Use of computerized tests to assess the cognitive impact of interventions in the elderly

Oliveira, Rafaela Sanches de; Trezza, Beatriz Maria; Busse, Alexandre Leopold; Jacob Filho, Wilson

doi:10.1590/S1980-57642014DN82000004

ABSTRACT

With the aging of the population, the possibility of the occurrence of cognitive decline rises. A number of types of intervention seek to attenuate or reverse this impairment. The use of computerized tests helps quantify the effects of interventions on cognitive function in the elderly. The objective of the present review was to analyze studies that have utilized computerized cognitive tests to determine the effects of interventions in the elderly population, describing the batteries and tests employed, the populations studied and reports by authors on the limitations or benefits of employing these tests in older adults. The review was performed on the PubMed database using the descriptors: cognitive computerized test and elderly. We retrieved 530 studies and, following analysis of their abstracts, selected 32 relevant to the subject. The studies utilized 19 different types of computerized tests and batteries to assess the interventions, which were predominantly drug trials. There were no reports on limitations in the use of the computerized tests, suggesting this type of intervention had good applicability, sensitivity, and little or no practice effects in this population.

Key words: elderly; neuropsychological tests; diagnosis by computer; intervention studies

RESUMO

Com o envelhecimento da população aumenta a possibilidade de ocorrência de um declínio cognitivo. Diversas formas de intervenção buscam amenizar ou reverter este prejuízo. O emprego de testes computadorizados auxilia na detecção dos efeitos das intervenções nas funções cognitivas dos idosos. O objetivo desta revisão foi o de analisar os estudos que utilizaram testes cognitivos computadorizados para verificar o efeito de intervenções na população idosa, descrevendo as baterias e testes empregados, as populações analisadas e o relato dos autores sobre limitações ou facilidades do emprego destes testes na população. Foi revista a base de dados PubMed com os descritores: teste cognitivo computadorizado e idoso. Encontramos 530 estudos e, pela leitura dos resumos, selecionamos 32 pela relevância com o tema. Estes utilizaram 19 tipos de testes ou baterias computadorizadas para avaliar as intervenções, que na sua maioria foram medicamentosas. Não houve relato de limitações na utilização dos testes computadorizados, sugerindo que a aplicação desta forma de avaliação tenha boa aplicabilidade, sensibilidade e pouco ou nenhum efeito de aprendizagem nesta população.

Palavras-chave: idoso; testes neuropsicológicos; diagnóstico por computador; estudos de intervenção

