Combined Cognitive and Physical Exercises Through Computer Games in Elderly: The LLM Project

Study Overview
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Brief Summary
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The study involved Information and Communication Technologies (ICT) and more specifically computer exercises blended with game activities. It was hypothesized that ICT facilitated, game blended combined cognitive and physical exercise improves global cognition when compared to a control group; and that the number of sessions within exercising participants predict cognitive benefits. In addition, we explored the impact of potential moderators on combined exercise-induced cognitive benefits.

Detailed Description
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The multicenter study was part of the Long Lasting Memories (LLM) project (www.longlastingmemories.eu), which was funded by the European Commission (Information and Communication Technologies Policy Support Program (ICT-PSP) for a three year period (2009-2012). It used a pre-post-test design with the between-participant factor group [intervention vs. passive control]. Post-test was conducted within 2 weeks after completion of the exercise period. Interventions were carried out in Athens and Thessaloniki (Greece) within day care centers, hospitals, senior care centers, a memory outpatient center, local parishes, at university campus facilities (university community installations), and at participants' homes. Institutions had to provide at least 5 exercise weeks, with a frequency of at least 1 physical and 2 cognitive exercise sessions per week, resulting in at least 5 physical and 10 cognitive exercise sessions in total.

Official Title
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The Effects of Combined Cognitive and Physical Exercises Through Computer Games in Elderly: The Long Lasting Memories Project (LLM)

Conditions
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Mild Cognitive Impairment, Mild Dementia, Healthy

Intervention / Treatment
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* Other: LLM training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: no severe cognitive impairment [Mini-Mental State Examination, MMSE ≥ 18], fluent language skills, agreement of a medical doctor and time commitment to the test and exercise protocol. Exclusion Criteria: concurrent participation in another study, severe physical or psychological disorders which precluded participation in the intervention (i.e., inability to follow instructions), unrecovered neurological disorders such as stroke, traumatic brain injury, unstable medication within the past three months, severe and uncorrectable vision problems, or hearing aid for less than three months.

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LLM training<br>Participants use the FitForAll exergaming computer platform as the physical training component (PTC); Participants use the language adapted Version of the BrainFitness Program as the cognitive training component (CTC) | Other: LLM training<br>* Participants use the FitForAll exergaming computer platform as the physical training component (PTC); Participants use the language adapted Version of the BrainFitness Program as the cognitive training component (CTC)<br>* Other names: PTC+CTC;|
| No Intervention: Passive Control<br>Participants do not receive an intervention serving as passive controls | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| overall cognition | Greek versions of the California Verbal Learning Test [CVLT], the Digit Span Test and the Trail Making Test [TMT] were used to assess cognitive outcomes. | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| physical fitness | Physical capacity was measured by means of the Senior Fitness Test | 2 months | 
| Episodic memory | calculated by averaging z-standardized sub-scores of the three cognitive tests (primary outcome) | 2 months | 
| working memory | calculated by averaging z-standardized sub-scores of the three cognitive tests (primary outcome) | 2 months | 
| executive function | calculated by averaging z-standardized sub-scores of the three cognitive tests (primary outcome) | 2 months | 
| Quality of Life | WHOQoL (WHO Quality of Life) | 2 months | 
| Instrumental Activities of daily living | IADL | 2 months | 
| Depressive symptoms | GDS (Geriatric depression scale) | 2 months | 
| Brain function | changes in abnormal brain waves that correlate with mild cognitive decline and dementia as measured by EEG | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cognitive training, physical training, exercise games, novelty serious games, computer training, mild cognitive impairment, mild dementia, healthy elderly