Effects of the Multicomponent Cognitive Training Program BrainProtect in Cognitively Healthy Adults: A Randomized Controlled Trial

Article type: Research Article

Authors: Falkenreck, Julia Maria^a | Kunkler, Michelle Celine^a | Ophey, Anja^b | Weigert, Hannah^a | Friese, Andrea^c | Jahr, Petra^d | Nelles, Gereon^e | Kalbe, Elke^{b; 1} | Polidori, M. Cristina^{a; g; 1; *}

Affiliations: [a] Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany | [b] Department of Medical Psychology ∣ Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany | [c] AF Gehirntraining, Bedburg, Germany | [d] C Plus, Krefeld, Germany | [e] Neuromed-Campus Hohenlind, Cologne, Germany | [g] CECAD, University of cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

Correspondence: [*] Correspondence to: M. Cristina Polidori, MD, PhD, FRCP, Ageing Clinical Research, CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Tel.: +49 221 478 32753; E-mail:maria.polidori-nelles@uk-koeln.de.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Cognitive integrity is a fundamental driver of health. The exact structure of strategies against cognitive impairment is still under debate. Objective:To compare the short-term effects of a multicomponent cognitive training (BrainProtect) with those of general health counseling (GHC) on cognitive abilities and health-related quality of life (HRQoL) in healthy adults in Germany. Methods:In this parallel randomized controlled trial (RCT), 132 eligible cognitively healthy adults (age ≥50 years, Beck Depression Inventory ≤9/63; Montreal Cognitive Assessment ≥26/30) were randomized to either GHC (N = 72) or to intervention with BrainProtect (intervention group, IG; N = 60). IG participants received 8 weekly sessions of 90 min of the group-based BrainProtect program focusing on executive functions, concentration, learning, perception, and imagination, plus nutritional and physical exercise units. Before and after intervention, all participants underwent neuropsychological testing and HRQoL evaluation, blinded for pretest. Results:No significant training effect was observed for the primary endpoint of global cognition as assessed by CERAD-Plus-z Total Score (p = 0.113; ηp2 = 0.023). Improvements in several cognitive subtests were shown in the IG (N = 53) compared to the GHC (N = 62) without adverse events. Differences reached significance for verbal fluency (p = 0.021), visual memory (p = 0.013), visuo-constructive functions (p = 0.034), and HRQoL (p = 0.009). Significance was lost after adjustment, though several changes were clinically relevant. Conclusion:BrainProtect did not significantly impact global cognition in this RCT. Nevertheless, the results of some outcomes indicate clinically meaningful changes, so that a strengthening of the cognitive performance by BrainProtect cannot be excluded. Further studies with larger sample size are needed to confirm these findings.

Keywords: Alzheimer’s disease, cognitive integrity, cognitive training, healthy aging, prevention

DOI: 10.3233/JAD-220619

Journal: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1013-1034, 2023