Computer-based Cognitive Training Research Articles

Tablet computer-based cognitive training for visuomotor integration in children with developmental delay: a pilot study

BackgroundImpaired visuomotor integration (VMI) is commonly observed in children with developmental delay (DD). This pilot study aimed to evaluate the effects of tablet computer-based cognitive training on the VMI in children with DD.MethodsThis study included children aged 4 to under 18 years diagnosed with DD. The children participated in a 12-week tablet computer-based visual-spatial and visuomotor training program. They were administered the Mind Rx Kids Program (Brain Academy, Seoul, South Korea). The participants underwent daily 30-min tablet computer-based training for 12 weeks. The primary visuomotor function was measured using the Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition (VMI-6). For secondary outcomes, measurements were taken before and after 12-week treatment using the Quality of Upper Extremity Skills Test (QUEST), Functional Independence Measure for Children (WeeFIM), Childhood Autism Rating Scale (CARS), Attention deficit hyperactivity disorder Rating Scale (ARS), and Child Smartphone Addiction Observer Scale. The Wilcoxon signed-rank test was used to compare the pre- and post-treatment outcomes.ResultsTen children with DD participated in this study. The results of the 12-week tablet computer-based cognitive training showed significant improvements in the raw score, standard score, percentile score, and equivalent age of the Beery VMI-6. Additionally, there were significant improvements in QUEST and WeeFIM scores. Although there were improvements in the CARS, ARS, and smartphone addiction observer scale, these were not statistically significant.ConclusionThis pilot study confirmed that applying tablet computer-based cognitive training to children with DD not only improves VMI, but also enhances fine motor skills and activities of daily living. Furthermore, the results of this study indicate that tablet computer-based cognitive training does not increase digital media addiction. Therefore, children with DD can engage in tablet computer-based cognitive training at home without concerns about digital media addiction.

Computerized cognitive games versus cognitive exergame: the comparison of motor and cognitive functions enhancement in the elderly

BackgroundConsidering the importance of cognitive and motor functions of the elderly people, the present study was conducted to evaluate the effectiveness of a cognitive exergame, called Neurolight compared to computerized cognitive games, in enhancing core executive functions and motor performance.MethodsA total of 36 individuals in the age range of 60 to 69 years were studied in the form of three groups: The control group continued their daily activities, while the Neurolight group underwent a cognitive-motor training and the Maghzineh performed a computer-based cognitive training program for 24 sessions. Before and after interventions, working memory, inhibitory control, and balance were measured respectively by the N-back, Stroop, and TUG tests.ResultsThe results showed that cognitive-motor exercises using Neurolight, for 24 sessions, were able to significantly improve working memory, inhibitory control, and balance in individuals in this age group.ConclusionThis finding supports the other studies suggesting combined cognitive and physical exercises for better effect. Based on its findings, the use of this exercise system can be suggested to coaches and therapists working with the elderly.

Predicting Adherence to Computer-Based Cognitive Training Programs Among Older Adults: Study of Domain Adaptation and Deep Learning.

Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs. Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.

Effects of computer-based cognitive training vs. paper-and-pencil-based training on the cognitive development of typically developing children: Protocol for a randomized controlled trial

The research aims to evaluate the effectiveness of a computerized cognitive training program in improving executive functions and attention in elementary school children, compared to a traditional paper-and-pencil intervention. The study has been formulated as a randomized controlled trial with pre- and post-intervention measures. For the study, third-grade children with typical development aged between 7 and 9 years will be recruited. Participants will be randomly assigned to the two study arms (control and experimental). The experimental group will participate in a computerized intervention using the NeuronUp cognitive stimulation platform for 8 weeks, twice a week. Sessions will be conducted using computers in the computer lab of the participating educational institution. The active control group will engage in paper-and-pencil cognitive training for the same duration and intensity as the experimental group. Evaluators will be blinded to the assignment, and participants will be blinded to the target intervention. Hypothesis testing will be conducted through ANOVA-MR, and logistic regressions will be implemented to assess the effect of socioeconomic variables on children's performance. These results are expected to contribute to the discussion on the opportunities and benefits offered by cognitive training programs on the cognitive development of typically developing children.

The Efficacy of a Home-Based Functional Skills Training Program for Older Adults With and Without a Cognitive Impairment.

