Background: Cognitive interventions that incorporate compensatory strategies may be particularly effective for individuals with Mild Cognitive Impairment (MCI). This meta-analysis evaluated the efficacy of compensatory cognitive interventions for individuals with MCI. Specifically, the following were evaluated: (1) the overall efficacy across cognitive outcomes, (2) effectiveness on different cognitive domains, and (3) influence of study-level moderators. Method: Database searches were conducted, and relevant studies were screened for inclusion criteria and underwent data extraction. A meta-analysis was performed across 23 included studies, followed by subgroup moderator and sensitivity analyses. Results The overall pooled effect size across all cognitive outcomes was g = 0.37, though sensitivity analyses adjusting for small-study bias suggested an effect in the small range ( g = 0.22). Domain-specific analyses indicated significant positive effects on mental status and general cognition ( g = 0.31), memory ( g = 0.43), working memory and attention ( g = 0.44), executive functioning ( g = 0.28), and language ( g = 0.29). Subgroup analyses revealed no overall significant differences between intervention approach, strategy type, control type, or intervention format. However, multicomponent approaches yielded significant effects for executive functioning and working memory, external strategies showed larger effects for memory and working memory/attention, and group-based formats provided greater improvements across outcomes. Conclusion Compensatory-based interventions offer small-to-moderate benefits for individuals with MCI, particularly in the domains of memory and attention/working memory. While study-level moderators did not demonstrate significant differences, trends suggest that multicomponent approaches, using both external and internal strategies, and a group intervention format may confer some benefits.

Abstract Background Poor memory for treatment is associated with poorer treatment adherence and poorer patient outcomes. The memory support intervention (MSI) was developed to improve patient memory for treatment with the goal of improving patient outcomes. The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether a new, streamlined, and potent version of the MSI improves outcomes for midlife and older adults. This streamlined MSI is comprised of constructive memory supports that will be applied to a broader range of treatment content. The platform for this study is the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C). We will focus on midlife and older adults who are low income and experiencing mobility impairments. Methods Participants (N = 178) will be randomly allocated to TranS-C + MSI or TranS-C alone. Both intervention arms include eight 50-min weekly sessions. Assessments will be conducted at pre-treatment, post-treatment, 6-, and 12-month follow-up (6FU and 12FU). Aim 1 will compare the effects of TranS-C + MSI versus TranS-C alone on sleep and circadian functioning, daytime functioning, well-being, and patient memory. Aim 2 will test whether patient memory for treatment mediates the relationship between treatment condition and patient outcomes. Aim 3 will evaluate if previously reported poor treatment response subgroups will moderate the relationship between treatment condition and (a) patient memory for treatment and (b) treatment outcome. Exploratory analyses will compare treatment condition on (a) patient adherence, patient-rated treatment credibility, and patient utilization of treatment contents, and (b) provider-rated acceptability, appropriateness, and feasibility. Discussion This study has the potential to provide evidence for (a) the efficacy of a new simplified version of the MSI for maintaining health, well-being, and functioning, (b) the wider application of the MSI for midlife and older adults and to the treatment of sleep and circadian problems, and (c) the efficacy of the MSI for sub-groups who are likely to benefit from the intervention. Trial registration ClinicalTrials.gov NCT05986604. Registered on 2 August 2023.

Background:To determine if the use of theory, data and end-user perspectives to guide an adaptation of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) yields better outcomes and improves the "fit" of TranS-C to community mental health centers (CMHCs), relative to the standard version. Methods:Ten counties in California were cluster-randomized by county to Adapted or Standard TranS-C. Within each county, adults who exhibited sleep and circadian dysfunction and serious mental illness (SMI) were randomized to immediate TranS-C or Usual Care followed by Delayed Treatment with TranS-C (UC-DT). Facilitation was the implementation strategy. The participants were 93 CMHC providers who delivered TranS-C (Standard = 30; Adapted = 63) and 396 CMHC patients (Standard = 74; Adapted = 124; UC-DT = 198). Patient assessments were completed at pre-treatment, post-treatment, and six months after treatment (6FU). Provider assessments were completed at post-training, mid-treatment, and post-treatment. Results:TranS-C (combining Adapted and Standard), relative to UC-DT before delayed treatment with TranS-C, was associated with improvement from pre- to post-treatment in sleep disturbance (b = -10.91, p < 0.001, d = -1.52), sleep-related impairment (b = -9.52, p < 0.001, d = -1.06), sleep health composite (b = 1.63, p < 0.001, d = 0.95), psychiatric symptoms (b = -6.72, p < 0.001, d = -0.52), and overall functional impairment (b = -5.12, p < 0.001, d = -0.71). TranS-C's benefits for functional impairment and psychiatric symptoms were mediated by improvements in sleep and circadian problems. Adapted versus Standard TranS-C did not differ on provider ratings of fit and better fit did not mediate the relation between TranS-C condition and patient outcome. Conclusions:TranS-C can be delivered by CMHC providers. Although Adapted and Standard TranS-C both fit the CMHC context, several advantages emerged for the adapted version.

