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Effects of multicomponent attention training in a nonrandomized controlled trial of healthy adults

Uchida, Junko Shimokawa, Tetsuya Nagao, Toru Tanemura, Rumi 神戸大学

2023

概要

Cognitive decline along with aging affects multiple domains of cognitive function, including
attention, working memory (WM), memory, and executive function1-4), resulting in a reduction in the
quality of independent life5,6). To maintain and improve cognitive function, diet7), exercise programs8), and
socially active lifestyles9) have been proposed for older adults, and cognitive interventions have also been
reported to maintain or improve cognitive function in older adults10,11). Most of these reports focus on
cognitive interventions for WM12-14), memory15,16), and executive function17-19). Although these cognitive
functions include attentional components, interventions focused directly on attention have not been wellstudied.
Attention-related interventions are crucial for various reasons. Aging studies find that attention is
susceptible to the effects of aging20,21), and a decline in attention may be predictive of progression to
dementia in healthy older adults22). Early memory deficits in Alzheimer's disease may not be from impaired
memory processes23) but inadequate attention. Moreover, studies in the field of brain injury model cognitive
processes as functionally hierarchical, where fundamental abilities such as arousal and attention are placed
at lower levels as cognitive foundation24,25). Consistent with this model, attention leads to the performance
of higher-order functions such as memory26). Additionally, Norman and Shallice proposed the Supervisory
Attention System (SAS) to collect and monitor information and select appropriate actions27) and observed
that the malfunctioning of SAS induces a selection of wrong actions. These studies indicate that attention
must perform efficiently and adequately for higher cognitive functions such as memory and executive
functions to work effectively and suggest that attention training is vital for age-related cognitive decline.
Among the various types of training for attention, we focus on multicomponent attention training,
which intervenes in each element of attention. Attention consists of multiple components28,29), and Sohlberg
et al. classified it into five: focused attention, sustained attention, selective attention, divided attention, and
alternating attention30). They created Attention Process Training (APT)31,32) that works on each component
of attention and found the effects of APT on brain injury patients33,34). Attention research in the aging
literature has focused on selective attention only35-37), and to the best of our knowledge, no study has
examined all five components.
In this study, based on a prediction that multicomponent attention training would also be effective in
maintaining and improving cognitive function in healthy adults, we examined the effectiveness of
multicomponent attention training in healthy adults. We administered ten sessions of multicomponent
attentional training to healthy adults over a two-week period and used neuropsychological testing. We
assessed 1) changes in cognitive function due to training in each age range and 2) whether the changes, if
any, vary with age. ...

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