESULTS: The majority of participants chose to continue to use SPT (52%). Those randomized to SPT maintained improvements in UFOV performance. A significant dose effect of SPT was evident such that more hours of training were associated with greater UFOV performance improvements. The cognitive benefits derived from SPT in PD may be maintained for up to three months. CONCLUSION: Future research should determine how long gains endure and explore if such training gains transfer.

• MeSH
• činnosti denního života psychologie   MeSH
• kognice * MeSH
• kognitivní poruchy komplikace   psychologie   terapie   MeSH
• lidé MeSH
• Parkinsonova nemoc komplikace   psychologie   terapie   MeSH
• praxe (psychologie) * MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Purpose of the Study: Hearing impairment (HI) is associated with driving safety (e.g., increased crashes and poor on-road driving performance). However, little is known about HI and driving mobility. This study examined the longitudinal association of audiometric hearing with older adults' driving mobility over 3 years. Design and Methods: Secondary data analyses were conducted of 500 individuals (63-90 years of age) from the Staying Keen in Later Life (SKILL) study. Hearing (pure tone average of 0.5, 1, and 2kHz) was assessed in the better hearing ear and categorized into normal hearing ≤25 dB hearing level (HL); mild HI 26-40 dB HL; or moderate and greater HI ≥41 dB HL. The Useful Field of View Test (UFOV) was used to estimate the risk for adverse driving events. Multivariate analysis of covariance compared driving mobility between HI levels across time, adjusting for age, sex, race, hypertension, and stroke. Adjusting for these same covariates, Cox regression analyses examined incidence of driving cessation by HI across 3 years. Results: Individuals with moderate or greater HI performed poorly on the UFOV, indicating increased risk for adverse driving events (p < .001). No significant differences were found among older adults with varying levels of HI for driving mobility (p values > .05), including driving cessation rates (p = .38), across time. Implications: Although prior research indicates older adults with HI may be at higher risk for crashes, they may not modify driving over time. Further exploration of this issue is required to optimize efforts to improve driving safety and mobility among older adults.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• nedoslýchavost epidemiologie   MeSH
• proporcionální rizikové modely MeSH
• řízení motorových vozidel statistika a číselné údaje   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• věkové faktory MeSH
• zdravotní stav MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

BACKGROUND: The etiology of Parkinson's disease (PD) remains unclear, and environmental risk-factors such as occupation have attracted interest. OBJECTIVE: The goal was to investigate occupational complexity in relation to PD. METHODS: We conducted a population-based cohort study based on the Swedish Twin Registry that included 28,778 twins born between 1886 and 1950. We identified 433 PD cases during the study period. Data on occupation were collected from either the 1970 or 1980 Swedish census, and occupational complexity was assessed via a job exposure matrix. Cox proportional hazard regression analyses with age as the underlying time scale were used to assess PD risk as a function of the three domains of occupational complexity: data, people, and things. Sex and smoking were included as covariates. Analyses stratified by twin pair were conducted to test for confounding by familial factors. RESULTS: High occupational complexity with data and people was associated with increased risk overall (Hazard Ratio [HR]  = 1.07, 95% confidence interval [CI] 1.02-1.14, and HR = 1.10, 95% CI 1.01-1.21, respectively), and in men (HR = 1.08, 95% CI 1.01-1.16, and HR = 1.15, 95% CI 1.03-1.28, respectively). Complexity with things was not associated with risk of PD. When the analyses were stratified by twin pair, the HRs for occupational complexity with data and people were attenuated in men. CONCLUSIONS: High complexity of work with data and people is related to increased risk of PD, particularly in men. The attenuation of risk observed in the twin pair-stratified analyses suggests that the association may partly be explained by familial factors, such as inherited traits contributing to occupational selection or other factors shared by twins.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• Parkinsonova nemoc epidemiologie   etiologie   MeSH
• pracovní expozice * MeSH
• registrace MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Švédsko MeSH