What are the effects of significantly improved cognitive function on global cognition, executive function, processing speed, memory, attention, and mood?

From the Guidelines

Significantly improved cognitive function can be achieved through lifestyle interventions, including regular physical exercise, cognitive training, and proper nutrition, which have been shown to improve global cognition, executive function, processing speed, memory, attention, and mood. The most recent and highest quality study, published in 2022 1, suggests that exercise, in particular, is a cornerstone strategy for the prevention and treatment of dementia, with multicomponent exercise interventions being the most effective for improving cognition in older adults with mild cognitive impairment.

Key findings from this study include:

• Multicomponent exercise was found to be the most effective type of exercise for improving cognition in older adults with mild cognitive impairment
• Resistance exercise was found to be the most effective type of exercise for improving cognition in older adults with established dementia
• The World Health Organization recommends at least 150-300 minutes of moderate-intensity aerobic physical activity per week, or 75-150 minutes of vigorous-intensity aerobic physical activity, and at least three times a week of muscle-strengthening activities involving major muscle groups
• The dose-response relationship between exercise and cognition is critical, with high-dose interventions (>150 min/week) being no more effective than low-dose ones (<150 min/week) in older adults with cognitive impairment

Other studies, such as the 2021 review published in the Journal of Internal Medicine 1, also support the use of lifestyle interventions, including exercise and cognitive training, to improve cognitive function in older adults. Additionally, the 2024 multispecialty practice recommendations for the management of diabetes, cardiorenal, and metabolic diseases 1 highlight the importance of lifestyle interventions in reducing the risk of cognitive dysfunction, which is strongly associated with diabetes and obesity.

In terms of specific recommendations, regular physical exercise, such as aerobic exercise or resistance training, for at least 150 minutes per week, combined with cognitive training and proper nutrition, is likely to have a positive impact on cognitive function. However, it is essential to consult with a healthcare provider to determine the most appropriate treatment plan based on individual health conditions and needs.

From the FDA Drug Label

The SIB, a multi-item instrument, has been validated for the evaluation of cognitive function in patients with moderate to severe dementia. The SIB evaluates selective aspects of cognitive performance, including elements of memory, language, orientation, attention, praxis, visuospatial ability, construction, and social interaction The ADAS-cog examines selected aspects of cognitive performance including elements of memory, orientation, attention, reasoning, language, and praxis.

The effects of significantly improved cognitive function on global cognition, executive function, processing speed, memory, attention, and mood are not directly addressed in the provided drug labels.

• Memory: may be improved as the SIB evaluates elements of memory
• Attention: may be improved as the SIB and ADAS-cog evaluate elements of attention However, the provided information does not allow for a comprehensive answer to the question. 2 2

From the Research

Effects of Improved Cognitive Function

The effects of significantly improved cognitive function on various aspects of cognition and mood can be understood through the following points:

• Global Cognition: Studies have shown that certain interventions, such as cholinesterase inhibitors 3 and computerised cognitive training 4, can lead to slight improvements in global cognitive function in individuals with vascular cognitive impairment or mild cognitive impairment.
• Executive Function: The evidence for the effect of cognitive training on executive function is mixed, with some studies finding little to no difference 4 and others suggesting that multicomponent training may be beneficial 5.
• Processing Speed: There is limited evidence on the effect of cognitive training on processing speed, with one study finding very low-quality evidence for this outcome 4.
• Memory: Cognitive training, particularly multicomponent and multidomain forms of intervention, may improve memory in individuals with mild cognitive impairment 5. Additionally, memory-focused interventions appear to be more effective than multidomain approaches 5.
• Attention: Cognitive training can improve overall attention, selective attention, and divided attention in older adults with mild cognitive impairment 6.
• Mood: While the evidence is limited, some studies suggest that cognitive training may have a positive effect on mood, although this is not a primary outcome in most studies.

Key Findings

Some key findings from the studies include:

• Donepezil, a cholinesterase inhibitor, may improve cognition, clinical global impression, and activities of daily living in patients with vascular cognitive impairment 3, 7.
• Computerised cognitive training may lead to slight improvements in global cognitive function and episodic memory in cognitively healthy older adults 4.
• Multicomponent training and multidomain-focused strategies may be effective in improving cognition in individuals with mild cognitive impairment 5.
• Cognitive training can improve attention functions in older adults with mild cognitive impairment 6.