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Study Suggests Face-to-Face Conversation Improves Cognitive Skills In the Elderly

September 5, 2015

TRCI_v1_i1_COVER.indd“One integral component of being socially active is the ability to interact with others”

One of the important lessons learned from years of research on the aging brain is the “use it or lose it” practice of staying cognitively active. Challenging and exercising your brain by reading, playing an instrument, learning a language and interacting with others requires working memory, decision-making, learning and executive function. These activities may also delay the onset of dementia and other neurodegenerative disorders.

While popular brain training games call on several of these core brain functions, researchers at the Oregon Health & Science University (OHSU) and the University of Michigan hypothesized that real human interaction and conversation was the key to maintaining or even improving cognition in our later years.

“One integral component of being socially active is the ability to interact with others,” wrote the authors of a new paper in Alzheimer’s & Dementia. “Linguistic ability is known to be highly correlated with late-life changes in cognition in healthy older adults and those with dementia. Furthermore, the results from psychological studies have suggested that the task of conversation is highly cognitively stimulating. Conversations require attention, working memory, the organization and control of thought (executive functions), and social cognition to understand others’ intentions and feelings, in addition to linguistic ability.”

The research team, led by Hiroko Dodge PhD, associate professor of neurology at OHSU, designed an experiment to test the effect of regular human interaction on cognitive skills. They hoped that by demonstrating positive change in memory and executive function from face-to-face conversation, innovative communications programs using Web-based video conferencing could be developed to help isolated and lonely seniors.

Dr. Dodge and her team recruited 83 volunteers, aged 77 to 84, to participate in a full cognitive assessment, followed by a social intervention program. For six weeks, the intervention group received daily face-to-face video calls from trained interviewers that lasted about 30 minutes. The control group received voice-only telephone calls.

All volunteers were tested again after the intervention period and at 12 and 18 weeks post baseline. The testing battery included:

  • the composite of verbal fluency for letters (F, A, and S) for language skill
  • a word list learning test to measure immediate memory
  • a word list delayed recall test to measure delayed memory
  • the Cogstate Detection Task for psychomotor speed
  • the Cogstate One Back and Two Back tests for working memory

“This study incorporated a well-rounded neuropsychological battery of traditional paper and pencil and computerized assessments, with the Cogstate battery consisting of a brief measure of psychomotor function (the Detection task), and two measures of working memory (the One Back and Two Back tasks),” said Adrian Schembri, PhD, Science Director of R&D at Cogstate. “This enabled an analysis of various cognitive domains across the intact cognition and MCI groups. There were variations in improvement across the neuropsychological test battery following the intervention, demonstrating that the traditional paper and pencil and computerized assessments were complimentary in evaluating cognitive functioning at baseline and over the course of the conversational interactions intervention.”

The key to the face-to-face interviews was to engage the volunteer in storytelling and opinion generation rather than simple yes/no questions. By triggering memories with cues such as showing a photo of the first moon landing or asking about their childhood, more brain regions are engaged.

“Conversation requires synthesis of multiple cognitive functions,” wrote the authors. “To present an understandable story or “rationality,” the speaker must organize their ideas and thoughts and pay attention to the other’s response. Thus, attention, executive function, and abstract reasoning are simultaneously engaged. To take full advantage of this synthetic aspect of conversation, we placed an emphasis on spontaneous responses rather than structured answers (i.e., the participants had to organize their thoughts).”

For the intervention participants who were cognitively normal (no signs of mild cognitive impairment), they improved their semantic and phonemic fluency scores, which require executive function skills, at the 18-week assessment significantly more than the control group. For those volunteers who did suffer some signs of MCI, a trend towards improved psychomotor speed was observed in the video interview group.

Going forward, the researchers would like to expand their study to longer intervention and follow-up periods across a wider test group. Still, the signs are encouraging that low-cost Web video technologies can be used to connect elderly adults with family or caregivers to provide companionship and now improve cognitive function.

“This age group is the fastest growing segment of the population in most developed countries and faces the greatest risk of developing cognitive impairment or dementia because of their risk factor of age alone,” concluded the researchers. “Developing prevention approaches with high adherence that could delay the onset of dementia for even a few years could have a large effect on the overall disease burden, especially among the oldest of the old group, and is urgently needed.”

Questions or comments?  Please contact Dan Peterson