Evidence for Neurocognitive Plasticity in At-Risk Older Adults: The Experience Corps Program
Open accessAbstract
OBJECTIVE: To determine whether Experience Corps (EC), a social service program, would improve age-vulnerable executive functions and increase activity in brain regions in a high-risk group through increased cognitive and physical activity. METHODS: Eight community-dwelling, older female volunteers and nine matched wait-list controls were recruited to serve in the ongoing EC: Baltimore program in three elementary schools. We employed functional magnetic resonance imaging (fMRI) preintervention and postintervention to examine whether EC volunteers improved executive function and showed increased activity in the prefrontal cortex relative to controls. fMRI volunteers were trained and placed with other volunteers 15 h/wk for 6 months during the academic year to assist teachers in kindergarten through third grade to promote children's literacy and academic achievement. RESULTS: Participants were African American and had low education, low income, and low Mini-Mental State Examination scores (M = 24), indicative of elevated risk for cognitive impairment. Volunteers exhibited intervention-specific increases in brain activity in the left prefrontal cortex and anterior cingulate cortex over the 6-month interval relative to matched controls. Neural gains were matched by behavioral improvements in executive inhibitory ability. CONCLUSIONS: Using fMRI, we demonstrated intervention-specific short-term gains in executive function and in the activity of prefrontal cortical regions in older adults at elevated risk for cognitive impairment. These pilot results provide proof of concept for use-dependent brain plasticity in later life, and, that interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.
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Written from the paper’s full text.
TL;DR
In a pilot fMRI study, 8 older African American women volunteering in Experience Corps and 9 matched wait-list controls showed intervention-specific increases in left prefrontal cortex and anterior cingulate activity and improved executive inhibitory performance over 6 months. The authors conclude this provides proof of concept for use-dependent neurocognitive plasticity in at-risk older adults.
Key findings
- Experience Corps volunteers showed intervention-specific increases in brain activity over 6 months relative to controls in the anterior cingulate cortex (Time × Group: F(1,13) = 13.22; p < .003), left dorsal lateral prefrontal cortex (F(1,13) = 5.16; p < .04), and left ventral lateral prefrontal cortex (F(1,13) = 8.99; p < .01).
- Behavioral gains matched neural changes: the intervention group had a greater reduction in interference scores over 6 months (Time × Group: F(1,13) = 5.28; p < .04), and accuracy improved in the incongruent conditions (Time × Group × Congruency: F(1,13) = 5.77; p < .03).
- Participants were African American with low education, low income, and low Mini-Mental State Examination scores (abstract M = 24; table EC M = 24.5 vs control M = 26.4), indicating elevated risk for cognitive impairment.
- No regions showed an intervention-related decrease in activity; right prefrontal regions did not show significant changes meeting threshold.
Methods
- Pilot pre–post fMRI study with 8 community-dwelling older female Experience Corps volunteers and 9 matched wait-list controls, recruited to the ongoing EC: Baltimore program in three elementary schools; volunteers were trained and placed 15 h/wk for 6 months during the academic year to assist teachers in kindergarten through third grade with literacy and academic achievement.
- Participants completed a flanker selective attention task during 3.0T fMRI, with four conditions (congruent/incongruent × small/large cue) presented 40 times each for 160 trials; analyses used repeated measures ANOVA and FSL/FLAME with regions of interest in the anterior cingulate cortex and left/right dorsal and ventral prefrontal cortex, thresholded at Z > 3.1 and corrected cluster p = .01.
Limitations
- Stated: the small sample was necessarily restricted to women due to gender differences in brain morphology, limiting generalizability; it remains unknown whether the program enhances or maintains cognition among more ethnically and socioeconomically diverse individuals.
- Stated: the design cannot definitively discern whether effects were mediated primarily by cognitive versus physical pathways, or whether benefits represent synergy across activity domains.
- Evident: this is a small pilot with matched wait-list controls rather than a large randomized trial; laterality differences and their functional significance are unclear, and the authors state these hypotheses require replication in a larger sample; structural changes and supporting white matter tracts were not determined.
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Claims the paper makes
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- Findingown data§ RESULTS
Accuracy rates did not reliably differ between the control and intervention groups at baseline.
“Accuracy rates did not reliably differ between the control and the intervention groups at baseline (all p > .05).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
The three-way interaction for accuracy was due to a greater intervention-specific improvement in accuracy in the incongruent conditions (p<.05).
“Post hoc comparisons revealed that this three-way interaction was due to a greater intervention-specific improvement in accuracy in the incongruent conditions (p < .05)”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
The right prefrontal regions, although active at baseline for both groups, did not show significant changes in activation that met threshold.