The performance of everyday technology-based tasks, such as online banking or shopping, can be challenging for older adults, especially those with a cognitive impairment. Technology-based tasks are cognitively demanding and require learning new skills. This study explored the efficacy of a technology-based functional skills assessment and training program (FUNSAT) among aging adults with and without mild cognitive impairment (MCI) in home settings. One hundred and eighty-four racially/ethnically diverse male and female adults aged 65+ participated in the study. The sample included 75 noncognitively impaired (NC) older adults and 109 older adults with MCI. The FUNSAT program includes medication and money management, transportation, and shopping tasks. The MCI participants were randomized to the FUNSAT training or FUNSAT training combined with computer-based cognitive training (FUNSAT/CCT). The nonimpaired adults received the FUNSAT training only. Using alternative forms of the assessment component of the FUNSAT program, assessments occurred at baseline, post-training, and 1- and 3-month post-training. This paper reports the post-training results. The findings indicated that the performance of both the nonimpaired and MCI participants improved significantly for all 6 tasks post-training. Specifically, training resulted in improvements in task completion time and task errors. Participants also reported greater confidence when performing the tasks in the real world. Nonimpaired aging adults and those with MCI can learn to perform technology-based everyday tasks. Further, home-based technology training protocols are feasible for aging adults with and without a cognitive impairment. NCT0467944 1.

Memory Game Intervention in Improving Cognitive Ability and Memory in Elderly with Dementia: A Literature Review

Dementia is a disorder that results in a decline in memory and cognitive function, and can interfere with daily activities. There needs to be interventions that can help prevent dementia, and one effective intervention is memory games, that can be accessed through devices such as smartphones and computers with animations and sounds that help improve memory performance and can be used for early screening of dementia symptoms. The purpose of this literature review is to explore the benefits of brain training apps and computer – based cognitive training as nursing interventions to improve cognitive function and prevent dementia in elderly. Method : used in this literature review is systematic study by collecting and analyzing relevant literature related to the research topic. Keywords used are dementia, elderly, brian-memory game, memory game, app-based game, virtual reality, cognitive impairment. Academic journals were searched through online databases such as ClinicalKey Nursing, Google Scholar, Proquest, ScienceDirect, and EMBASE from 2015-2023. Results : this Literature Review show that brain training apss and computer based cognitive training can be effective nursing interventions to improve cognitive function and prevent dementia in the elderly. Several articles analyzed show that brain training apps and computer-based cognitive training can help improve cognitive function in the elderly, especially in terms of memory and attention. In addition, brain training apps and computer – based cognitive training can also help prevent dementia symptoms in the elderly and improve their quality of life by increasing their ability to perform daily activities. Conclusion : Nurses and healthcare professionals can utilize brain training apps and computer-based cognitive training as one way to improve the quality of life for the elderly. However, it is important to note that brain training apps and computer-based cognitive training should be tailored to the needs and characteristicts of the elderly to provide optimal benefits.

The effectiveness of cognitive training in people in psychiatry with depressive symptoms – A randomized controlled study

Ninety percent of people with depression also report suffering from additional cognitive disorders. However, despite the high prevalence, the effectiveness of cognitive training methods for mental illnesses has not yet been extensively researched.In our study, ninety-six adult patients with depressive symptoms were randomly assigned to one of two intervention groups or a passive control group. Ultimately, 48 patients successfully completed the training and assessments. The first intervention group completed computer-based cognitive training (three times a week for 20 min). The second intervention group practiced different memory strategies three times a week, in addition to completing the same computer-based cognitive training as the first intervention group.All groups demonstrated several improvements in cognitive performance and experienced benefits in everyday life over time. However, we found neither a significant group effect nor a significant time × group interaction effect for any of the measures. Despite this, on a descriptive level, the intervention groups showed improvements across all five cognitive test performance outcomes (especially attention and working memory) and displayed better scores in the post intervention assessment of the self-reported personal variables (well-being, emotional regulation and depressive symptoms). Approximately 50 % of the subjects in each group did not complete the training or the post intervention assessment and were excluded. We worked closely with healthcare professionals, therapists and doctors and were thus able to gather not only research results but also valuable experience in dealing with patients with depressive symptoms who are undergoing cognitive training. Our findings and experiences may have implications for optimizing the reintegration of people with depressive symptoms.

Dynamic Cognitive-Motor Training versus Cognitive Computer-Based Training in People with Multiple Sclerosis: A Preliminary Randomized Controlled Trial with 2-Month Follow-Up.

