Background: Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia, characterized by subjective cognitive decline and objective memory impairment. Cognitive training has consistently shown short-term benefits for individuals with MCI, but evidence on the long-term effectiveness is extremely limited. Given the progressive nature of MCI and the need for sustainable strategies to delay cognitive decline, research on the long-term impact of cognitive training is necessary and timely. Mobile-based platforms offer a promising solution by enhancing accessibility and adherence, but their durability of effect over extended periods remains underexplored. Objective: This study aimed to evaluate the long-term effects of a mobile-based cognitive training app on the cognitive function of older adults with MCI. Methods: In total, 28 older adults with MCI used Cogthera, a mobile cognitive training app based on metamemory training. Participants completed 2 training sessions daily for 3 months, and 9 (32%) continued for an additional 12 months. Cognitive function and quality of life were assessed using the Alzheimer’s Disease Assessment Scale-Cognitive Subscale 14 and EQ-5D-5L. Results: Cognitive function improved over 15 months, as measured by Alzheimer’s Disease Assessment Scale-Cognitive Subscale (F2,35.56=7.08; P=.003). EQ-5D-5L scores increased at 3 months but did not show sustained change at 15 months (F2,42.14=3.40; P=.04). Greater cognitive improvements were associated with younger age, higher functional status, and lower baseline cognitive function. Conclusions: This study showed that long-term use of a mobile-based metamemory cognitive training app was associated with cognitive improvements over 15 months. Although limited by the small sample size and the absence of a control group, these findings suggest potential for mobile cognitive training as a sustainable intervention that warrants validation in larger trials.

Study suggests shingles vaccination delays the onset of mild cognitive impairment and dementia, and slows disease progression in individuals already living with dementia. ...

Background: Mild cognitive impairment (MCI) may affect up to 20% of people over 65. Global incidence of MCI is increasing, and technology is being explored for early intervention. Theories of technology adoption (TA) predict that useful and easy-to-use solutions will have higher rates of adoption, however these models do not specifically consider older people with cognitive impairments, or the unique human-computer interaction (HCI) challenges posed by MCI. There are gaps in understanding the combined impacts of aging and cognitive impairment on factors affecting TA for older people with MCI, and it is not clear how MCI impacts HCI and device and interaction modality preferences for this population. Objective: This study collates opinions from older people with MCI about technology solutions proposed for them, to understand if solutions are useful, easy to use and what changes are suggested. It also identifies which devices and interaction modalities are preferred, and other factors which may affect usage and adoption. Methods: This scoping review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A consistent search was performed across nine electronic databases (ACM Digital Library, EBSCOhost CINAHL Plus with Full Text, EBSCOhost Computers and Applied Sciences Complete, Google Scholar, JMIR, IEEE Xplore, EBSCOhost Medline, Scopus, Web of Science Core Collection) for studies published between 1 January 2014 and 1 May 2024. Extracted data was analyzed using inductive, thematic analysis. Results: We identified 4271 studies and after removal of duplicates and screening, 83 studies remained for data extraction. Inductive, thematic analysis of feedback from older people with MCI about technology solutions proposed for them identified five themes (i) purpose and need, (ii) solution design and ease of use, (iii) self-impression, (iv) lifestyle, and (v) interaction modality. Solutions are perceived as useful, even though gaps in functional support exist, however, they are not perceived as entirely easy to use, due to issues related to usability and user experience. Devices which are light, portable, common and have large screens are preferred, as is multimodal interaction, in particular speech, visual/text and touch. Conclusions: Using technology can create feelings which positively or negatively affects a user's comfort, confidence and overall well-being. Older people with MCI value independence and autonomy, and solution designs should support these. Usefulness, ease of use, security, privacy, cost, physical comfort and convenience are important considerations for use of technology. Reliable technology creates trust, confidence and feelings of empowerment. This review recommends future work to (i) improve usability and user experience, (ii) enhance personalization, (iii) better understand interaction preferences and effectiveness, (iv) enable options for multimodal interaction, and (v) more seamlessly integrate solutions into users’ lifestyles.