“The right prefrontal regions, although active at baseline for both groups, did not show significant changes in activation that met threshold.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
In the ACC, there was a significant Time × Group interaction (F(1,13)=13.22; p<.003).
“In a repeated measures analysis of the ACC (cluster size = 1704 mm3), we observed a significant Time × Group interaction (F (1,13) = 13.22; p < .003)”
Quote in the paperSubstantial claim - Findingown data§ Results
Neural gains were matched by behavioral improvements in executive inhibitory ability.
“Neural gains were matched by behavioral improvements in executive inhibitory ability.”
Quote in the paperSubstantial claim
- Findingown data§ RESULTS
The intervention-specific improvement in accuracy in the incongruent conditions was independent of cue size (F(1,13)=2.160; p<.16).
“that was independent of cue size (F (1,13) = 2.160; p < .16).”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
There was no significant Time × Group interaction for accuracy (F(1,13)=1.28; p<.28).
“Compared with RT measures, there was no significant Time × Group interaction (F (1,13) = 1.28; p < .28).”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
There was a significant Time × Group × Congruency interaction for accuracy (F(1,13)=5.77; p<.03).
“However, there was a significant Time × Group × Congruency interaction (F (1,13) = 5.77; p < .03).”
Quote in the paperSubstantial claim - Findingown data§ Results
Volunteers exhibited intervention-specific increases in brain activity in the left prefrontal cortex and anterior cingulate cortex over the 6-month interval relative to matched controls.
“Volunteers exhibited intervention-specific increases in brain activity in the left prefrontal cortex and anterior cingulate cortex over the 6-month interval relative to matched controls.”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
The percent reduction in interference was equivalent across large and small cue sizes.
“The percent reduction in interference was equivalent across large and small cue sizes.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
There were no significant interactions with congruency or cue size for the ACC.
“There were no interactions with congruency or cue size, suggesting that intervention-specific gains in the ACC were independent of congruency condition or cue size or that there was insufficient power.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
No regions showed an intervention-related decrease in activity.
“No regions showed an intervention-related decrease in activity.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
At baseline, response times were slower for large cues than for small cues.
“Furthermore, at baseline, RTs were slower for the incongruent condition compared with the congruent condition (F (1,15) = 21.27; p < .001) and for large cues compared with small cues (F (1,15) = 25.33; p < .001), as expected.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
The intervention group showed a greater reduction in interference scores over the 6-month interval compared with matched controls.
“We observed a significant Time × Group interaction (F (1,13) = 5.28; p < .04) in interference scores such that the intervention group showed a greater reduction in interference over the 6-month interval compared with matched controls (see Figure 2).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
In the left dLPFC, there was a significant Time × Group interaction (F(1,13)=5.16; p<.04).
“Similar analyses of the left dLPFC (cluster size = 2704 mm3) also revealed a significant Time × Group interaction (F (1,13) = 5.16; p < .04)”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
Consistent with prior fMRI studies using the flanker task, the study observed significant increases in activity in regions associated with the attentional network, including the left and right dorsal lateral prefrontal cortex, the ventral lateral prefrontal cortex, and the ACC.
“Consistent with prior fMRI studies using the flanker task, we observed significant increases in activity in regions associated with the attentional network, including the left and right dorsal lateral prefrontal cortex, the ventral lateral prefrontal cortex, and the ACC (26).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [26] Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004;101(9):3316–3321. doi: 10.1073/pnas.0400266101. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- Findingown data§ RESULTS
The intervention group showed a significant increase in left dLPFC activity over time.
“with the intervention group showing a significant increase in activity over time (Figure 2).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
The Time × Group × Cue-size interaction for interference was not significant.
“Similarly, the Time × Group × Cue-size interaction was not significant (F (1,13) = 1.80; p < .20).”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
The intervention group showed a significant increase in left vLPFC activity at follow-up.
“with those in the intervention group showing a significant increase in activity at follow-up.”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
The ACC Time × Group interaction was due to a significant intervention-specific increase in activity over the 6-month follow-up.
“that was due to a significant intervention-specific increase in activity over the 6-month follow-up (see Figure 3).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
Pre-post comparisons showed EC-intervention-specific improvements in the ability to selectively attend during the most attention demanding task conditions (incongruent).
“Pre–post comparisons of each group’s ability to filter conflicting distracters (incongruent RT–congruent RT) for small and large cues are presented in Figure 3 and show EC-intervention–specific improvements in the ability to selectively attend during the most attention demanding task conditions (incongruent).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
In the left vLPFC, there was a significant Time × Group interaction (F(1,13)=8.99; p<.01).