Head-worn augmented reality (AR) is a hotly pursued and increasingly feasible contender paradigm for replacing or complementing smartphones and watches for continual information consumption. Here, we compare three different AR navigation aids (on-screen compass, on-screen radar and in-world vertical arrows) in a wide-area outdoor user study (n=24) where participants search for hidden virtual target items amongst physical and virtual objects. We analyzed participants search task performance, movements, eye-gaze, survey responses and object recall. There were two key findings. First, all navigational aids enhanced search performance relative to a control condition, with some benefit and strongest user preference for in-world arrows. Second, users recalled fewer physical objects than virtual objects in the environment, suggesting reduced awareness of the physical environment. Together, these findings suggest that while navigational aids presented in AR can enhance search task performance, users may pay less attention to the physical environment, which could have undesirable side-effects.

Visual features previously associated with reward can capture attention even when task-irrelevant, a phenomenon known as value-driven attention capture (VDAC). VDAC persists without reinforcement, unlike other forms of learning, where removing reinforcement typically leads to extinction. In five experiments, factors common to many studies were manipulated to examine their impact on VDAC and its extinction. All experiments included learning and test phases. During learning, participants completed a visual search task during which one of two target colors was associated with a reward, and the other with no reward. During test, 1 week later, participants completed another visual search task in which the reward association was not reinforced. When a rewarded feature remained task-relevant (Experiment 1), VDAC was observed. When the rewarded feature was made task-irrelevant (Experiments 2-5) there was no evidence of a VDAC effect, except when the target feature was physically salient and there was a reduction in the frequency of exposure to the reward-associated feature (Experiment 5). We failed to find evidence of VDAC in Experiments 2-4, suggesting that VDAC may depend on the demands of the task resulting in vulnerability to VDAC. When VDAC was observed, extinction was also observed. This indicates that VDAC is subject to extinction as would be expected from an effect driven by reinforcement learning.

During visual search tasks, irrelevant visual features previously associated with reward can capture spatial attention, a phenomenon known as value-driven attention capture (Anderson et al., 2011). Here we tested whether visual features previously associated with reward impact performance during a sustained attention task with no required shifts of spatial attention. Participants completed a modified version of the continuous temporal expectancy task (CTET; O’Connell et al., 2009). The CTET is a sustained attention task that requires continuous monitoring of a stimulus sequence for rare task-relevant targets. Participants (N=27) completed a two-phase version of the CTET during which participants viewed a rapid serial visual presentation (RSVP) stream of faces and cars (equiprobable). Ninety percent of the stimuli were presented for 800 ms, but 10% were infrequent targets presented for 1120 ms. When the long duration targets were detected, participants discriminated whether the stimulus was a face or a car. Targets were surrounded by a red or blue colored border and non-targets surrounded by randomly selected colors. One target color resulted in a 5¢ reward, and the other color resulted in no reward. During training the proportion of correct target detections was higher for the rewarded compared to non-rewarded targets (BF>1000). During the test phase, one week later, participants completed the same task with no reward feedback. Participants continued to correctly detect rewarded at a higher rate compared to non-rewarded stimuli (BF>1000). Our results suggest that visual features associated with reward can subsequently continue to affect performance during sustained attention even when the association is no longer reinforced. While the effect of rewarded visual features has been extensively demonstrated in selective attention tasks (Anderson et al., 2011; Anderson & Yantis, 2013), here we show that such reward associations can also improve performance during sustained attention even in the absence of shifts of spatial attention.

