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دوره 15، شماره 2 - ( 5-1404 )
جلد 15 شماره 2 صفحات 169-159 |
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Izadkhah F, bahrami A, Moradi J, Fouladi Fard M H. Effect of Brain Exercises on Working Memory and Sustained Attention in the Elderly with Alzheimer's Disease. cmja 2025; 15 (2) :159-169
URL: http://cmja.arakmu.ac.ir/article-1-1039-fa.html
URL: http://cmja.arakmu.ac.ir/article-1-1039-fa.html
ایزدخواه فرشته، بهرامی علیرضا، مرادی جلیل، فولادی فرد محمد حسین. اثربخشی تمرینات ورزش مغزی بر حافظه کاری و توجه پایدار سالمندان مبتلا به آلزایمر. فصلنامه طب مکمل. 1404; 15 (2) :159-169
1- استادیار، گروه رفتار حرکتی و روان‌شناسی ورزشی، دانشکده علوم ورزشی، دانشگاه شهید چمران اهواز، اهواز، ایران. ، f.izadkhah@scu.ac.ir
2- دانشیار، گروه رفتار حرکتی و روان‌شناسی ورزش، دانشکده علوم ورزشی، دانشگاه اراک، اراک، ایران
3- دانشجوی دکتری رفتار حرکتی، دانشکده علوم ورزشی، دانشگاه اراک، اراک، ایران
2- دانشیار، گروه رفتار حرکتی و روان‌شناسی ورزش، دانشکده علوم ورزشی، دانشگاه اراک، اراک، ایران
3- دانشجوی دکتری رفتار حرکتی، دانشکده علوم ورزشی، دانشگاه اراک، اراک، ایران
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INTRODUCTION
Alzheimer’s disease is the leading cause of dementia, accounting for 60-80% of cases worldwide (1). It is a progressive neurodegenerative disorder marked by a gradual loss of cognitive abilities, including memory, attention, reasoning, and language (2). As populations age, in both developed and developing countries, Alzheimer’s disease has become a major public health issue. The rising number of Alzheimer’s disease cases not only causes emotional strain on patients and their families but also imposes a significant financial burden on healthcare systems due to long-term care requirements (3).
One of the earliest and most debilitating symptoms of Alzheimer’s disease is a decline in cognitive functions, especially working memory and sustained attention. Working memory is the brain's ability to hold and manipulate information briefly, which is vital for decision-making, problem-solving, and performing complex tasks (4). Sustained attention, on the other hand, refers to the ability to stay focused and alert over long periods. Both are essential for maintaining independence and quality of life in older adults (5).
Traditional pharmacological treatments for Alzheimer's have shown only limited efficacy in slowing down cognitive decline and often come with adverse effects. As a result, there is growing interest in non-pharmacological interventions that may offer safer and more sustainable cognitive support (1). Among these, brain exercises—often referred to as “brain gym” activities—have emerged as a promising approach. These cognitive training exercises aim to stimulate brain function through targeted mental activities, thereby improving neuroplasticity and enhancing cognitive performance (2).
The present study aimed to investigate whether a structured brain exercise program could lead to measurable improvements in working memory and sustained attention in elderly individuals diagnosed with Alzheimer’s disease. By assessing changes over time, including post-intervention and follow-up stages, the study aimed to determine both the immediate and lasting effects of brain training interventions.
METHODS
This research used a semi-experimental approach, applied design with a pretest-posttest model and follow-up analysis. The goal was to assess the effectiveness of a brain training program, specifically designed for elderly individuals with Alzheimer's disease. The study involved 26 elderly participants, all of whom had a clinical diagnosis of Alzheimer’s disease and were selected through convenience sampling. These participants were randomly divided into two groups: an experimental group that received the intervention, and a control group that did not.
Before the intervention, both groups underwent a pretest to evaluate their baseline levels of working memory and sustained attention. The experimental group then participated in a brain exercise training program comprising 12 sessions, conducted over six weeks, with two sessions per week. Each session lasted 30 minutes and included a series of structured cognitive exercises designed to activate different areas of the brain, such as memory recall games, attention tasks, pattern recognition exercises, and problem-solving tasks.
The control group received no specific cognitive intervention during this period but continued with their regular routines. After the six-week intervention, both groups were re-evaluated using the same measures to determine posttest results. To examine the lasting effects of the intervention, a follow-up assessment was conducted after an additional period without further training.
Statistical analyses were performed using Multivariate Analysis of Variance (MANOVA), allowing the researchers to examine differences across multiple time points and between groups. p-value of less than 0.05 was considered statistically significant. The collected data was analyzed in SPSS software (version 22).
RESULTS
The current findings indicated that brain exercise training had a statistically significant positive effect on the cognitive functions of elderly individuals with Alzheimer’s disease. Participants in the experimental group demonstrated significant improvements in both sustained attention and working memory from the pretest to the posttest.
Specifically, the MANOVA results showed significant differences in sustained attention (P=0.001) and working memory (P=0.001) between the experimental and control groups after the intervention. These cognitive improvements were evident immediately after training and persisted during the follow-up phase, indicating that the benefits lasted over time. At the follow-up stage, no statistically significant decline was observed in performance (P=0.99), suggesting the intervention had a lasting impact on the participants’ cognitive abilities.
The control group, by contrast, exhibited no significant changes in cognitive function during the same period, further reinforcing the effectiveness of the brain exercise training program.