“The left vLPFC (cluster size = 1576 cubic mm) showed a similar Time × Group interaction (F (1,13) = 8.99; p < .01)”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
There were no significant interactions with congruency or cue size for the left dLPFC.
“As with the ACC, there were no significant interactions with congruency or cue size.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
Corresponding fMRI group comparisons showed increased activity in attentional control regions of the PFC (middle and inferior frontal regions bilaterally) and the parietal regions.
“Corresponding fMRI group comparisons similarly showed increased activity in attentional control regions of the PFC (middle and inferior frontal regions bilaterally) and the parietal regions, suggesting more efficient filtering or inhibiting of target information from distraction (Figure 3).”
Quote in the paperSubstantial claim - Findingown data§ RESULTS
These attentional network regions showed elevated activity for the incongruent condition compared with the congruent condition (collapsed across cue size), meeting a voxel-wise threshold of p < .01 and a cluster-wise threshold of p < .05.
“These regions showed elevated levels of activity for the incongruent condition compared with the congruent condition (collapsed across cue size) that met a voxel-wise threshold of p < .01 and a cluster-wise threshold of p < .05.”
Quote in the paperNot a substantial claim - Findingown data§ RESULTS
The control and intervention groups did not reliably differ for any condition at the baseline assessment.
“The control group and intervention group did not reliably differ for any condition at the baseline assessment (all p > .05).”
Quote in the paperSubstantial claim - Interpretationown data§ Conclusions
Individuals at risk for cognitive impairment have sufficient neurocognitive reserves or plasticity to benefit immediately and substantially from high-impact activity intervention.
“Our promising short-term findings among individuals at risk for cognitive impairment suggest that they have sufficient neurocognitive reserves or plasticity to benefit immediately and substantially from this type of high-impact activity intervention.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Prefrontal cortical regions that support executive functions are particularly vulnerable to declines at later ages.
“Executive planning and organizational skills appear to be important to maintaining functional independence (4–7) and appear to be particularly vulnerable to declines at later ages (8–10) along with the prefrontal cortical regions of the brain that support them (11–14).”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [11] Buckner RL. Memory and executive function in aging and AD: multiple factors that cause decline and reserve factors that compensate. Neuron. 2004;44(1):195–208. doi: 10.1016/j.neuron.2004.09.006. [DOI] [PubMed] [Google Scholar]
Not checked in the free run.
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Not checked in the free run.
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Not checked in the free run.
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Not checked in the free run.
- Interpretationreasoning§ RESULTS
The intervention group showed increases in left vLPFC activity across all conditions.
“indicating that the intervention group showed increases in this region across all conditions”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
The pilot randomized trial demonstrated program-specific benefits in the physical health of senior volunteers.
“A pilot randomized trial of this program in Baltimore demonstrated program-specific benefits in children’s academic achievement (18) and in the physical (17) and cognitive health (8) of senior volunteers.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Fried LP, Carlson MC, Freedman M, et al. A social model for health promotion for an aging population: initial evidence on the Experience Corps model. J Urban Health. 2004;81(1):64–78. doi: 10.1093/jurban/jth094. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- Premisecitation§ Conclusions
Little is known about the efficacy of community-based cognitive and physical exercise programs to improve a range of cognitive abilities.
“To date, little is known about the efficacy of community-based cognitive and physical exercise programs to improve a range of cognitive abilities (3).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Studenski S, Carlson MC, Fillit H, Greenough WT, Kramer A, Rebok GW. From bedside to bench: does mental and physical activity promote cognitive vitality in late life? Sci Aging Knowledge Environ. 2006;2006(10):pe21. doi: 10.1126/sageke.2006.10.pe21. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Interpretationown data§ Results
The participants' demographic and cognitive characteristics indicate elevated risk for cognitive impairment.
“Participants were African American and had low education, low income, and low Mini-Mental State Examination scores (M = 24), indicative of elevated risk for cognitive impairment.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Those at greatest risk for executive deficits showed substantial and clinically meaningful improvements in these and other functions because of participating in Experience Corps.
“Specifically, we found that those at greatest risk for executive deficits showed substantial and clinically meaningful improvements in these and other functions because of participating in EC.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Carlson MC, Xue QL, Zhou J, Fried LP. Executive decline and dysfunction precedes declines in memory: the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci. 2009;64(1):110–117. doi: 10.1093/gerona/gln008. [DOI] [PMC free article] [PubMed] [Google Scholar]
Not checked in the free run.