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REFERENCES

¹ Kane R, Kay GG. Computerized assessment in neuropsychology: a review of tests and test batteries. Neuropsychol Rev 1992;3:1-117.
² Wild K, Howieson D, Webbe F, Seelye A, Kaye J. The status of computerized cognitive testing in aging: a systematic review. Alzheimers Dement 2008;4:428-437.
³ Schatz P, Browndyke J. Applications of computer-based neuropsychological assessment. J Head Trauma Rehabil 2002;17:395-410.
⁴ Falleti MG, Maruff P, Collie A, Darby DG. Practice effects associated with the repeated assessment of cognitive function using the CogState battery at 10- minute, one week and one month test-retest intervals. J Clin Exp Neuropsychol 2006;28:1095-1112.
⁵ Zygouris S, Tsolaki M. Computerized cognitive testing for older adults: a review. Am J Alzheimers Dis Other Dement 2014;1-16.
⁶ Richter Y, Herzog Y, Lifshitz Y, Hayun R, Zchut S. The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints: a pilot. Clin Interv Aging 2013;8;557-563.
⁷ Bozoki A, Radovanovic M, Winn B, Heeter C, Anthony JC. Effects of a computer-based cognitive exercise program on age-related cognitive decline. Arch Gerontol Geriatr 2013;57:1-7.
⁸ Nagamatsu LS, Chan A, Davis JC, et al. Physical activity improves verbal and spatial memory in older adults with probable mild cognitive impairment: a 6-month randomized controlled trial. J Aging Res 2013; 1:1-10.
⁹ Krannich JH, Tobias T, Broscheit J, Leyh R, Müllges W. Diabetes severely affects attentional performance after coronary artery bypass grafting. J Cardiothorac Surg 2012;7:1-4.
¹⁰ Sanchez-Ramosa J, Ciminob C, Avilac R, et al. Pilot study of granulocyte-colony stimulating factor for treatment of Alzheimer's disease. J Alzheimers Dis 2012;31:843-855.
¹¹ Loring DW, Marino SE, Parfitt D, Finney GR, Meador KJ. Acute lorazepam effects on neurocognitive performance. Epilepsy Behav 2012;25: 329-333.
¹² Egan M, Yaari R, Liu L, et al. Pilot randomized controlled study of a histamine receptor inverse agonist in the symptomatic treatment of AD. Curr Alzheimer Res 2012;9:481-490.
¹³ Gold M, Newhouse PA, Howard D, Kryscio RJ. Nicotine treatment of mild cognitive- impairment A 6-month double-blind pilot clinical trial. Neurology 2012;78:91-101.
¹⁴ Cremer J, Stoppe C, Fahlenkamp AV, et al. Early cognitive function, recovery and well-being after sevoflurane and xenon anaesthesia in the elderly: a double-blinded randomized controlled trial. Med Gas Res 2011;1:9.
¹⁵ Macpherson H, Ellis KA, Sali A, Pipingas A. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement - a randomized controlled Trial. Psychopharmacology (Berl). 2012;220:351-365.
¹⁶ Pengelly A, Snow J, Mills SY, Scholey A, Wesnes K, Butler LR. Short-term study on the effects of rosemary on cognitive function in an elderly population. J Med Food 2012;15:10-17.
¹⁷ Dunbar GC, Kuchibhatla RV, Lee G, TC-1734 (AZD3480) AAMI Clinical Study Group (USA). A randomized double-blind study comparing 25 and 50 mg TC-1734 (AZD3480) with placebo, in older subjects with age-associated memory impairment. J Psychopharmacol 2011;25: 1020-1029.
¹⁸ Richter Y, Herzog Y, Cohen T, Steinhart Y. The effect of phosphatidylserine-containing omega-3 fatty acids on memory abilities in subjects with subjective memory complaints: a pilot study. Clin Interv Aging 2010;5:313-316.
¹⁹ Kim BR, Kim DY, Chun MH, Yi JH, Kwon JS. Effect of repetitive transcranial magnetic stimulation on cognition and mood in stroke patients - a double-blind, sham-controlled trial. Am J Phys Med Rehabil 2010; 89:362-368.
