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

Sponsor

University of Ulm (Other)

Overall Status

Completed

CT.gov ID

NCT02667314

Collaborator

Ravensburger Spieleverlag GmbH (RSV), Germany (Other)

100

Enrollment

Location

Arms

Duration (Months)

4.2

Patients Per Site Per Month

Study Details

Study Description

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	N/A

Detailed Description

see References section below for the study protocol article

Study Design

Study Type:

Interventional

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 :

Feb 1, 2016

Actual Primary Completion Date :

Feb 1, 2018

Actual Study Completion Date :

Feb 1, 2018

Arms and Interventions

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)

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

Outcome Measures

Primary Outcome Measures

Change in global visuospatial cognition from baseline to post intervention and to the 1.5-year follow-up [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

Change in visual perception from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Judgment of Line Orientation Test
Change in visuoconstruction from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Copying in Complex Figure Tests; parallel versions for baseline and post-test
Change in mental rotation from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Mental Rotations Test-Letters (2D) and Form A (3D)
Change in visuospatial processing speed from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Trail Making Test A
Change in visuospatial flexibility from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Trail Making Test B
Change in visuospatial working memory from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Block span (Wechsler Memory Scale, German version)
Change in visuospatial reasoning from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Block design (Wechsler Adult Intelligence Scale-III, German version)
Change in visuospatial episodic memory from baseline to post intervention and to the 1.5-year follow-up [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
Change in psychological health from baseline to post intervention and to the 1.5-year follow-up [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)
Change in psychological well-being from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
WHO-Five Well-being Index (WHO-5), German version
Change in self-efficacy from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
General Self-Efficacy Scale, German version
Change in perceived stress from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
Perceived Stress Scale-14, German translation
Change in objective everyday functioning from baseline to post intervention and to the 1.5-year follow-up [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)
Change in self-reported everyday functioning from baseline to post intervention and to the 1.5-year follow-up [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
Change in jigsaw puzzle performance from baseline to post intervention and to the 1.5-year follow-up [Baseline and post intervention (after 5 weeks and 1.5 years)]
40-pieces mini puzzle (completed pieces per minute)
Hair cortisol concentration at the 1.5-year follow-up [1.5-year follow-up]
Hair cortisol will be measured in 1cm segements
Hair dehydroepiandrosteron concentration at the 1.5-year follow-up [1.5-year follow-up]
Hair dehydroepiandrosteron will be measured in 1cm segements
Hair brain-derived neurotrophic factor concentration at the 1.5-year follow-up [1.5-year follow-up]
Hair brain-derived neurotrophic factor will be measured in 1cm segements
Neurocognitive disorder [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).

Eligibility Criteria

Criteria

Ages Eligible for Study:

50 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

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