- Study design and conductown data§ RESULTS
Both groups were matched on all sociodemographic variables.
“As shown in Table 1, both groups were matched on all sociodemographic variables.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Executive planning and organizational skills are important to maintaining functional independence.
“Executive planning and organizational skills appear to be important to maintaining functional independence (4–7) and appear to be particularly vulnerable to declines at later ages (8–10) along with the prefrontal cortical regions of the brain that support them (11–14).”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [4] Carlson MC, Fried LP, Xue QL, Bandeen-Roche K, Zeger SL, Brandt J. Association between executive attention and physical functional performance in community-dwelling older women. J Gerontol B Psychol Sci Soc Sci. 1999;54(5):S262–S270. doi: 10.1093/geronb/54b.5.s262. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
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Not checked in the free run.
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Not checked in the free run.
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Not checked in the free run.
- Interpretationown data§ Conclusions
The pilot results provide proof of concept for use-dependent brain plasticity in later life.
“These pilot results provide proof of concept for use-dependent brain plasticity in later life, and, that interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.”
Quote in the paperSubstantial claim- Rests on an assumption: Changes in fMRI BOLD activity in the left prefrontal cortex and anterior cingulate cortex reflect use-dependent neurocognitive plasticity.
- Premisecitation§ Conclusions
A pilot randomized trial of the Experience Corps program in Baltimore demonstrated program-specific benefits in children's academic achievement.
“A pilot randomized trial of this program in Baltimore demonstrated program-specific benefits in children’s academic achievement (18) and in the physical (17) and cognitive health (8) of senior volunteers.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Rebok GW, Carlson MC, Glass TA, et al. Short-term impact of Experience Corps participation on children and schools: results from a pilot randomized trial. J Urban Health. 2004;81(1):79–93. doi: 10.1093/jurban/jth095. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- Interpretationreasoning§ DISCUSSION
Individuals exhibited use-dependent neural plasticity by exercising and reactivating skills that may have been relatively unused for years or even decades.
“Individuals exhibited use-dependent neural plasticity by exercising and reactivating skills that may have been relatively unused for years or even decades.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Engaging in complex work and leisure environments has been associated with improved mental flexibility over the long term, particularly among older adults.
“Engaging in complex work and leisure environments has been associated with improved mental flexibility over the long term, particularly among older adults (15).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [15] Schooler C, Mulatu MS, Oates G. The continuing effects of substantively complex work on the intellectual functioning of older workers. Psychol Aging. 1999;14(3):483–506. doi: 10.1037//0882-7974.14.3.483. [DOI] [PubMed] [Google Scholar]
Not checked in the free run.
- Study design and conductown data§ RESULTS
At baseline, both intervention and control groups showed comparable levels of activity across all three ROIs: the ACC, left vLPFC, and left dLPFC.
“At baseline, both intervention and control groups showed comparable levels of activity across all three ROIs, the ACC, left ventral prefrontal cortex (vLPFC), and left dorsal prefrontal cortex (dLPFC).”
Quote in the paperSubstantial claim - Study design and conductown data§ DISCUSSION
These previously sedentary at-risk participants were amenable to the fMRI environment on repeated exams, as demonstrated by 100% retention.
“Additionally, these previously sedentary at-risk participants were amenable to the fMRI environment on repeated exams, as demonstrated by 100% retention”
Quote in the paperNot a substantial claim - Interpretationown data§ RESULTS
The increased activity in attentional control regions suggests more efficient filtering or inhibiting of target information from distraction.
“suggesting more efficient filtering or inhibiting of target information from distraction”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
The pilot randomized trial demonstrated program-specific benefits in the cognitive health of senior volunteers.
“A pilot randomized trial of this program in Baltimore demonstrated program-specific benefits in children’s academic achievement (18) and in the physical (17) and cognitive health (8) of senior volunteers.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Carlson MC, Xue QL, Zhou J, Fried LP. Executive decline and dysfunction precedes declines in memory: the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci. 2009;64(1):110–117. doi: 10.1093/gerona/gln008. [DOI] [PMC free article] [PubMed] [Google Scholar]
Not checked in the free run.
- Premisecitation§ Conclusions
Executive functions are particularly vulnerable to declines at later ages.
“Executive planning and organizational skills appear to be important to maintaining functional independence (4–7) and appear to be particularly vulnerable to declines at later ages (8–10) along with the prefrontal cortical regions of the brain that support them (11–14).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [8] Carlson MC, Xue QL, Zhou J, Fried LP. Executive decline and dysfunction precedes declines in memory: the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci. 2009;64(1):110–117. doi: 10.1093/gerona/gln008. [DOI] [PMC free article] [PubMed] [Google Scholar]
Not checked in the free run.
