Affiliations: [a]
Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
| [b] Academic Unit for Psychiatry of Old Age, Parkville, The University of Melbourne, VIC, Australia
| [c]
School of Psychology, Griffith Taylor Building, The University of Sydney, New South Wales, Australia
| [d]
Centre for Research in Ageing and Cognitive Health, Washington Singer Laboratories, The University of Exeter, UK
| [e]
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
Correspondence:
[*]
Correspondence to: Alex Bahar-Fuchs, Academic Unit for Psychiatry of Old Age, 34-54 Poplar Rd., Parkville, The University of Melbourne, VIC, Australia. Tel.: +61 3 83872480; E-mail: alex.bahar@unimelb.edu.au.
Abstract: Background:Computerized Cognitive Training (CCT) has been shown to improve cognitive function in older adults with mild cognitive impairment (MCI) or mood-related neuropsychiatric symptoms (MrNPS), but many questions remain unresolved. Objective:To evaluate the extent to which CCT benefits older adults with both MCI and MrNPS, and its effects on meta-cognitive and non-cognitive outcomes, as well as establish whether adapting difficulty levels and tailoring to individuals’ profile is superior to generic training. Methods:Older adults with MCI (n = 9), MrNPS (n = 11), or both (MCI+, n = 25) were randomized into a home-based individually-tailored and adaptive CCT (n = 21) or an active control condition (AC; n = 23) in a double-blind design. Interventions lasted 8–12 weeks and outcomes were assessed after the intervention, and at a 3-month follow-up. Results:Participants in both conditions reported greater satisfaction with their everyday memory following intervention and at follow-up. However, participants in the CCT condition showed greater improvement on composite measures of memory, learning, and global cognition at follow-up. Participants with MrNPS in the CCT condition were also found to have improved mood at 3-month follow-up and reported using fewer memory strategies at the post-intervention and follow-up assessments. There was no evidence that participants with MCI+ were disadvantaged relative to the other diagnostic conditions. Finally, informant-rated caregiver burden declined at follow-up assessment in the CCT condition relative to the AC condition. Conclusions:Home-based CCT with adaptive difficulty and personal tailoring appears superior to more generic CCT in relation to both cognitive and non-cognitive outcomes. Mechanisms of treatment effect and future directions are discussed.