²⁰ Pietrzak RH, Maruff P, Snyder PJ. Methodological improvements in quantifying cognitive change in clinical trials: an example with single-dose administration of donepezil. J Nutr Health Aging 13:268-273;2009.
²¹ Thomas E, Snyder PJ, Pietrzak RH, Jackson CE, Bednar M, Maruff P. Specific impairments in visuospatial working and short-term memory following low-dose scopolamine challenge in healthy older adults. Neuropsychologia 2008;46:2476-2484.
²² Galvin JE, Cornblatt B, Newhouse P, et al. Effects of galantamine on measures of attention results from 2 clinical trials in alzheimer disease patients with comparisons to donepezil. Alzheimer Dis Assoc Disord 2008;22:30-38.
²³ Wattanathorn J, Mator L, Muchimapura S, et al. Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol 2008;116:325-332.
²⁴ Sathiavageeswaran M, Burman P, Lawrene D, et al. Effects of GH on cognitive function in elderly patients with adult-onset GH deficiency: a placebo-controlled 12-month study. Eur J Endocrinol 2007;156:439-447.
²⁵ Dunbar GC, Inglis F, Kuchibhatla R, Sharma T, Tomlinson M, Wamsley J. Effect of ispronicline, a neuronalnicotinic acetylcholine receptorpartial agonist, in subjects with ageassociated memory impairment (AAMI). J Psychopharmacol 2007;21:171-178.
²⁶ Ferris S, Schneider L, Farmer M, et al. A double-blind, placebo-controlled trial of memantine in age-associated memory impairment (memantine in AAMI). Int J Geriatr Psychiatry 2007;22:448-455.
²⁷ Anstey KJ, Lord SR, Hennessy M, Mitchell P, Mill K, von Sanden C. The effect of cataract surgery on neuropsychological test performance: a randomized controlled Trial. J Int Neuropsychol Soc 2006;12:632-639.
²⁸ Plati MC, Covre P, Lukasova K, de Macedo EC. Depressive symptoms and cognitive performance of the elderly: relationship between institutionalization and activity programs. Rev Bras Psiquiatr 2006;28:118-121.
²⁹ Seltzer B, Zolnouni M, Nunez M, et al. Efficacy of donepezil in early-stage Alzheimer disease. a randomized placebo-controlled trial. Arch Neurol 2004;61:1852-1856.
³⁰ Silbert BS, Maruff, Evered LA, et al. Detection of cognitive decline after coronary surgery: acomparison of computerized and conventional tests. Brit J Anaesthes 2004;92:814-820.
³¹ White HK, Levin ED. Chronic transdermal nicotine patch treatment effects on cognitive performance in age-associated memory impairment. Psychopharmacology 2004;171:465-1471.
³² Legangneux E, McEwen J, Wesnes KA, et al. The acute effects of amisulpride (50 mg and 200 mg) and haloperidol (2 mg) on cognitive function in healthy elderly volunteers. J Psychopharmacol 2000;14:164-171.
³³ Louis WJ, Mander AG, Dawson M, O'Callaghan C, Conway EL. Use of computerized neuropsychological tests (CANTAB) to assess cognitive effects of antihypertensive drugs in the elderly. J Hypertens 1999;17: 1813-1819.
³⁴ Barker A, Jones R, Prior J, Wesnes K. Scopolamine-induced cognitive impairment as a predictor of cognitive decline in healthy elderly volunteers: a 6-year follow-up. Int Geriatr Psychiatry 1998;13:244-247.
³⁵ Deijen JB, van der Beek EJ, Orlebeke JF, van den Berg H. Vitamin B-6 supplementation in elderly men: effects on mood, memory, performance and mental effort. Psychopharmacology (Berl.) 1992;109:489-496.
³⁶ Extermann M, Chen H, Booth-Jones M, Meyer J, Balducci L, Jacobsen P. Pilot testing of the computerized cognitive test MicrocogTM in chemotherapy-treated older cancer patients. Crit Rev Oncol Hematol 2005;54:137-143.
³⁷ van den Goor J, Saxby B, Tijssen J, Wesnes K, de Mol B, Nieuwland R. Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures. Perfusion 2008;23:267-273.
³⁸ Oliveira RS, Trezza BM, Busse AL, et al. Efeito de aprendizagem de testes cognitivos computadorizados em idosos. Einstein. 2014 (In press).