By situating computer-generated content in the physical world, mobile augmented reality (AR) can support many tasks that involve effective search and inspection of physical environments. Currently, there is limited information regarding the viability of using AR in realistic wide-area outdoor environments and how AR experiences affect human behavior in these environments. Here, we conducted a wide-area outdoor AR user study ($n=48$) using a commercially available AR headset (Microsoft Hololens 2) to compare (1) user interactions with physical and virtual objects in the environment (2) the effects of different lighting conditions on user behavior and AR experience and (3) the impact of varying cognitive load on AR task performance. Participants engaged in a treasure hunt task where they searched for and classified virtual target items (green “gems”) in an augmented outdoor courtyard scene populated with physical and virtual objects. Cognitive load was manipulated so that in half the search trials users were required to monitor an audio stream and respond to specific target sounds. Walking paths, head orientation and eye gaze information were measured, and users were queried about their memory of encountered objects and provided feedback on the experience. Key findings included (1) Participants self-reported significantly lower comfort in the ambient natural light condition, with virtual objects more visible and participants more likely to walk into physical objects at night; (2) recall for physical objects was worse than for virtual objects, (3) participants discovered more gems hidden behind virtual objects than physical objects, implying higher attention on virtual objects and (4) dual-tasking modified search behavior. These results suggest there are important technical, perceptual and cognitive factors that must be considered if the full potential of “anywhere and anytime mobile AR” is to be realized.

Our work has demonstrated that previously rewarded features that remain task relevant continue to capture attention during an extinction phase. Here, we investigated the conditions under which such value-driven capture is extinguished. In three experiments (E), participants learned to associate a target color with reward, and another with no reward in a visual search paradigm. One week later, during the extinction phase, this association was no longer reinforced. In E1, the colors that previously defined targets were presented as distractors, as is typical of paradigms in this literature, however we failed to observe an effect of former reward-associations on RT, suggesting that reward did not reliably capture attention when task-irrelevant. E2 was identical to E1, but included an absent condition where neither formerly rewarded or non-rewarded colors were present. In E2 a value-driven capture effect was not observed. However, trials containing either a previously rewarded or non-rewarded distractor that had previously been selected were significantly slower compared to trials where no previously selected stimulus was present, which persisted throughout extinction. These findings demonstrate that the role of selection history (previous experience selecting a feature) appears to play a critical role in shaping attention, unique from that of reward history. E3 was also identical to E1 but targets were defined as salient shape singletons during extinction, another common feature in this literature. In contrast to E1 and E2, value-driven attention capture by formerly reward associated colors was extinguished. The rate of extinction in E3 was rapid, which could be the result of competition for attentional priority between the salient singleton and the distractor. These findings demonstrate that the extinction of value-driven capture depends on various factors that affect priority for attention, especially those features that bias attention away from reward-associated features.

Healthy ageing is associated with decline in cognitive abilities such as language. Aerobic fitness has been shown to ameliorate decline in some cognitive domains, but the potential benefits for language have not been examined. In a cross-sectional sample, we investigated the relationship between aerobic fitness and tip-of-the-tongue states. These are among the most frequent cognitive failures in healthy older adults and occur when a speaker knows a word but is unable to produce it. We found that healthy older adults indeed experience more tip-of-the-tongue states than young adults. Importantly, higher aerobic fitness levels decrease the probability of experiencing tip-of-the-tongue states in healthy older adults. Fitness-related differences in word finding abilities are observed over and above effects of age. This is the first demonstration of a link between aerobic fitness and language functioning in healthy older adults.

Visual stimuli previously associated with reward can capture attention in the absence of reinforcement (Anderson & Yantis, 2012). We investigated whether reward-associated attentional capture would persist after repeated exposure in the absence of reinforcement or whether the effect could eventually be extinguished. During the training phase, which consisted of 800 trials, participants (n=12) learned to associate one of two target colors (red and blue) with reward, and the other with the absence of reward. One week later, during the extinction phase, participants completed 1600 trials of the same task but were no longer rewarded. Reaction times were significantly faster to reward-associated targets than no reward-associated targets. Critically, there was an interaction between reward condition and task phase such that the difference between rewarded and unrewarded trials was significantly larger during training (MD=50.32ms, SEM=10.8) than extinction (MD=25.08ms, SEM=4.64), suggesting that there was reduction of the reward-associated capture effect during extinction. However, when the analysis was broken down by block, there was an interaction between reward condition and block during training, but not during extinction. This interaction indicates the presence of learning during training, because the difference between rewarded and unrewarded trials increased over the course of the training phase, but not during extinction. These findings suggest that while the effect of value-driven attentional capture is reduced, extinction learning did not occur. However, 7 out of the 12 participants displayed some extinction learning, whereby the difference between previously reward-associated and no reward-associated targets decreased from the first to the last block of the extinction phase. Although there is evidence of a reduction in the effect of value-associated stimuli, the effect still remains statistically significant over 1600 trials, suggesting evidence for some persistence. Thus, reward learning is persistent, but individual differences may play a role in how value-driven attention is learned and extinguished. Meeting abstract presented at VSS 2017