Background: Mild cognitive impairment (MCI) is a precursor of dementia. Therefore, MCI identification and monitoring are crucial to delaying dementia onset. Given the limits of existing clinical tests, objective support tools are needed. Objective: This work investigates quantitative handwriting analysis, tailored to enable domestic monitoring, as a noninvasive approach for MCI screening and assessment. Methods: A sensorized ink pen, used on paper and equipped with sensors, memory, and a communication unit, was used for data acquisition. The tasks included writing a grocery list and free text to mimic daily life handwriting, and a clinical dictation test (parole-non-parole [PnP] test), featuring regular, irregular, and made-up words, aimed at assessing MCI dysgraphia. From the recorded data, 106 indicators describing the performance in terms of time, fluency, exerted force, and pen inclination were computed. A total of 57 patients with MCI were recruited, of whom 45 performed a test-retest protocol. The indicators were examined to assess their test-retest reliability. The indicators from the test repetition were used to assess their relationship with the scores of clinical tests via correlation analysis. For the PnP test, differences in the indicators among the 3 types of words were statistically investigated. These analyses were conducted separately for the cursive (2/3 of the sample) and block letters (1/3 of the sample) allographs, with the level of significance set at 5%. Data from healthy older adults were available for the grocery list (34 participants) and free text (45 participants) tasks. These were exploited to build machine learning classification models for the distinction between patients with MCI and healthy controls. Results: When dealing with reliability, 93% and 44% of the indicators were characterized by a significant reliability of at least moderate intensity for cursive and block letters respectively. As for the correlation analysis, patients with preserved cognitive status and daily life functionality were associated with significantly better temporal performances, both in free writing and PnP. The analysis of PnP highlighted the presence of surface dysgraphia in the recruited sample, as irregular words showed significantly worse temporal indicators with respect to regular and made-up ones. The classification models’ built-in free writing data achieved accuracies ranging from 0.80 to 0.93 and F1-scores from 0.81 to 0.92 according to the input dataset. Conclusions: The presented results suggest the suitability of ecological handwriting analysis for the all-around monitoring of MCI, from early screening to disease progression evaluation.

Background: Approximately 20% of the global population is affected by mild cognitive impairment (MCI), with around 15% progressing to dementia within 2 years. Touch-based multimedia applications can support cognitive, social, and physical functioning, potentially enhancing daily life and strengthening caregiver-patient relationships through shared engagement. Although interest in dyadic, technology-assisted interventions is increasing, empirical evidence on their feasibility and acceptability in home-based settings remains scarce. In particular, little is known about their impact on caregiver–care recipient dynamics and the factors that facilitate or hinder their use. Objective: We aimed to evaluate the feasibility of a dyadic, tablet-based multimedia intervention for individuals with MCI and their caregivers in a home setting, focusing on user experiences, use barriers and facilitators, and the intervention’s impact on the caregiver-patient relationship. Methods: We applied qualitative triangulation, combining naturalistic observations and semistructured interviews. Data were analyzed using qualitative content analysis. The intervention was codeveloped by a multidisciplinary team and implemented as a user-centered, tablet-based modular platform with customizable cognitive, physical, and interactive exercises. Results: We recruited a total of 40 participants, comprising 20 (50%) individuals with MCI and their 20 (50%) caregivers. Our study confirmed the feasibility of a touch-based multimedia intervention for both groups. Despite initial challenges with navigation and touch interfaces, most participants demonstrated increased confidence and competence, particularly with tailored caregiver support. Instances of enhanced communication and emotional connection were described by care partners and then became visible during their interaction with the intervention. Shared moments of laughter, mutual encouragement, and coordinated task execution indicated that the intervention could create opportunities for relational closeness. Biography-related tasks proved particularly effective, stimulating meaningful conversation and storytelling that facilitated the sharing of personal memories and experiences. While some dyads experienced occasional tensions due to impatience, differing expectations, or dominant behavior by one partner, the overall atmosphere was one of cooperation, support, and adaptability. The intervention demonstrated how technology can serve as a tool to facilitate shared experiences, promote cognitive engagement, and enrich interpersonal relationships in everyday caregiving contexts. Conclusions: Our findings show that the home-based implementation of a dyadic, touch-based multimedia intervention can be feasible for individuals with MCI and their caregivers. A key finding is that biographically oriented content fosters caregiver-patient relationships by acting as a catalyst for personal dialogues and collective reminiscence. These interactions enhance emotional intimacy and mutual understanding, highlighting the potential of technology-driven interventions in dementia care. The intervention incorporated multiple domains, including cognitive stimulation, physical activation, and communicative-social interaction, all of which proved highly promising. In addition, the regular implementation of the intervention in home settings appears to be a realistic and achievable approach.