1
Disclosure: The authors report no conflicts of interest.

Publication Dates

Publication in this collection
Apr-Jun 2014

History

Received
06 Jan 2014
Accepted
16 Mar 2014

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹ Kane R, Kay GG. Computerized assessment in neuropsychology: a review of tests and test batteries. Neuropsychol Rev 1992;3:1-117.

[2] ² Wild K, Howieson D, Webbe F, Seelye A, Kaye J. The status of computerized cognitive testing in aging: a systematic review. Alzheimers Dement 2008;4:428-437.

[3] ³ Schatz P, Browndyke J. Applications of computer-based neuropsychological assessment. J Head Trauma Rehabil 2002;17:395-410.

[4] ⁴ Falleti MG, Maruff P, Collie A, Darby DG. Practice effects associated with the repeated assessment of cognitive function using the CogState battery at 10- minute, one week and one month test-retest intervals. J Clin Exp Neuropsychol 2006;28:1095-1112.

[5] ⁵ Zygouris S, Tsolaki M. Computerized cognitive testing for older adults: a review. Am J Alzheimers Dis Other Dement 2014;1-16.

[6] ⁶ Richter Y, Herzog Y, Lifshitz Y, Hayun R, Zchut S. The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints: a pilot. Clin Interv Aging 2013;8;557-563.

[7] ⁷ Bozoki A, Radovanovic M, Winn B, Heeter C, Anthony JC. Effects of a computer-based cognitive exercise program on age-related cognitive decline. Arch Gerontol Geriatr 2013;57:1-7.

[8] ⁸ Nagamatsu LS, Chan A, Davis JC, et al. Physical activity improves verbal and spatial memory in older adults with probable mild cognitive impairment: a 6-month randomized controlled trial. J Aging Res 2013; 1:1-10.

[9] ⁹ Krannich JH, Tobias T, Broscheit J, Leyh R, Müllges W. Diabetes severely affects attentional performance after coronary artery bypass grafting. J Cardiothorac Surg 2012;7:1-4.

[10] ¹⁰ Sanchez-Ramosa J, Ciminob C, Avilac R, et al. Pilot study of granulocyte-colony stimulating factor for treatment of Alzheimer's disease. J Alzheimers Dis 2012;31:843-855.

[11] ¹¹ Loring DW, Marino SE, Parfitt D, Finney GR, Meador KJ. Acute lorazepam effects on neurocognitive performance. Epilepsy Behav 2012;25: 329-333.

[12] ¹² Egan M, Yaari R, Liu L, et al. Pilot randomized controlled study of a histamine receptor inverse agonist in the symptomatic treatment of AD. Curr Alzheimer Res 2012;9:481-490.

[13] ¹³ Gold M, Newhouse PA, Howard D, Kryscio RJ. Nicotine treatment of mild cognitive- impairment A 6-month double-blind pilot clinical trial. Neurology 2012;78:91-101.

[14] ¹⁴ Cremer J, Stoppe C, Fahlenkamp AV, et al. Early cognitive function, recovery and well-being after sevoflurane and xenon anaesthesia in the elderly: a double-blinded randomized controlled trial. Med Gas Res 2011;1:9.

[15] ¹⁵ Macpherson H, Ellis KA, Sali A, Pipingas A. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement - a randomized controlled Trial. Psychopharmacology (Berl). 2012;220:351-365.

[16] ¹⁶ Pengelly A, Snow J, Mills SY, Scholey A, Wesnes K, Butler LR. Short-term study on the effects of rosemary on cognitive function in an elderly population. J Med Food 2012;15:10-17.

[17] ¹⁷ Dunbar GC, Kuchibhatla RV, Lee G, TC-1734 (AZD3480) AAMI Clinical Study Group (USA). A randomized double-blind study comparing 25 and 50 mg TC-1734 (AZD3480) with placebo, in older subjects with age-associated memory impairment. J Psychopharmacol 2011;25: 1020-1029.

[18] ¹⁸ Richter Y, Herzog Y, Cohen T, Steinhart Y. The effect of phosphatidylserine-containing omega-3 fatty acids on memory abilities in subjects with subjective memory complaints: a pilot study. Clin Interv Aging 2010;5:313-316.

[19] ¹⁹ Kim BR, Kim DY, Chun MH, Yi JH, Kwon JS. Effect of repetitive transcranial magnetic stimulation on cognition and mood in stroke patients - a double-blind, sham-controlled trial. Am J Phys Med Rehabil 2010; 89:362-368.

[20] ²⁰ Pietrzak RH, Maruff P, Snyder PJ. Methodological improvements in quantifying cognitive change in clinical trials: an example with single-dose administration of donepezil. J Nutr Health Aging 13:268-273;2009.

[21] ²¹ Thomas E, Snyder PJ, Pietrzak RH, Jackson CE, Bednar M, Maruff P. Specific impairments in visuospatial working and short-term memory following low-dose scopolamine challenge in healthy older adults. Neuropsychologia 2008;46:2476-2484.