CONCLUSION
In summary, this study shows that brain exercise training effectively enhances working memory and sustained attention in elderly individuals with Alzheimer’s disease. The structured cognitive intervention produced statistically significant improvements that persisted over time, suggesting the potential for lasting cognitive benefits. Given the increasing prevalence of Alzheimer’s and the limitations of medication options, brain training programs provide a practical and accessible alternative for supporting cognitive health in aging populations. Implementing these programs in clinical settings, elderly care homes, or even at home can complement existing treatments. Future research should aim to understand the mechanisms behind these cognitive gains, optimize training duration and frequency, and evaluate the long-term effects on other cognitive functions and daily activities.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Shahid Chamran University of Ahvaz with the ethical code IR.SCU.REC.1403.122.
Funding
None.
Authors' Contributions
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all those who provided scientific consultation for this paper.
Alzheimer’s disease is the leading cause of dementia, accounting for 60-80% of cases worldwide (1). It is a progressive neurodegenerative disorder marked by a gradual loss of cognitive abilities, including memory, attention, reasoning, and language (2). As populations age, in both developed and developing countries, Alzheimer’s disease has become a major public health issue. The rising number of Alzheimer’s disease cases not only causes emotional strain on patients and their families but also imposes a significant financial burden on healthcare systems due to long-term care requirements (3).
One of the earliest and most debilitating symptoms of Alzheimer’s disease is a decline in cognitive functions, especially working memory and sustained attention. Working memory is the brain's ability to hold and manipulate information briefly, which is vital for decision-making, problem-solving, and performing complex tasks (4). Sustained attention, on the other hand, refers to the ability to stay focused and alert over long periods. Both are essential for maintaining independence and quality of life in older adults (5).
Traditional pharmacological treatments for Alzheimer's have shown only limited efficacy in slowing down cognitive decline and often come with adverse effects. As a result, there is growing interest in non-pharmacological interventions that may offer safer and more sustainable cognitive support (1). Among these, brain exercises—often referred to as “brain gym” activities—have emerged as a promising approach. These cognitive training exercises aim to stimulate brain function through targeted mental activities, thereby improving neuroplasticity and enhancing cognitive performance (2).
The present study aimed to investigate whether a structured brain exercise program could lead to measurable improvements in working memory and sustained attention in elderly individuals diagnosed with Alzheimer’s disease. By assessing changes over time, including post-intervention and follow-up stages, the study aimed to determine both the immediate and lasting effects of brain training interventions.
METHODS
This research used a semi-experimental approach, applied design with a pretest-posttest model and follow-up analysis. The goal was to assess the effectiveness of a brain training program, specifically designed for elderly individuals with Alzheimer's disease. The study involved 26 elderly participants, all of whom had a clinical diagnosis of Alzheimer’s disease and were selected through convenience sampling. These participants were randomly divided into two groups: an experimental group that received the intervention, and a control group that did not.
Before the intervention, both groups underwent a pretest to evaluate their baseline levels of working memory and sustained attention. The experimental group then participated in a brain exercise training program comprising 12 sessions, conducted over six weeks, with two sessions per week. Each session lasted 30 minutes and included a series of structured cognitive exercises designed to activate different areas of the brain, such as memory recall games, attention tasks, pattern recognition exercises, and problem-solving tasks.
The control group received no specific cognitive intervention during this period but continued with their regular routines. After the six-week intervention, both groups were re-evaluated using the same measures to determine posttest results. To examine the lasting effects of the intervention, a follow-up assessment was conducted after an additional period without further training.
Statistical analyses were performed using Multivariate Analysis of Variance (MANOVA), allowing the researchers to examine differences across multiple time points and between groups. p-value of less than 0.05 was considered statistically significant. The collected data was analyzed in SPSS software (version 22).
RESULTS
The current findings indicated that brain exercise training had a statistically significant positive effect on the cognitive functions of elderly individuals with Alzheimer’s disease. Participants in the experimental group demonstrated significant improvements in both sustained attention and working memory from the pretest to the posttest.
Specifically, the MANOVA results showed significant differences in sustained attention (P=0.001) and working memory (P=0.001) between the experimental and control groups after the intervention. These cognitive improvements were evident immediately after training and persisted during the follow-up phase, indicating that the benefits lasted over time. At the follow-up stage, no statistically significant decline was observed in performance (P=0.99), suggesting the intervention had a lasting impact on the participants’ cognitive abilities.
The control group, by contrast, exhibited no significant changes in cognitive function during the same period, further reinforcing the effectiveness of the brain exercise training program.
CONCLUSION
In summary, this study shows that brain exercise training effectively enhances working memory and sustained attention in elderly individuals with Alzheimer’s disease. The structured cognitive intervention produced statistically significant improvements that persisted over time, suggesting the potential for lasting cognitive benefits. Given the increasing prevalence of Alzheimer’s and the limitations of medication options, brain training programs provide a practical and accessible alternative for supporting cognitive health in aging populations. Implementing these programs in clinical settings, elderly care homes, or even at home can complement existing treatments. Future research should aim to understand the mechanisms behind these cognitive gains, optimize training duration and frequency, and evaluate the long-term effects on other cognitive functions and daily activities.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Shahid Chamran University of Ahvaz with the ethical code IR.SCU.REC.1403.122.
Funding
None.
Authors' Contributions
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all those who provided scientific consultation for this paper.
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مجله طب مکمل
اراک، سردشت، میدان بسیج، مجتمع دانشگاهی دانشگاه علوم پزشکی اراک، بال آبی، دفتر مجله طب مکمل
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