Background: Early assessment of mild cognitive impairment (MCI) in older adults is crucial, as it enables timely interventions and decision-making. In recent years, researchers have been exploring the potential of gamified interactive systems (GISs) to assess pathological cognitive decline. However, effective methods for integrating these systems and designing GISs that are both engaging and accurate in assessing cognitive decline are still under investigation. Objective: We aimed to comprehensively investigate GISs used to assess MCI. Specifically, we reviewed the existing systems to understand the different game types (including genres and interaction paradigms) used for assessment. In addition, we examined the cognitive functions targeted. Finally, we investigated the evidence for the performance of assessing MCI through GISs by looking at the quality of validation for these systems in assessing MCI and the diagnostic performance reported. Methods: We conducted a scoping search in IEEE Xplore, ACM #Digital Library, and Scopus databases to identify interactive gamified systems developed for assessing MCI. Game types were categorized according to genres and interaction paradigms. The cognitive functions targeted by the systems were compared with those assessed in the Montreal Cognitive Assessment (MoCA). Finally, we examined the quality of validation against the reference standard (ground truth), relevance of controls, and sample size. Where provided, the diagnostic performance on sensitivity, specificity, and area under the curve was reported. Results: A total of 81 articles covering 49 GISs were included in this review. The primary game types used for MCI assessment were classified as casual games (30/49, 61%), simulation games (17/49, 35%), full-body movement games (4/49, 8%), and dedicated interactive games (3/49, 6%). Of the 49 systems, 6 (12%) assessed cognitive functions comprehensively, compared to those functions assessed via the MoCA. Of the 49 systems, 14 (29%) had validation studies, with sensitivities ranging from 70.7% to 100% and specificities ranging from 56.5% to 100%. The reported diagnostic performances of GISs were comparable to those of common screening instruments, such as Mini-Mental State Examination and MoCA, with some systems reporting near-perfect performance (area under the curve>0.98). However, these findings often stemmed from small samples and retrospective designs. Moreover, some of these systems’ model training and validation exhibited substantial deficiencies. Conclusions: This review provides a comprehensive summary of GISs for assessing MCI, exploring the cognitive functions assessed by these systems and evaluating their diagnostic performance. The results indicate that current GISs hold promise for the assessment of MCI, with several systems demonstrating diagnostic performance comparable to established screening tools. Nevertheless, despite some systems reporting impressive performance, there is a need for improvement in validation, particularly concerning sample size and methodological rigor. Future work should prioritize prospective validation and present greater methodological consistency.

Gabapentin can provide welcome relief for back pain, but people who use it over multiple prescriptions have a higher risk of dementia.

The benefits of Alzheimer’s treatments donanemab and lecanemab remain too small to justify the additional costs

