Computerized Cognitive Training for Older Adults at Higher Dementia Risk due to Diabetes: Findings From a Randomized Controlled Trial.
Bahar-Fuchs, A., Barendse, M. E. A., Bloom, R., Ravona-Springer, R., Heymann, A., Dabush, H., Bar, L., Slater-Barkan, S., Rassovsky, Y., & Schnaider Beeri, M..
(2020)J Gerontol A Biol Sci Med Sci.
DOI: https://doi.org/10.1093/gerona/glz073
Abstract
Background: To evaluate the effects of adaptive and tailored computerized cognitive training on cognition and disease self-management in
older adults with diabetes.
Methods: This was a single-blind trial. Eighty-four community-dwelling older adults with diabetes were randomized into a tailored and
adaptive computerized cognitive training or a generic, non-tailored or adaptive computerized cognitive training condition. Both groups trained
for 8 weeks on the commercially available CogniFit program and were supported by a range of behavior change techniques. Participants in
each condition were further randomized into a global or cognition-specific self-efficacy intervention, or to a no self-efficacy condition. The
primary outcome was global cognition immediately following the intervention. Secondary outcomes included diabetes self-management, meta-
memory, mood, and self-efficacy. Assessments were conducted at baseline, immediately after the training, and at a 6-month follow-up.
Results: Adherence and retention were lower in the generic computerized cognitive training condition, but the self-efficacy intervention was not associated
with adherence. Moderate improvements in performance on a global cognitive composite at the posttreatment assessments were observed in both
cognitive training conditions, with further small improvement observed at the 6-month follow-up. Results for diabetes self-management showed a modest
improvement on self-rated diabetes care for both intervention conditions following the treatment, which was maintained at the 6-month follow-up.
Conclusions: Our findings suggest that older adults at higher dementia risk due to diabetes can show improvements in both cognition and
disease self-management following home-based multidomain computerized cognitive training. These findings also suggest that adaptive
difficulty and individual task tailoring may not be critical components of such interventions.
Trial registration: NCT02709629.
This study evaluated how computerised cognitive training programs effect cognition and disease management in older adults with diabetes. Participants were trained on either a tailored and adaptive computerised cognitive program or a generic non-tailored or adaptive computerised cognitive program. Each condition was further randomised into 3 subgroups; global self-efficacy, cognition-specific self efficacy or no self-efficacy condition. Global cognition was the primary outcome measured, with diabetes self-management, meta-memory, mood and self-efficacy being the secondary outcomes measured. The results showed that both groups had improved cognitive performance and disease self-management, however there were better retention rates in the tailored and adaptive group. The study was limited by the participants predominately being high functioning, well educated and motivated compared to the general population with diabetes. The study was also not sufficiently powered to detect complex relationships between training conditions, SE conditions and timepoints.
This study evaluated how computerised cognitive training programs effect cognition and disease management in older adults with diabetes. Participants were trained on either a tailored and adaptive computerised cognitive program or a generic non-tailored or adaptive computerised cognitive program. Each condition was further randomised into 3 subgroups; global self-efficacy, cognition-specific self efficacy or no self-efficacy condition. Global cognition was the primary outcome measured, with diabetes self-management, meta-memory, mood and self-efficacy being the secondary outcomes measured. The results showed that both groups had improved cognitive performance and disease self-management, however there were better retention rates in the tailored and adaptive group. The study was limited by the participants predominately being high functioning, well educated and motivated compared to the general population with diabetes. The study was also not sufficiently powered to detect complex relationships between training conditions, SE conditions and timepoints.