Background: Recent studies underscore the intricate relationship between cognitive and motor impairments in Multiple Sclerosis (MS), often exacerbated by CNS damage compromising neural connections. These cognitive-motor deficits contribute to reduced efficiency in daily activities and heightened risks of falls and accidents. The combination of challenging cognitive-motor training in a more ecological setting could improve cognitive functions in people with MS (PwMS). Objective: This study aims to compare the impact of dynamic cognitive-motor training versus computer-based cognitive training on overall cognitive efficiency in PwMS. Methods: Thirty-eight PwMS were recruited through the neurorehabilitation services of an Institute of research and health. Twenty-four participants were randomly assigned to the Cognitive-Motor group (CMg) and Cognitive Therapy group (CTg). Participants underwent three training sessions per week for four weeks, each lasting 50 min. The primary outcome was a comprehensive cognitive assessment using the Cognitive Impairment Index (CII), and the secondary outcomes were the Multiple Sclerosis Quality of Life Questionnaire MSQOL-54 and the Stroop Color Word Interference Test (SCWT). Results: Significant differences in the CII scores across T0, T1, and T2, as indicated by Friedman's test (χ2(2) = 14.558, p = .001), were found in the CMg. A significant difference in the change in health subscale of the MSQOL-54 was observed when comparing the groups across T0, T1, and T2 (χ2(2) = 6.059, p = .048). There were also statistically significant differences for the emotional well-being (χ2(2) = 7.581, p = .023) and health distress (χ2(2) = 11.902, p = .003) subscales. Post hoc analysis showed a statistically significant improvement in health-related quality of life (HRQOL) for the former at T1 vs. T0 (Z = -2.502, p = .012 and for the latter at T2 vs. T0 (Z = -2.670, p = .008), respectively. Conclusions: Our results support the combination of cognitive-motor training to enhance cognitive functional outcomes and quality of life compared to computer-based cognitive training in PwMS.

A feasibility, randomised controlled trial of Club Connect: a group-based healthy brain ageing cognitive training program for older adults with major depression within an older people’s mental health service

BackgroundUsing the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework, we outline steps taken to implement an evidence-based cognitive training program, Club Connect, in older adults with major depressive disorder in an Older People’s Mental Health Service in Sydney, Australia. The primary aim was to explore feasibility (or ‘reach’), tolerability (or ‘implementation’), and acceptability (or ‘adoption’). The secondary aim was to explore the most sensitive clinical outcomes and measurement tools (i.e. ‘effectiveness’) to inform a formal randomised controlled trial, and to explore the healthcare resources used (i.e. costs) to assist decision-making by health care managers and policy-makers in relation to future resource allocation.MethodsUsing a single blinded feasibility design, 40 participants (mean age: 76.13 years, SD: 7.45, range: 65–95 years) were randomised to either (a) Club Connect, a 10-week group-based multifaceted program, comprising psychoeducation and computer-based cognitive training, or (b) a waitlist control group.ResultsImplementing group-based cognitive training within a clinical setting was feasible, well tolerated and accepted by participants. Further, cognitive training, in comparison to the waiting list control, was associated with moderate to very large effect size improvements in depression, stress and inhibition (ηp2 = 0.115–0.209). We also found moderate effect size improvements on measures of daily functioning, wellbeing and cognitive flexibility. Small effect size improvements for other cognitive and psychosocial outcomes were also observed. The average cost per person participating in in the intervention was AU$607.50.ConclusionsOur findings support the feasibility of implementing group-based cognitive training into a specialised clinical (public health) setting. This trial was registered on the Australian and New Zealand Clinical Trial Registry (ACTRN12619000195156, 12/02/2019).

The influence of eight cognitive training regimes upon cognitive screening tool performance in post-stroke survivors: a network meta-analysis.

Traditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined. This study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs. Searches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention's impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282). Fifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions. The network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making. https://www.crd.york.ac.uk/PROSPERO/, identifier in PROSPERO (CRD42023463282).

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial.

Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior. In this study, we tested the effects of web-based targeted cognitive and social cognitive training (TCT) delivered in conjunction with an innovative digital smartphone app called Personalized Real-Time Intervention for Motivational Enhancement (PRIME). The PRIME app provides users with a motivational coach to set personalized goals and secure social networking for peer support. This study investigated whether deficits in cognition and motivation in people with a psychosis spectrum disorder (N=100) can be successfully addressed with 30 hours of TCT+PRIME as compared with 30 hours of a computer games control condition (CG) plus PRIME (CG+PRIME). Here, we describe our study procedures, the feasibility and acceptability of the intervention, and the results on all primary outcomes. In this double-blind randomized controlled trial, English-speaking participants completed all cognitive training, PRIME activities, and assessments remotely. Participants completed a diagnostic interview and remote cognitive, clinical, and self-report measures at baseline, posttraining, and at a 6-month follow-up. This study included participants from 27 states across the United States and 8 countries worldwide. The study population was 58% (58/100) female, with a mean age of 33.77 (SD 10.70) years. On average, participants completed more than half of the cognitive training regimen (mean 18.58, SD 12.47 hours of training), and logged into the PRIME app 4.71 (SD 1.58) times per week. The attrition rate of 22% (22/100) was lower than that reported in our previous studies on remote cognitive training. The total sample showed significant gains in global cognition (P=.03) and attention (P<.001). The TCT+PRIME participants showed significantly greater gains in emotion recognition (P<.001) and global cognition at the trend level (P=.09), although this was not statistically significant, relative to the CG+PRIME participants. The total sample also showed significant improvements on multiple indices of motivation (P=.02-0.05), in depression (P=.04), in positive symptoms (P=.04), and in negative symptoms at a trend level (P=.09), although this was not statistically significant. Satisfaction with the PRIME app was rated at 7.74 (SD 2.05) on a scale of 1 to 10, with higher values indicating more satisfaction. These results demonstrate the feasibility and acceptability of remote cognitive training combined with the PRIME app and that this intervention can improve cognition, motivation, and symptoms in individuals with psychosis. TCT+PRIME appeared more effective in improving emotion recognition and global cognition than CG+PRIME. Future analyses will test the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning. ClinicalTrials.gov NCT02782442; https://clinicaltrials.gov/study/NCT02782442.

Possibilities of a computerized training program for recovery of the attention and memory function in vascular cognitive disorders

Aim of the study was to assess the possibilities of recovering the functions of attention and short-term memory in patients with vascular cognitive disorders using a computer program for cognitive training. Material and methods. The study included 17 cardiac surgery patients who underwent a course of cognitive training, starting from 3–4 days after surgery, daily for 5–7 days. The cognitive training program consisted of tasks stimulating the functions of selective attention, visuospatial and working memory. Results. Almost all patients (88 %) reported an acceptable level of subjective difficulty in the performing cognitive training. After completing the cognitive training program, the selective attention improved in 53 % of cases, working memory – in 67 %, the visuospatial memory test scores – in 47 % of patients. Conclusions. The computer-based cognitive training program showed acceptable subjective difficulty in cardiac surgery patients. Approximately 50 % of patients showed an improvement in trained cognitive functions at the final stage of training. The results of approbation of the cognitive training program give an opportunity to determine the degree of compliance of cognitive rehabilitation methods with the psychophysiological status of patients undergoing cardiac surgery, including in the late postoperative period.

Feasibility of a novel neurofeedback system: a parallel randomized single-blinded pilot study

Neurocognitive assessment tools have been proposed to optimize, maintain, and improve perceptual-cognitive performance. Here, we investigated the feasibility and efficacy of a novel neurofeedback system, neuroMoon (nM), on cognitive abilities compared with one of the most popular perceptual-cognitive training (PCT) tools both in sports and rehabilitation called NeuroTracker (NT). Thirty-one young athletes performed a comprehensive battery of cognitive tests from the Vienna Test System before and after a 12-session computer-based cognitive training program using nM (n = 11, age 22.6 ± 3.8 years), nM sham (CON, n = 10, age 20.3 ± 1.2 years) or NT (n = 10, age 20.5 ± 1.7 years) device. A series of repeated-measures ANOVA was performed to detect changes in cognitive abilities in response to the training. Participants had faster median reaction time in both the color-naming and word-reading conditions of the Stroop test (all p < 0.005), regardless of group. Regarding the task switching test, statistical analysis indicated faster working time and mean reaction time of the incongruent stimuli, repetition task, and shifting task (all p < 0.005), nevertheless, these changes were also regardless of group. In addition, we found fewer omitted (pre: 17.5 ± 8.3, post: 6.4 ± 1.5, d = 1.311) and more correct (pre: 261.6 ± 36.1, post: 278.6 ± 38.7, d = − 1.020) post-intervention answers in the determination test, regardless of group. Finally, participants in each group performed the digit span backward test with larger post (6.42 ± 1.54) vs. pre (5.55 ± 1.43) scores following the PCT (d = − 0.801). Overall, PCT with nM as compared with NT induced similar results in cognitive abilities suggesting its potential to be used to achieve and maintain better mental performance. However, considering that the sham stimulation also induced similar improvements in cognitive abilities, future studies should clearly determine the cognitive measures that could benefit from NF training.