- cites [9] Kempen GI, van Heuvelen MJ, van Sonderen E, van den Brink RH, Kooijman AC, Ormel J. The relationship of functional limitations to disability and the moderating effects of psychological attributes in community-dwelling older persons. Soc Sci Med. 1999;48(9):1161–1172. doi: 10.1016/s0277-9536(98)00427-4. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [10] Dulaney CL, Rogers WA. Mechanisms underlying reduction in Stroop interference with practice for young and old adults. J Exp Psychol Learn Mem Cogn. Mar 1994;20(2):470–484. doi: 10.1037//0278-7393.20.2.470. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Interpretationown data§ Conclusions
Interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.
“These pilot results provide proof of concept for use-dependent brain plasticity in later life, and, that interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.”
Quote in the paperSubstantial claim- Rests on an assumption: Changes in fMRI BOLD activity in the left prefrontal cortex and anterior cingulate cortex reflect use-dependent neurocognitive plasticity.
- Interpretationreasoning§ DISCUSSION
The present finding suggests generalization of EC improvements over different measures of executive function.
“Indeed, the present finding suggests generalization of EC improvements over different measures of executive function.”
Quote in the paperSubstantial claim - Interpretationreasoning§ DISCUSSION
Overall, these pilot findings hold promise for enhancing functional reserve and neural plasticity among those at great risk.
“Overall, these pilot findings hold promise for enhancing functional reserve and neural plasticity among those at great risk.”
Quote in the paperNot a substantial claim - Interpretationown data§ DISCUSSION
EC participants started with lower baseline inhibitory ability than those in the exercise intervention.
“Although both studies demonstrated improved inhibitory efficiency (speed), EC participants started with lower baseline inhibitory ability than those in the exercise intervention.”
Quote in the paperSubstantial claim - Study design and conductreasoning§ DISCUSSION
The study design does not allow definitive discernment of whether the effects of the intervention on cognitive function were mediated primarily by cognitive and physical pathways, respectively, or whether benefits represent the synergy of increased activity in all domains.
“Finally, this study design does not allow us to definitively discern whether the effects of this intervention on cognition function were mediated primarily by cognitive and physical pathways, respectively, or whether benefits represent the synergy of increased activity in all domains.”
Quote in the paperNot a substantial claim - Interpretationown data§ DISCUSSION
The study replicated the impact of EC on executive functions using a sensitive measure that focuses on the age-vulnerable ability to inhibit distraction in one's environment.
“First, we replicated the impact of EC on executive functions using a sensitive measure that focuses on the age-vulnerable ability to inhibit distraction in one’s environment.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 15
- May combine two claims. 16
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSAt baseline, response times were slower for the incongruent condition than for the congruent condition.
“Furthermore, at baseline, RTs were slower for the incongruent condition compared with the congruent condition (F (1,15) = 21.27; p < .001) and for large cues compared with small cues (F (1,15) = 25.33; p < .001), as expected.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSNo other main effects or interactions for accuracy were significant.
“No other main effects or interactions were significant (all p > .05).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSThe fMRI protocol was well tolerated at baseline and follow-up.
“No adverse events were reported in the intervention or control arms, and the fMRI protocol was well tolerated at baseline and follow-up.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSAt baseline, accuracy was marginally worse for large cues compared with small cues.
“At baseline, accuracy was worse for the incongruent condition compared with the congruent condition (F (1,15) = 6.32; p < .02) and marginally worse for large cues compared with small cues (F (1,15) = 2.59; p < .06).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ RESULTSAt baseline, both groups showed improved performance on the incongruent condition when a small cue was available but no similar benefit of cue size on the congruent condition.
“At baseline, both groups showed improved performance on the incongruent condition when a small cue was available but showed no similar benefit of cue size on the congruent condition (F (1,15) = 19.52; p < .001).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSNo adverse events were reported in the intervention or control arms.
“No adverse events were reported in the intervention or control arms, and the fMRI protocol was well tolerated at baseline and follow-up.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSThere was a nonsignificant increase in right dorsal prefrontal activity for the incongruent condition for both the intervention and control groups (p < .16).
“However, there was a nonsignificant increase in the right dorsal prefrontal activity for the incongruent condition for both the intervention and the control groups (p < .16).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ ResultsThe fMRI pilot participants were African American and had low education, low income, and low Mini-Mental State Examination scores (mean about 24-25).
