Improvements in Cognitive Skills of Older Adults Using Dynamic Visual Attention Training

The goal of this study is to show that neurotraining in the center of the motion working range (PATH) that improves the contrast sensitivity for direction discrimination (dorsal stream activity significantly improves cognitive skills in older adults more than in those who do training to improve orientation discrimination: ventral stream activity (sham training). Brain training will be administered for 20 minutes three times a week for 12 weeks: Arm 1) PATH neurotraining and Arm 2) Sham training. The investigators predict that older adults who do PATH neurotraining will improve their visual and cognitive skills, improving attention, multitasking, processing speed, reading fluency, and working memory, significantly more than those doing sham training. This prediction will be evaluated by measuring whether older adults improve on standardized tests of cognitive skills following PATH neurotraining more than older adults doing orientation discrimination training to improve processing speed and attention. MEG brain imaging will be used to show that PATH training improves the dorsal, attention, and executive control networks, as found previously, more than does sham training. The investigators predict these improvements will be found in both healthy adults and those with MCI.

The feasibility of rapid, effective brain training will be evaluated by using behavioral methods to remediate age-related cognitive decline, and to treat the cognitive impairment and/or behavioral symptoms associated with MCI, as well as to slow and/or reverse the course of cognitive decline or to prevent it entirely. PATH neurotraining provides a computer-based product to remediate the visual and cognitive difficulties of older adults rapidly and effectively. The innovative PATH neurotraining improves the center of the motion working range, whereas the sham training improves the center of the orientation discrimination working range. The two brain training groups will be balanced, in terms of healthy older adults and those with MCI. A subject will be considered to have MCI if the WAIS Working Memory Index score is less than 50 percent, and the MOCA has a score of 19-25. These groups will also be balanced in terms of age and reading speed, a sensitive measure of processing speed.

Half of the older adults will complete the PATH neurotraining for 12 weeks and half will complete sham training for 12 weeks. An additional 12 weeks will be needed to train staff, recruit subjects, and complete the standardized tests and MEG imaging. The choice of which adults will do each type of brain training will be randomized, to be determined by study statistician Prof. John Shelley-Tremblay. After initial standardized testing, 12 adults doing PATH training will be selected for pre-post MEG brain imaging.

Precise measurements using pre- and post- standardized tests of cognitive skills will be used to validate the improved visual and cognitive (attention, processing speed, and memory) performance reported previously in older adults. Standardized tests and MEG imaging on a subset will be administered by staff before and after cognitive training to evaluate improvements in cognitive skills following treatment (PATH neurotraining) and control (sham training) interventions.

Evaluating improvements in cognitive skills of older adults will be grouped by subject type: whether the adult is healthy or has MCI to determine which intervention improves cognitive skills the most. The investigators predict that PATH neurotraining will significantly improve (at p ≤ 0.05) reading speed, working memory and attention (cognitive flexibility) in older adults more than after training on sham training. This will be evaluated by both: 1) measuring whether older adults improve on the standardized tests listed above following brain training, and 2) MEG brain source imaging to validate that dorsal stream, attention, and executive control networks improve in function significantly following PATH neurotraining.