Computer-based cognitive training for cognitive development of alcohol-exposed children in South Africa: a feasibility randomised control trial

Children exposed to alcohol in utero may suffer from cognitive and physical sequelae. The most impactful damage in terms of daily functioning is to higher order cognitive functions involved in planning and goal-directed behaviour, referred to as executive functions. Cognitive training interventions are used as a remedial tool for executive function deficits but require implementation by professionals. For the South African context, where resources are limited, a tablet computer-based cognitive training game was developed. This study aimed to establish the feasibility of implementing and evaluating this intervention in South Africa for children exposed to alcohol prenatally. This was a three-arm feasibility randomised control trial comparing an alcohol exposed intervention arm, to an alcohol exposed control arm, and a non-exposed normative arm. Arm allocation was based on self-reported maternal alcohol use during a structured interview. To assess feasibility, we evaluated participant recruitment and barriers to implementation. Executive functions were measured at baseline and following intervention to evaluate the preliminary impact of the intervention. No significant differences were found between the three arms on the post-intervention assessments. The retention rate was acceptable for a randomised control trial; however, there was significant variance in the length of time spent playing the game overall. The majority of participants learned to play the game quickly and progressed through the difficulty levels. In conclusion, a full randomised control trial using the recruitment, randomisation and implementation method would be suitable in the South African context. The statistical outcomes of this trial do not support a full-scale randomised control trial of this intervention.

Design and baseline characteristics of the Cognitive and Aerobic Resilience for the Brain (CARB) study

BackgroundTreatments that delay progression of cognitive impairment in older adults are of great public health significance. This manuscript outlines the protocol, recruitment, baseline characteristics, and retention for a randomized controlled trial of cognitive and aerobic physical training to improve cognition in individuals with subjective cognitive dysfunction, the “Cognitive and Aerobic Resilience for the Brain” (CARB) study. MethodsCommunity-dwelling, older adults with self-reported memory loss were randomly assigned to receive either computer-based cognitive training, aerobic physical training, combined cognitive and physical training, or education control. Treatment was delivered 2- to 3-times per week in 45- to 90-min sessions for 12 weeks by trained facilitators videoconferencing into subject's home. Outcome assessments of were taken at the baseline, immediately following training, and 3-months after training. Results191 subjects were randomized into the trial (mean age, 75.5 years; 68% female; 20% non-white; mean education, 15.1 years; 30% with 1+ APOE e4 allele). The sample was generally obese, hypertensive, and many were diabetic, while cognition, self-reported mood, and activities of daily living were in the normal range. There was excellent retention throughout the trial. Interventions were completed at high rates, participants found the treatments acceptable and enjoyable, and outcome assessments were completed at high rates. ConclusionsThis study was designed to determine the feasibility of recruiting, intervening, and documenting response to treatment in a population at risk for progressive cognitive decline. Older adults with self-reported memory loss were enrolled in high numbers and were well engaged with the intervention and outcome assessments.

Outcomes of a computer-based cognitive training (CoRe) in early phases of cognitive decline: a data-driven cluster analysis

The present study aimed to identify clusters of cognitive profiles as well as to explore the effects of these clusters on demographic/individual characteristics and on improvements after a computer-based cognitive training (CCT) in early cognitive impairment. Fifty-seven subjects underwent to an adaptive CCT for 3 weeks (4 individual face-to-face sessions/week of 45 min) and were evaluated at baseline (T0), post-intervention (T1), and after 6 (T2) and 12 (T3) months. Clusters of cognitive profiles were explored with k-means analysis. The analysis revealed two clusters, which were composed by 27 and 30 patients characterized by lower (Cluster 1) and higher (Cluster 2) cognitive functioning. At T1, cognitive performance improved in both groups, but Cluster 1 gained more benefits in global cognitive functioning than Cluster 2. However, at T3, Cluster 2 remained stable in its clinical condition, whereas Cluster 1 showed a pronounced worsening. In conclusion, Cluster 1 profile was associated with a more marked but also short-lasting responsiveness to CCT, whereas patients fitting with Cluster 2 characteristics seemed to obtain more CCT benefits in terms of stability or even delay of cognitive/functional decline. These findings may have relevant implications in informing the timing and modality of delivery of CCT.