“Participants were African American and had low education, low income, and low Mini-Mental State Examination scores (M = 24), indicative of elevated risk for cognitive impairment.”
- Also stated in: § METHODS · plain
“Participants were African American, 80% of whom had a high school education and marginally normal global cognitive scores on the MMSE (average = 24.5).”
- Also stated in: § RESULTS · plain
“Participants were African American, with low income, low education levels, and an average MMSE score of 25, a score lower than typically observed in volunteer samples.”
Quote in the paperNot a substantial claim- Also stated in: § METHODS · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSAt baseline, accuracy was worse for the incongruent condition compared with the congruent condition.
“At baseline, accuracy was worse for the incongruent condition compared with the congruent condition (F (1,15) = 6.32; p < .02) and marginally worse for large cues compared with small cues (F (1,15) = 2.59; p < .06).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ RESULTSThe small cue improved accuracy more for the incongruent condition than for the congruent condition.
“In addition, the small cue improved accuracy more for the incongruent condition than the congruent condition (F (1,15) = 4.52; p < .05).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ RESULTSNeither congruency nor cue size interacted with time or group for the left vLPFC.
“Again, neither congruency nor cue size interacted with time or group, indicating that the intervention group showed increases in this region across all conditions (Figure 2).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ DISCUSSIONThe study observed EC-related increases in the ACC during the executive function task, whereas the exercise intervention led to decreased activation in this region.
“First, we observed EC-related increases in the ACC during the executive function task, whereas the exercise intervention led to decreased activation in this region.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ DISCUSSIONThe study observed lateralized increases in left prefrontal cortical activity in the EC sample while the exercise intervention observed right prefrontal cortical increases.
“Second, we observed the lateralized increases in left prefrontal cortical activity in the EC sample while the exercise intervention observed the right prefrontal cortical increases.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ DISCUSSIONThose enrolled in the program met the intensive service requirements, which led to unprecedented doses over a relatively short-exposure period.
“and those enrolled in the program met the intensive service requirements, which led to unprecedented doses over a relatively short-exposure period.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ RESULTSOnly one participant, in the intervention group, dropped out prior to follow-up due to personal health reasons.
“Only one participant, in the intervention group, dropped out prior to follow-up due to personal health reasons.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Premisereasoning§ ConclusionsComplex environments impose cognitive challenges through the diversity of stimuli and the number of decisions required.
“Complex environments impose cognitive challenges through the diversity of stimuli and the number of decisions required.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown data§ ConclusionsUsing fMRI, the study demonstrated intervention-specific short-term gains in executive function and in the activity of prefrontal cortical regions in older adults at elevated risk for cognitive impairment.
“Using fMRI, we demonstrated intervention-specific short-term gains in executive function and in the activity of prefrontal cortical regions in older adults at elevated risk for cognitive impairment.”
Quote in the paperSubstantial claimMay combine two claims.
Premisereasoning§ ConclusionsComplex environments exercise organizational, inhibitory, and working memory skills, all components of executive function.
“As a result, they exercise organizational, inhibitory, and working memory skills, all components of executive function.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Premisecitation§ ConclusionsLeisure-time cognitive, physical, and social activities help maintain cognitive and functional health.
“Epidemiological observational studies have suggested that leisure-time cognitive, physical, and social activities help maintain cognitive and functional health (for reviews, see (2,3)).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [2] Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol. 2004;3(6):343–353. doi: 10.1016/S1474-4422(04)00767-7. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [3] Studenski S, Carlson MC, Fillit H, Greenough WT, Kramer A, Rebok GW. From bedside to bench: does mental and physical activity promote cognitive vitality in late life? Sci Aging Knowledge Environ. 2006;2006(10):pe21. doi: 10.1126/sageke.2006.10.pe21. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
May combine two claims.
Interpretationown data§ DISCUSSIONThe results replicate and build on the previous pilot trial of EC and cognition, and on an fMRI trial of physical activity in older adults.
“The results replicate and build on the previous pilot trial of EC and cognition, and on an fMRI trial of physical activity in older adults.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationreasoning§ DISCUSSIONThis pilot study provides proof of concept for the feasibility and utility of neuroimaging to begin to understand how a multimodal activity program in the community gets under the skin to improve executive functions and supporting brain regions.
“This pilot study provides proof of concept for the feasibility and utility of neuroimaging to begin to understand how a multimodal activity program in the community gets under the skin to improve executive functions and supporting brain regions.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ METHODSThe regions of interest were similar to activated regions found in previous studies of the flanker task.
