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Background: Subjective memory complaints (SMC) are common among older adults, but it is unclear to what extent adults with SMC spontaneously use memory strategies to compensate for their memory problems. As SMC may be a risk factor for memory decline later, it is important to extend our knowledge about spontaneous compensatory mechanisms in older adults with SMC. Method: Self-reported strategy use and observed strategy use were assessed in 38 adults with and 38 without SMC. Results: Adults with SMC used more strategies in daily life than those without. In the SMC group, memory complaints were positively correlated with strategy use. Only in adults without SMC, a significant correlation was found between observed strategy use and task performance. Conclusion: Strategy use in older adults with SMC may be compensatory in nature, but did not increase their objective memory performance. Therefore, older adults with SMC might benefit from interventions aimed at optimizing strategy use. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of a multifaceted Treatment for Social cognition and Emotion regulation (TScEmo) in patients with a traumatic brain injury. Participants: Sixty-one patients with moderate to severe traumatic brain injury randomly assigned to an experimental T-ScEmo intervention or a Cogniplus control condition. Interventions: T-ScEmo is a compensatory strategy training for impairments in emotion recognition, theory of mind, and social behavioral skills. Cogniplus is a computerized cognitive function training. Both interventions were given in 16 to 20 weekly 1-hour sessions. Main Measures: Social cognition tests and questionnaires for social behavior (self- and proxy-rated) administered at baseline, immediately posttreatment, and at 3 to 5 months of follow-up. Results: Compared with the Cogniplus group, the T-ScEmo group improved significantly on facial affect recognition, theory of mind, proxy-rated empathic behavior, societal participation, and treatment goal attainment, which lasted up to 5 months after treatment. At follow-up, the T-ScEmo group also reported higher quality of life and their life partners rated relationship quality to be higher than the Cogniplus group. Conclusion: This study shows that impairments in social cognition can be effectively dealt with by using a comprehensive treatment protocol, leading to improvements in everyday life social functioning. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety poststroke. Design Multicenter, assessor-blinded, randomized controlled trial. Setting Ambulatory rehabilitation setting. Participants Patients who had a Hospital Anxiety and Depression Scale-depression subscale (HADS-D) score >7 at least 3 months poststroke (N=61). Interventions Participants were randomly allocated to either augmented CBT or computerized cognitive training (CCT). The CBT intervention was based on the principles of recognizing, registering, and altering negative thoughts and cognitions. CBT was augmented with goal-directed real-life activity training given by an occupational or movement therapist. Main Outcome Measures HADS-D was the primary outcome, and measures of participation and quality of life were secondary outcomes. Outcome measurements were performed at baseline, immediately posttreatment, and at 4- and 8-month follow-up. Analysis was performed with linear mixed models using group (CBT vs CCT) as the between-subjects factor and time (4 assessments) as the within-subjects factor. Results Mixed model analyses showed a significant and persistent time effect for HADS-D (mean difference, −4.6; 95% confidence interval, −5.7 to −3.6; P <.001) and for participation and quality of life in both groups. There was no significant group × time effect for any of the outcome measures. Conclusions Our augmented CBT intervention was not superior to CCT for the treatment of mood disorders after stroke. Future studies should determine whether both interventions are better than natural history. [ABSTRACT FROM AUTHOR]

• Cognitive rehabilitation and mindfulness reduced cognitive complaints. • Positive effects on cognitive complaints did not persist six months post-treatment. • Mindfulness had a long-term positive effect on processing speed. • Cognitive rehabilitation showed long-term benefits on personalized goals. • Thus both treatments have specific contributions when treating cognitive problems. Cognitive problems, both complaints and objective impairments, are frequent and disabling in patients with multiple sclerosis (MS) and profoundly affect daily living. However, intervention studies that focus on cognitive problems that patients experience in their daily lives are limited. This study therefore aimed to investigate the effectiveness of cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT) on patient-reported cognitive complaints in MS. In this randomized-controlled trial, MS patients with cognitive complaints completed questionnaires and underwent neuropsychological assessments at baseline, post-treatment and 6-month follow-up. Patient-reported cognitive complaints were primarily investigated. Secondary outcomes included personalized cognitive goals and objective cognitive function. CRT and MBCT were compared to enhanced treatment as usual (ETAU) using linear mixed models. Patients were randomized into CRT (n = 37), MBCT (n = 36) or ETAU (n = 37), of whom 100 completed the study. Both CRT and MBCT positively affected patient-reported cognitive complaints compared to ETAU at post-treatment (p <.05), but not 6 months later. At 6-month follow-up, CRT had a positive effect on personalized cognitive goals (p =.028) and MBCT on processing speed (p =.027). Patients with less cognitive complaints at baseline benefited more from CRT on the Cognitive Failures Questionnaire (i.e. primary outcome measuring cognitive complaints) at post-treatment (p =.012–.040), and those with better processing speed at baseline benefited more from MBCT (p =.016). Both CRT and MBCT alleviated cognitive complaints in MS patients immediately after treatment completion, but these benefits did not persist. In the long term, CRT showed benefits on personalized cognitive goals and MBCT on processing speed. These results thereby provide insight in the specific contributions of available cognitive treatments for MS patients. [ABSTRACT FROM AUTHOR]