Background: Sleep holds promise as a modifiable risk factor for neurodegenerative diseases and dementia. Clinical trials to modify sleep in people at risk of or in the early stages of dementia are needed. Monitoring natural sleep from home could support pragmatic and decentralized large-scale clinical trials. However, whether longitudinal sleep research can be successfully delivered remotely in this population has not been established yet. Objective: We investigated the feasibility of remote longitudinal research using wearable devices, web-based cognitive tasks, and a smartphone app to record sleep and cognition in older adults with mild cognitive impairment (MCI) or dementia. Methods: Older adults with MCI or dementia due to Alzheimer disease or Lewy body disease and cognitively healthy participants completed at-home sleep and circadian monitoring (digital sleep diaries, actigraphy, wearable sleep electroencephalography, and saliva samples) and digital cognitive assessments for 8 weeks. Feasibility outcomes included recruitment, retention, and data completeness. Results: In total, 41 participants consented (n=10, 24% participants with Alzheimer disease; n=11, 27% participants with Lewy body disease; and n=20, 49% controls). There were predominantly male and White British participants, with a mean age of 70.9 (SD 5.9) years. Retention was very high, with 40 (98%) participants completing 8 weeks of remote monitoring. Data completeness for sleep electroencephalography was 91% and ranged from 79% to 97% for all remote tasks and was overall high across all participant subgroups. In total, 30% (12/40) of participants reported receiving external support with completing study tasks. Conclusions: High rates of retention, data completeness, and data quality suggested that longitudinal multimodal sleep and cognitive profiling using novel and remote monitoring technology is feasible in older adults with MCI and dementia and healthy older adults, even without study partner support. Remote monitoring should be considered for mechanistic and interventional trials. Careful consideration should be given to how to ensure remote monitoring technologies reduce burden and enhance inclusivity, particularly in communities traditionally underserved by research and those with lower digital literacy.

Dr. Dean Ornish publishes the first randomized controlled trial investigating whether a plant-based diet and lifestyle program may reverse the course of early-stage Alzheimer's disease.

Exercise May Slow Alzheimer’s Linked Cognitive Decline.

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Background: As the global population ages, the prevalence of dementia is expected to rise significantly. To alleviate the burden on health care systems and the economy, it is essential to develop effective strategies to enhance cognitive function in older adults. Previous studies have shown that combined nonpharmacological interventions can improve cognition across various domains in older individuals. However, there is no established gold standard for the exact combination and duration of these interventions, which makes it challenging to assess their overall effectiveness. Objective: Given the diversity of nonpharmacological multimodal interventions aimed at preventing cognitive decline in older adults with mild cognitive impairment (MCI), this scoping review sought to identify and summarize the characteristics and outcomes of these interventions. Methods: We adhered to the Arksey and O’Malley methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and searched 4 electronic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) systematically on July 6, 2023, and updated the search on April 17, 2024, using specific terms and keywords. Results: This review included 45 studies from 18 countries with 4705 participants from 2014 to 2024 encompassing different combinations of physical training (PT), cognitive training (CT), nutrition intervention, psychosocial intervention, social activities, and electrical stimulation. There is a growing numbers of studies combining PT and CT for MCI treatment, with additional modalities often added to address various aspects of the condition. Compared to single-modal interventions and usual care, multimodal approaches demonstrated significantly better improvements in cognition domains such as attention, global cognition, executive function, memory, processing speed, and verbal fluency. Technology has been instrumental in delivering these interventions and enhancing the effects of PT and CT. Multimodal interventions also show promise in terms of acceptability and user experience, which can improve treatment adherence. Conclusions: Research is limited regarding the cost-effectiveness and optimal dosage of these interventions, making it difficult to assess the additional benefits of incorporating more modalities. Future research should examine the long-term effects of incorporating multiple modalities, using standardized MCI criteria and outcome measures.

European Commission grants authorisation for Eisai and Biogen therapy

Healthy Living with mild cognitive impairment (MCI) is a support and educational series for people with MCI and their families. Classes offer attendees support, guidance and science-backed strategies ...

Alzheimer’s disease (AD) is the most common form of dementia with continuum of disease progression of increasing severity from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) and...

An abnormal form of the tau protein found to accumulate in the brains of Alzheimer’s disease patients also accumulates in the eyes of patients with the condition, according to new findings from Cedars...

Background: Dementia is characterized by impairments in an individual’s cognitive and functional abilities. Digital cognitive assessments have been shown to be effective in detecting mild cognitive impairment and dementia but whether they can stage the…