Valentin Bragin, M.D., PhD, Marina Chemodanova, PhD, MEd, Aysik Vaysman, M.D., PhD, Ilya Bragin BS, Eugene Grinayt, PhD Pavlo Chernyavskyy. Stress Relief and Memory Training Center, Brooklyn, NY, USA. Poster presented at the IPA 14th International Congress in Montréal, Canada. 2009 September 1-5
Background: Cognitive deficit often accompanies depression in elderly people. We postulate that cognitive training may be considered as an important adjunct modality to be utilized alongside a traditional treatment regimen of medication and psychotherapy.
Objective: The goal of this presentation is to describe a unique memory training protocol for depressed, cognitively impaired patients and present first training session data.
Design: 34 geriatric, computer-naïve, medically ill patients with mild to moderate depression and concomitant memory problems participated in cognitive training; this was their first experience with this protocol.
Materials and Methods: 12 male and 22 female patients (age 77.8±5.4, education 14.1±3.1) participated in this training. They were initially evaluated by the Mini Mental Status Exam. An original, computerized training protocol has been developed for use with different visual targets; for this trial, the target utilized was flowers.
The protocol consists of two parts. The first part is a 40 trial N-back task (3-back task). The patients were required to identify pictures shown for the first time as a new picture and then recognize pictures which were presented before. Approximately 25% of the pictures were displayed a second time for recognition. The second part is a learning task. During the learning task, the patients memorized a set of 10 simultaneously presented targets (pictures). The pictures appeared on the screen for multiple trials. After every trial, the patients selected these targets among 10 additional computer-generated targets. The trials continued until the patients memorized the maximum number of targets. Then the patients were asked to recognize these same targets five minutes later. Performance and errors were calculated for both tasks. Descriptive statistics and Spearman Correlations were performed on SPSS 16.
Results: MMSE score ranged from 23 to 30 (28.4±2.2). For the N back task performance was 7.2±2.5 and total errors were 7.9±4.3. For the learning task, after the first trial, performance was 5.6±2.2 and errors (intrusions) were 3.3±2.1. In the learning task, the minimum number of steps to achieve maximum results was 4.2±1.6; maximum performance was 9.4±1.1. Performance on five minute recall decreased to 7.9±2.4 and the number of errors were 1.9±2.1.
No significant correlations were seen between performances on the two tasks. Total errors on the N-back task were positively correlated with first trial errors on the learning task (r=.426, p<.001) and negatively correlated with five minute recall performance on the learning task (r=-.372, p<.003).
Conclusion: A cognitive memory training protocol was designed as a part of an integrative treatment program for depressed, cognitively impaired, medically ill elderly people. The training was well tolerated and had a positive impact on the patients’ emotional state. Future research needs to be done to evaluate the efficacy of this protocol.