Objective To identify moderators, mediators, and predictors of everyday task performance after an experimental combination of errorless learning and goal management training. Design Predictor analysis of a randomized controlled intervention trial. Setting Outpatient rehabilitation centers. Participants Patients (N=60) with acquired brain injury of nonprogressive nature with a minimal postonset time of 3 months. Interventions Participants were randomly allocated to 8 sessions of errorless or conventional goal management training. Main Outcome Measure Everyday task performance, assessed at baseline and after treatment by evaluating correct, ineffective, and missing task steps. Results Demographic variables, neuropsychological test performance, subjective cognitive function, and quality of life were selected as candidate predictors. The results showed that age ( P =.03) and estimated intelligence quotient (IQ) ( P =.02) emerged as moderators. Higher age was associated with better everyday task performance after conventional goal management training, whereas higher IQ was associated with better performance after errorless goal management training. Higher executive function scores after training predicted improved everyday task performance across the 2 treatment conditions ( P =.04). Conclusions The identified predictors may contribute to a more tailored cognitive rehabilitation approach in which treatments and patients are better matched when clinicians decide to train everyday tasks. [ABSTRACT FROM AUTHOR]

Background and aims: Using the source directed forgetting method, the present paper investigated whether older adults and Alzheimer's disease (AD) patients were able to inhibit source information. Methods: Younger adults, older adults and AD participants were presented with two sets of six items each: Set1 and Set2. Each item was presented by one of two sources: an experimenter black- or white-gloved hand. After the presentation of the Set1 items, participants were instructed either to forget or to continue remembering the source of the items. Afterward, all participants were presented with the Set2 items, and were asked to remember their source. Finally, subjects were exposed to the Set1 and Set2 items, and were asked to recall, for each item, its original source presentation (i.e., the experimenter black- or white-gloved hand). Results: In comparison with younger adults, older adults and AD participants showed no differences in remembering the source of the Set1 and Set2 items. In other words, they failed to inhibit the source information. Discussion and conclusion: Our outcomes are discussed in terms of retrieval inhibition deficits and changes in adaptive nature of memory in normal aging and AD. [ABSTRACT FROM AUTHOR]

Abstract: Winkens I, Van Heugten CM, Wade DT, Habets EJ, Fasotti L. Efficacy of Time Pressure Management in stroke patients with slowed information processing: a randomized controlled trial. Objective: To examine the effects of a Time Pressure Management (TPM) strategy taught to stroke patients with mental slowness, compared with the effects of care as usual. Design: Randomized controlled trial with outcome assessments conducted at baseline, at the end of treatment (at 5–10wk), and at 3 months. Setting: Eight Dutch rehabilitation centers. Participants: Stroke patients (N=37; mean age ± SD, 51.5±9.7y) in rehabilitation programs who had a mean Barthel score ± SD at baseline of 19.6±1.1. Intervention: Ten hours of treatment teaching patients a TPM strategy to compensate for mental slowness in real-life tasks. Main Outcome Measures: Mental Slowness Observation Test and Mental Slowness Questionnaire. Results: Patients were randomly assigned to the experimental treatment (n=20) and to care as usual (n=17). After 10 hours of treatment, both groups showed a significant decline in number of complaints on the Mental Slowness Questionnaire. This decline was still present at 3 months. At 3 months, the Mental Slowness Observation Test revealed significantly higher increases in speed of performance of the TPM group in comparison with the care-as-usual group (t=–2.7, P=.01). Conclusions: Although the TPM group and the care-as-usual group both showed fewer complaints after a 3-month follow-up period, only the TPM group showed improved speed of performance on everyday tasks. Use of TPM treatment therefore is recommended when treating stroke patients with mental slowness. [Copyright &y& Elsevier]