“These ROIs were similar to activated regions found in previous studies of the flanker task (26).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [26] Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004;101(9):3316–3321. doi: 10.1073/pnas.0400266101. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
May combine two claims.
Interpretationown data§ DISCUSSIONThese at-risk individuals exhibited measurable brain plasticity in direct response to such environmental enrichment, providing initial evidence of this program's potential to reverse cognitive and corresponding neural declines with age.
“These at-risk individuals exhibited measurable brain plasticity in direct response to such environmental enrichment, providing initial evidence of this program’s potential to reverse cognitive and corresponding neural declines with age.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed cognitive and neural changes are attributable to the Experience Corps intervention rather than to other factors.
May combine two claims.
Interpretationreasoning§ ConclusionsExecutive functions may contribute to both memory and functional difficulties and serve as an important target for preventive interventions.
“These findings suggest that executive functions may contribute to both memory and functional difficulties and serve as an important target for preventive interventions.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductreasoning§ DISCUSSIONThe small sample size, necessarily restricted to women due to gender differences in brain morphology, limits generalizability.
“Limitations of this pilot study include the small sample size necessarily restricted to women (due to gender differences in brain morphology), which limits generalizability”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ DISCUSSIONRecent epidemiological evidence in twin pairs suggests that socially engaging cognitive activities in midlife and early late-life may reduce risk for AD and dementia decades later and may be indicative of an enriched environment, which enhances the proliferation of new brain cells and promotes brain repair in animal models.
“Recent epidemiological evidence in twin pairs suggests that socially engaging cognitive activities in midlife and early late-life may reduce risk for AD and dementia decades later (30) and may be indicative of an enriched environment, which enhances the proliferation of new brain cells and promotes brain repair in animal models (31–33).”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [30] Carlson MC, Helms MJ, Steffens DC, Burke JR, Potter GG, Plassman BL. Midlife activity predicts risk of dementia in older male twin pairs. Alzheimers Dement. 2008;4(5):324–331. doi: 10.1016/j.jalz.2008.07.002. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [31] Gould E, Beylin A, Tanapat P, Reeves A, Shors TJ. Learning enhances adult neurogenesis in the hippocampal formation. Nat Neurosci. 1999;2(3):260–265. doi: 10.1038/6365. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [32] Greenough WT, Cohen NJ, Juraska JM. New neurons in old brains: learning to survive? Nat Neurosci. 1999;2(3):203–205. doi: 10.1038/6300. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [33] van Praag H, Kempermann G, Gage F. Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. Nat Neurosci. 1999;2(3):266–270. doi: 10.1038/6368. [DOI] [PubMed] [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
Interpretationreasoning§ DISCUSSIONThe implications of these findings for the assessment of postretirement lifestyle activity are that a broader range of cognitive activities embedded within social settings may confer great cognitive and brain benefits for older adults.
“The implications of these findings to the assessment of postretirement lifestyle activity are that a broader range of cognitive activities embedded within social settings may confer great cognitive and brain benefits for older adults.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationcitation§ DISCUSSIONThese improvements extended to corresponding increases in the activity of supporting prefrontal cortical substrates, further replicating seminal findings on the neurocognitive benefit of physical activity.
“These improvements extended to corresponding increases in the activity of supporting prefrontal cortical substrates, further replicate seminal findings on the neurocognitive benefit of physical activity (26–28).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [26] Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004;101(9):3316–3321. doi: 10.1073/pnas.0400266101. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [27] Colcombe SJ, Erickson KI, Scalf PE, et al. Aerobic exercise training increases brain volume in aging humans. J Gerontol A Biol Sci Med Sci. 2006;61(11):1166–1170. doi: 10.1093/gerona/61.11.1166. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [28] Kramer A, Erickson KI, Colcombe SJ. Exercise, cognition and the aging brain. J Appl Physiol. 2006;101(4):1237–1242. doi: 10.1152/japplphysiol.00500.2006. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
May combine two claims.
Interpretationreasoning§ DISCUSSIONAs in a prior pilot trial of EC, these individuals were at elevated risk for executive dysfunction and likely exerted more effort to successfully develop inhibitory skills, which may be reflected by increased ACC activity.
“Thus, as in a prior pilot trial of EC (21), these individuals were at elevated risk for executive dysfunction and likely exerted more effort to successfully develop inhibitory skills, which may be reflected by increased ACC activity.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] Carlson MC, Saczynski JS, Rebok GW, et al. Exploring the effects of an “everyday” activity program on executive function and memory in older adults: Experience Corps. Gerontologist. 2008;48(6):793–801. doi: 10.1093/geront/48.6.793. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Rests on an assumption: The ACC is involved in efficient filtering or inhibiting of conflicting information prior to generation of a motor response.
