SM Hadi Hosseini, Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd, Stanford, CA 94305-5795, USA, Tel: (650) 723-5798, Email:
J Prev Alzheimers Dis. 2021;8(1):100-109. doi: 10.14283/jpad.2020.55.
Findings that the brain is capable of plasticity up until old age have led to interest in the use of cognitive training as a potential intervention to delay the onset of dementia. However, individuals participating in training regimens differ greatly with respect to their outcomes, demonstrating the importance of considering individual differences, in particular age and baseline performance in a cognitive domain, when evaluating the effectiveness of cognitive training. In this review, we summarize existing literature on cognitive training in adults across the domains of episodic memory, working memory and the task-switching component of executive functioning to clarify the picture on the impact of age and baseline performance on cognitive training-related improvements. Studies targeting episodic memory induced greater improvements in younger adults with more intact cognitive abilities, explained in part by factors specific to episodic memory training. By contrast, older, lower baseline performance adults improved most in several studies targeting working memory in older individuals as well as in the majority of studies targeting executive functioning, suggesting the preservation of neural plasticity in these domains until very old age. Our findings can have important implications for informing the design of future interventions for enhancing cognitive functions in individuals at the prodromal stage of Alzheimer's Disease and potentially delaying the clinical onset of Alzheimer's Disease. Future research should more clearly stratify individuals according to their baseline cognitive abilities and assign specialized, skill-specific cognitive training regimens in order to directly answer the question of how individual differences impact training effectiveness.
大脑具有可塑性，这种发现一直持续到老年，这使得人们对认知训练作为一种潜在的干预手段以延缓痴呆症的发生产生了兴趣。然而，参加训练的个体在结果上存在很大差异，这表明在评估认知训练的有效性时，考虑个体差异，特别是年龄和认知域的基线表现非常重要。在这篇综述中，我们总结了在记忆、工作记忆和执行功能的任务转换成分等认知域中针对成年人的认知训练的现有文献，以阐明年龄和基线表现对认知训练相关改善的影响。针对情景记忆的研究在认知能力较为健全的年轻成年人中引起了更大的改善，这部分可以用情景记忆训练的特定因素来解释。相比之下，在针对老年人的工作记忆的多项研究中，以及在针对执行功能的大多数研究中，基线表现较低的老年成年人的改善最大，这表明在这些领域中，神经可塑性一直保持到非常高龄。我们的发现对设计未来干预措施以增强处于阿尔茨海默病前驱阶段的个体的认知功能以及潜在地延迟阿尔茨海默病的临床发病具有重要意义。未来的研究应该根据个体的基线认知能力更清楚地对个体进行分层，并分配专门的、特定技能的认知训练方案，以直接回答个体差异如何影响训练效果的问题。
