A Language-Based Training Intervention to Enhance Cognitive Health in Community-Dwelling Older Adults

A Language-Based Training Intervention to Enhance Cognitive Health in Community-Dwelling Older Adults

Taiwan is fast approaching a super-aged society, making it urgent to bolster cognitive health in otherwise healthy older adults. This integrated project tackles that need with a language-centered intervention grounded in predictive-coding and active-inference theory. Over 12 weeks, community-dwelling adults aged 65 + join small-group reading-and-writing workshops that train them to actively predict, monitor, and revise linguistic information. Ninety volunteers are randomly allocated to an active language-prediction group, a passive reading group, or a hobby board-game control. Before and after the course, researchers collect behavioural tests, EEG, fMRI, and AI-based speech-language analytics to quantify gains and transfer effects across cognition, emotion, and daily function.

Taiwan will enter a super-aged society in 2025, with adults aged 65 and above expected to comprise 20 % of the population-a shift that makes preserving cognitive health an urgent public-health priority. To meet this challenge, our integrated project draws on predictive-coding and active-inference theory to couple language science with neuroscience, psychology, occupational therapy, and large-language-model analytics. Within this framework, the present sub-project tests a 12-week, small-group language-training curriculum that meets once a week for two hours. Sessions weave together reading aloud, listening, oral summarising, writing, and guided discussion, all structured to elicit continual prediction, self-monitoring, feedback, and creative revision during language use.

Approximately ninety community-dwelling adults aged 65 years or older are being recruited and randomly assigned, in equal blocks of thirty, to one of three arms: an active language-prediction group that emphasises hypothesis-testing during language production and comprehension; a passive reading group that provides leisure reading and sharing without explicit predictive feedback; and a board-game control group that engages cognition but not language prediction.

Before and after the intervention, each participant completes a comprehensive battery. Behaviourally, the investigators assess verbal fluency, language memory, and real-time sentence-prediction accuracy, while electrophysiology (N400, anterior-positivity ERPs, anterior P2, and P300) and functional MRI capture neural plasticity associated with sentence processing, visual reasoning, and cognitive flexibility. Executive functions, divergent and convergent thinking, attention, affect, social cognition, and instrumental activities of daily living provide secondary endpoints to gauge transfer beyond language. Throughout the 12 weeks, spoken narratives are recorded and analyzed for idea density and syntactic complexity with large-language-model tools, yielding fine-grained markers of change unavailable to traditional testing.

The investigators anticipate that targeted, prediction-based training will rejuvenate age-diminished language-prediction signals, drive adaptive reorganization of executive and language networks, and produce broader cognitive and functional gains than either passive reading or non-linguistic gaming. Embedded in community settings, this program also seeks to foster lasting reading habits, strengthen collective cognitive resilience, and offer an ecologically valid blueprint for scaling evidence-based cognitive-health interventions.

Inclusion Criteria:

• Aged between 20 and 30 (healthy young adults) or aged 65 and above (healthy older adults).
• Native Mandarin Chinese speakers who had no exposure to non-indigenous languages before the age of five.
• Have completed at least a junior high school level of education.
• Right-handed.
• Have normal or corrected-to-normal vision (e.g., through glasses or contact lenses).
• Able to fully participate in the entire assessment and intervention schedule (with no more than two missed intervention sessions).
• Achieve a score of 23 or higher on the Montreal Cognitive Assessment (MoCA).

Exclusion Criteria:

• Participation in another cognitive intervention program within the past two months.
• Cognitive intervention is not feasible due to dyslexia or physical illness. Meet the diagnostic criteria for Mild Cognitive Impairment (MCI) or dementia.
• Presence of severe depression, or cognitive changes caused by other psychiatric, neurological disorders, or substance abuse, with symptoms that are unstable or interfere with functioning.
• History of brain injury or neurological conditions (e.g., stroke, aneurysm).
• Contraindications for MRI scanning, such as metal implants, pacemakers, or pregnancy.
• Claustrophobia (an anxiety disorder characterized by panic symptoms or fear of panic attacks in enclosed spaces such as elevators, vehicles, tunnels, or airplane cabins).
• Unable to undergo cognitive assessments due to visual or hearing impairments.