[22] ²² Galvin JE, Cornblatt B, Newhouse P, et al. Effects of galantamine on measures of attention results from 2 clinical trials in alzheimer disease patients with comparisons to donepezil. Alzheimer Dis Assoc Disord 2008;22:30-38.

[23] ²³ Wattanathorn J, Mator L, Muchimapura S, et al. Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol 2008;116:325-332.

[24] ²⁴ Sathiavageeswaran M, Burman P, Lawrene D, et al. Effects of GH on cognitive function in elderly patients with adult-onset GH deficiency: a placebo-controlled 12-month study. Eur J Endocrinol 2007;156:439-447.

[25] ²⁵ Dunbar GC, Inglis F, Kuchibhatla R, Sharma T, Tomlinson M, Wamsley J. Effect of ispronicline, a neuronalnicotinic acetylcholine receptorpartial agonist, in subjects with ageassociated memory impairment (AAMI). J Psychopharmacol 2007;21:171-178.

[26] ²⁶ Ferris S, Schneider L, Farmer M, et al. A double-blind, placebo-controlled trial of memantine in age-associated memory impairment (memantine in AAMI). Int J Geriatr Psychiatry 2007;22:448-455.

[27] ²⁷ Anstey KJ, Lord SR, Hennessy M, Mitchell P, Mill K, von Sanden C. The effect of cataract surgery on neuropsychological test performance: a randomized controlled Trial. J Int Neuropsychol Soc 2006;12:632-639.

[28] ²⁸ Plati MC, Covre P, Lukasova K, de Macedo EC. Depressive symptoms and cognitive performance of the elderly: relationship between institutionalization and activity programs. Rev Bras Psiquiatr 2006;28:118-121.

[29] ²⁹ Seltzer B, Zolnouni M, Nunez M, et al. Efficacy of donepezil in early-stage Alzheimer disease. a randomized placebo-controlled trial. Arch Neurol 2004;61:1852-1856.

[30] ³⁰ Silbert BS, Maruff, Evered LA, et al. Detection of cognitive decline after coronary surgery: acomparison of computerized and conventional tests. Brit J Anaesthes 2004;92:814-820.

[31] ³¹ White HK, Levin ED. Chronic transdermal nicotine patch treatment effects on cognitive performance in age-associated memory impairment. Psychopharmacology 2004;171:465-1471.

[32] ³² Legangneux E, McEwen J, Wesnes KA, et al. The acute effects of amisulpride (50 mg and 200 mg) and haloperidol (2 mg) on cognitive function in healthy elderly volunteers. J Psychopharmacol 2000;14:164-171.

[33] ³³ Louis WJ, Mander AG, Dawson M, O'Callaghan C, Conway EL. Use of computerized neuropsychological tests (CANTAB) to assess cognitive effects of antihypertensive drugs in the elderly. J Hypertens 1999;17: 1813-1819.

[34] ³⁴ Barker A, Jones R, Prior J, Wesnes K. Scopolamine-induced cognitive impairment as a predictor of cognitive decline in healthy elderly volunteers: a 6-year follow-up. Int Geriatr Psychiatry 1998;13:244-247.

[35] ³⁵ Deijen JB, van der Beek EJ, Orlebeke JF, van den Berg H. Vitamin B-6 supplementation in elderly men: effects on mood, memory, performance and mental effort. Psychopharmacology (Berl.) 1992;109:489-496.

[36] ³⁶ Extermann M, Chen H, Booth-Jones M, Meyer J, Balducci L, Jacobsen P. Pilot testing of the computerized cognitive test MicrocogTM in chemotherapy-treated older cancer patients. Crit Rev Oncol Hematol 2005;54:137-143.

[37] ³⁷ van den Goor J, Saxby B, Tijssen J, Wesnes K, de Mol B, Nieuwland R. Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures. Perfusion 2008;23:267-273.

[38] ³⁸ Oliveira RS, Trezza BM, Busse AL, et al. Efeito de aprendizagem de testes cognitivos computadorizados em idosos. Einstein. 2014 (In press).