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The Effect of Solving Jigsaw Puzzles on Visuospatial Cognition in Older Adults: Jigsaw Puzzles As Cognitive Enrichment (PACE)

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ClinicalTrials.gov Identifier: NCT02667314
Recruitment Status : Completed
First Posted : January 28, 2016
Last Update Posted : November 30, 2018
Sponsor:
Collaborator:
Ravensburger Spieleverlag GmbH (RSV), Germany
Information provided by (Responsible Party):
Iris Kolassa, University of Ulm

Brief Summary:
Meta-analyses indicate beneficial effects of cognitive training and cognitively challenging video games on cognition. However, cognitive effects of solving jigsaw puzzles - a popular, visuospatial cognitive leisure activity - have not been investigated, yet. Thus, the primary aim of this study is to evaluate the effect of solving jigsaw puzzles on visuospatial cognition. As secondary aims, effects on psychological outcomes (self-efficacy, perceived stress, well-being) and visuospatial everyday functioning (instrumental activities of daily living and self-reported cognitive failures in everyday life) are examined.

Condition or disease Intervention/treatment Phase
Cognitive Impairment Behavioral: Jigsaw puzzles Behavioral: Cognitive health counseling Not Applicable

Detailed Description:
see References section below for the study protocol article

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Investigator)
Primary Purpose: Prevention
Official Title: Jigsaw Puzzles As Cognitive Enrichment
Study Start Date : February 2016
Actual Primary Completion Date : February 2018
Actual Study Completion Date : February 2018

Arm Intervention/treatment
Experimental: Jigsaw Puzzle Group
Jigsaw puzzles & Cognitive health counseling
Behavioral: Jigsaw puzzles

Intervention period 1: Participants are asked to solve jigsaw puzzles at home 6 times per week for at least 1 hour over a period of 5 weeks.

Intervention period 2 (voluntary): Participants receive the possibility to solve jigsaw puzzles free-of-charge at home for a period of at least 3 month before the 1.5-year follow-up.


Behavioral: Cognitive health counseling
Cognitive health counseling regarding modifiable risk and protective factors of cognitive decline and dementia at baseline, and four telephone calls for expert monitoring (three calls during the 5-week period between pre- and posttest, and one call 12 month later)

Active Comparator: Cognitive Health Counseling Group
Cognitive health counseling only
Behavioral: Cognitive health counseling
Cognitive health counseling regarding modifiable risk and protective factors of cognitive decline and dementia at baseline, and four telephone calls for expert monitoring (three calls during the 5-week period between pre- and posttest, and one call 12 month later)




Primary Outcome Measures :
  1. Change in global visuospatial cognition from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Averaged score of eight z-standardized visuospatial cognitive ability scores (see secondary outcomes 2 - 9)


Secondary Outcome Measures :
  1. Change in visual perception from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Judgment of Line Orientation Test

  2. Change in visuoconstruction from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Copying in Complex Figure Tests; parallel versions for baseline and post-test

  3. Change in mental rotation from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Mental Rotations Test-Letters (2D) and Form A (3D)

  4. Change in visuospatial processing speed from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Trail Making Test A

  5. Change in visuospatial flexibility from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Trail Making Test B

  6. Change in visuospatial working memory from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Block span (Wechsler Memory Scale, German version)

  7. Change in visuospatial reasoning from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Block design (Wechsler Adult Intelligence Scale-III, German version)

  8. Change in visuospatial episodic memory from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Recall in Complex Figure Tests (sum score of immediate and delayed recall); parallel versions for baseline and post-test

  9. Change in psychological health from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Averaged score of three z-standardized psychological health sub-scores (see secondary outcomes 11 - 13)

  10. Change in psychological well-being from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    WHO-Five Well-being Index (WHO-5), German version

  11. Change in self-efficacy from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    General Self-Efficacy Scale, German version

  12. Change in perceived stress from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    Perceived Stress Scale-14, German translation

  13. Change in objective everyday functioning from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    TIADL (1-3): Timed instrumental activities of daily living (Task 1-3; sum-score)

  14. Change in self-reported everyday functioning from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    CFQ (visuospatial items): Cognitive Failures Questionnaire, sum score of visuo-spatial items; German version

  15. Change in jigsaw puzzle performance from baseline to post intervention and to the 1.5-year follow-up [ Time Frame: Baseline and post intervention (after 5 weeks and 1.5 years) ]
    40-pieces mini puzzle (completed pieces per minute)

  16. Hair cortisol concentration at the 1.5-year follow-up [ Time Frame: 1.5-year follow-up ]
    Hair cortisol will be measured in 1cm segements

  17. Hair dehydroepiandrosteron concentration at the 1.5-year follow-up [ Time Frame: 1.5-year follow-up ]
    Hair dehydroepiandrosteron will be measured in 1cm segements

  18. Hair brain-derived neurotrophic factor concentration at the 1.5-year follow-up [ Time Frame: 1.5-year follow-up ]
    Hair brain-derived neurotrophic factor will be measured in 1cm segements

  19. Neurocognitive disorder [ Time Frame: 1.5-year follow-up ]
    Neurocognitive disorder is a categorical outcome and includes mild and major neurocognitive disorders. Mild neurocognitive disorder (mild cognitive impairment) is defined by subjective cognitive decline (self-report), and an objective cognitive impairments in at least one cognitive abilitiy score (below -1 SD of the norm group), without an essential impairment of daily functioning compared to the premorbid level (self-report). In major neurocognitive decline (dementia), in addition to cognitive decline and impairment, daily functioning is essentially impaired compared to the permorbid level (self-report).



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Ages Eligible for Study:   50 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • No cognitive impairment (Mini-Mental State Examination ≥ 24)
  • Commitment to minimum jigsaw puzzle time (1 hour/day, 6 days/week, 5 weeks)
  • Interest in jigsaw puzzles
  • Low jigsaw puzzle experience (less than 5 completed puzzles within the last 5 years)

Exclusion Criteria:

  • Cognitive impairment (Mini-Mental State Examination < 24)
  • Participation in another interventional study
  • Self-reported psychiatric, neurologic or other disease, which could affect cognitive change over time
  • Self-reported, severe visual impairment or motoric impairment of the upper extremity which significantly affects ability to solve jigsaw puzzles

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02667314


Locations
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Germany
Clinical and Biological Psychology, University of Ulm
Ulm, Germany
Sponsors and Collaborators
University of Ulm
Ravensburger Spieleverlag GmbH (RSV), Germany
Investigators
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Principal Investigator: Iris-Tatjana Kolassa, Prof. University of Ulm, Germany
Additional Information:
Publications of Results:
Other Publications:
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Responsible Party: Iris Kolassa, Prof. Dr., University of Ulm
ClinicalTrials.gov Identifier: NCT02667314    
Other Study ID Numbers: Klipsy_044_PACE
First Posted: January 28, 2016    Key Record Dates
Last Update Posted: November 30, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Iris Kolassa, University of Ulm:
Cognition
Cognitive Aging
Dementia
Neurocognitive Disorders
Cognitive Therapy
Cognitive Reserve
Cognitive Enrichment
Jigsaw Puzzles
Additional relevant MeSH terms:
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Cognitive Dysfunction
Cognition Disorders
Neurocognitive Disorders
Mental Disorders