The paper relies on this without support.
The Flanker task validly measures executive inhibitory ability.
“This selective attention task measures one’s ability to rapidly determine the direction of a central target (arrow) while effectively inhibiting distracting information that flanks the target and may conflict with the target response (e.g., central target points left, whereas flanking arrows point right).”
The paper relies on this without support.
Changes in fMRI BOLD activity in the left prefrontal cortex and anterior cingulate cortex reflect use-dependent neurocognitive plasticity.
“These pilot results provide proof of concept for use-dependent brain plasticity in later life, and, that interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.”
The paper relies on this without support.
The observed cognitive and neural changes are attributable to the Experience Corps intervention rather than to other factors.
“These at-risk individuals exhibited measurable brain plasticity in direct response to such environmental enrichment”
The paper relies on this without support.
The ACC is involved in efficient filtering or inhibiting of conflicting information prior to generation of a motor response.
“The ACC has been implicated in the efficient filtering or inhibiting of conflicting information prior to generation of a motor response.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The review identified four non-RCTs.
“Eleven papers reported RCTs (n = 7) [30,33,35,37,54,58,62] and non-RCTs (n = 4) [27,29,34,57].”
From Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers (2013) · cites this paper as [29]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Reported overall MMSE mean conflicts with group means
MinorThe abstract reports an overall MMSE mean of 24, but Table 1 gives means of 24.5 for eight intervention participants and 26.4 for nine controls. Those group figures imply an overall mean of about 25.5.
“Participants were African American and had low education, low income, and low Mini-Mental State Examination scores (M = 24), indicative of elevated risk for cognitive impairment.”
“Characteristic EC, Mean Control, Mean N 8 9 Age, in y ( SD ) 68 (5.0) 67.78 (3.7) African American, n (%) 8 (100) 9 (100) Education, in y ( SD ) 12.4 (1.3) 11.6 (2.5) Widowed, n (%) 5 (62) 1 (11.1) MMSE ( SD ) 24.5 (3.6) 26.4 (1.7)”
Claim of 100% retention conflicts with a reported dropout
MinorThe results state that one intervention participant dropped out before follow-up, whereas the discussion describes retention on repeated exams as 100%.
“Only one participant, in the intervention group, dropped out prior to follow-up due to personal health reasons.”
“Additionally, these previously sedentary at-risk participants were amenable to the fMRI environment on repeated exams, as demonstrated by 100% retention, and those enrolled in the program met the intensive service requirements, which led to unprecedented doses over a relatively short-exposure period.”
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Flagged first, then by citations
Research works printed but not linked: 5
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- 2004, 44, 195
- 2003, 41, 1929
- Fried, 1997, Western Journal of Medicine, 167, 216
- Carlson, 2000, Aging (Milan, Italy), 12, 132
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- Authors
- Carlson, M. C., Erickson, K. I., Kramer, A. F., Voss, M. W., Bolea, N., Mielke, M., McGill, S., Rebok, G. W., Seeman, T., & Fried, L. P.
- Affiliations
- Johns Hopkins University (US)
- University of Pittsburgh (US)
- University of Illinois Urbana-Champaign (US)
- University of California, Los Angeles (US)
- Columbia University (US)
- ORCID
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-08-19
- Volume
- 64A
- Issue
- 12
- Pages
- 1275-1282
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC2781785
- OpenAlex
- W2146068507
- Semantic Scholar
- 4c03cf8c0614eedc3752b5dd16e46f0949ab83a1
- Cited by
- 286
- References
- 29
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 12 · 2023: 14 · 2022: 5 · 2021: 15 · 2020: 17 · 2019: 11 · 2018: 18 · 2017: 26 · 2016: 23 · 2015: 22 · 2014: 26 · 2013: 22 · 2012: 20
- FWCI
- 11.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30AG021334)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- executive function, older adults, prefrontal cortex, anterior cingulate cortex, inhibitory control, cognitive impairment risk, physical activity, cognitive activity
- MeSH terms
- Aged, Aging, Analysis of Variance, Black or African American, Cognition Disorders, Educational Status, Female, Follow-Up Studies, Health Promotion, Humans, Magnetic Resonance Imaging, Middle Aged, Neuropsychological Tests, Pilot Projects, Probability, United States, Cohort Studies, Cognitive Behavioral Therapy, Case-Control Studies, Treatment Outcome, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
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