Computer-Based Cognitive Training vs. Paper-and-Pencil Training for Language and Cognitive Deficits in Greek Patients with Mild Alzheimer's Disease: A Preliminary Study.

The purpose of the present study was to explore whether Computer-Based Cognitive Training (C-BCT) versus Paper-Pencil Cognitive Training (P-PCT) is more beneficial in improving cognitive and language deficits in Greek patients living with Alzheimer's disease (pwAD). Twenty pwAD were assigned to two groups: (a) the C-BCT group, receiving a computer-based cognitive training program using the RehaCom software, and (b) the P-PCT group, which received cognitive training using paper and pencil. The cognitive training programs lasted 15 weeks and were administered twice a week for approximately one hour per session. The analyses of each group's baseline versus endpoint performance demonstrated that the P-PCT group improved on delayed memory, verbal fluency, attention, processing speed, executive function, general cognitive ability, and activities of daily living. In contrast, the C-BCT group improved on memory (delayed and working), naming, and processing speed. Comparisons between the two groups (C-BCT vs. P-PCT) revealed that both methods had significant effects on patients' cognition, with the P-PCT method transferring the primary cognitive benefits to real-life activities. Our findings indicate that both methods are beneficial in attenuating cognitive and language deficits in pwAD. The need for large-scale neurobehavioral interventions to further clarify this issue, however, remains a priority.

Recent Updates on Prevention and Intervention in Child and Adolescent Mental Health: Biological Perspective

Psychiatric disorders in children and adolescents have a varied and heterogeneous presentation. Many risk factors play a role in the emergence of the disorder. Newer molecules have been tried for comorbidities in ASD and ADHD. Many have shown efficacy but need more robust evidence for clinical use. Oxytocin in ASD has shown efficacy however is not yet in clinical use. Viloxazine in ADHD has been FDA-approved and has shown efficacy in ADHD. Neuromodulation is tried in almost all disorders; however, studies are limited. Computer-based cognitive training has proven to be helpful in psychotic disorders. More trials are warranted to consolidate the evidence. Digital interventions and virtual reality can be a new way forward. Studies are limited.

Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial.

Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645). Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.

WHAT MOTIVATES PARTICIPATION IN ALZHEIMER’S PREVENTION RESEARCH: A MIXED-METHODS STUDY

Abstract 6.5 million Americans aged 65 and older are currently living with Alzheimer’s disease or related dementias (ADRD; Alzheimer’s Association, 2022). By 2060, it is estimated that this number will increase to 13.9 million (Matthews et al., 2018). Therefore, it is imperative to gain insight into participants’ personal motivations and expectations of research to advance community participation. The Preventing Alzheimer’s with Cognitive Training (PACT) study is a National Institute of Health, National Institute on Aging-funded, multi-site clinical trial examining the prevention of mild cognitive impairment and ADRD through computer-based cognitive training. Across 5 locations, data were collected from 2,360 cognitively normal participants (M=73.03 years, range=65–97, SD=5.04). The current project explores individuals’ motivations and expectations of cognitive training (CT) utilizing a mixed-method approach by coding qualitative open-ended questions about motivation to participate and comparing how motivational themes aligned with expectations about CT from the Expectations Assessment Scale (EAS; Rabipour et al., 2018). Six themes for participant motivation emerged: direct experience with the disease (26.9%), concern about brain health and aging (23.9%), general personal interest (17.9%), general interest in research (20.1%), referral to the study (5.8%), and altruism (5.4%). After completing the initial training session, motivation themes did not differentiate satisfaction with (p=.06) or perceived success of (p=.11) the CT program. Understanding participants’ motivations can further expand and optimize recruitment and retention strategies in AD prevention research. Future research will focus on how these themes influence adherence and retention and relate to participant demographic characteristics (i.e., education, gender, race, and ethnicity).