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Randomized Controlled Trial
. 2024;11(1):149-154.
doi: 10.14283/jpad.2023.80.

Computerized Cognitive Training in Mild Cognitive Impairment: Findings in African Americans and Caucasians

A Nwosu  1 , M Qian, J Phillips, C A Hellegers, S Rushia, J Sneed, J R Petrella, T E Goldberg, D P Devanand, P M Doraiswamy
Affiliations
Randomized Controlled Trial

Computerized Cognitive Training in Mild Cognitive Impairment: Findings in African Americans and Caucasians

A Nwosu et al. J Prev Alzheimers Dis. 2024.

Abstract

Background: African Americans with MCI may be at increased risk for dementia compared to Caucasians. The effect of race on the efficacy of cognitive training in MCI is unclear.

Methods: We used data from a two-site, 78-week randomized trial of MCI comparing intensive, home-based, computerized training with Web-based cognitive games or Web-based crossword puzzles to examine the effect of race on outcomes. The study outcomes were changes from baseline in cognitive and functional scales as well as MRI-measured changes in hippocampal volume and cortical thickness. Analyses used linear models adjusted for baseline scores. This was an exploratory study.

Results: A total of 105 subjects were included comprising 81 whites (77.1%) and 24 African Americans (22.8%). The effect of race on the change from baseline in ADAS-Cog-11 was not significant. The effect of race on change from baseline to week 78 in the Functional Activities Questionnaire (FAQ) was significant with African American participants' FAQ scores showing greater improvements at weeks 52 and 78 (P = 0.009, P = 0.0002, respectively) than white subjects. Within the CCT cohort, FAQ scores for African American participants showed greater improvement between baseline and week 78, compared to white participants randomized to CCT (P = 0.006). There was no effect of race on the UPSA. There was no effect of race on hippocampal or cortical thickness outcomes.

Conclusions: Our preliminary findings suggest that web-based cognitive training programs may benefit African Americans with MCI at least as much as Caucasians, and highlight the need to further study underrepresented minorities in AD prevention trials. (Supported by the National Institutes of Health, National Institute on Aging; ClinicalTrials.gov number, NCT03205709.).

Keywords: Alzheimer’s; Race; brain health; ethnicity; health disparities.

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Conflict of interest statement

DPD has received research grants from the National Institute on Aging and the Alzheimer’s Assocation and has served as a consultant on scientific advisory boards to Acadia, Corium, Genentech, TauRx, and a DSMB for BioXcel. PMD has received research grants from the National Institute on Aging, DARPA, DOD, ONR, Salix, Avanir, Avid, Cure Alzhaimer’s Fund, Karen L. Wrenn Trust, Steve Aoki Foundation, and advisory fees from Apollo, Brain Forum, Clearview, Lumos, Neuroglee, Otsuka, Verily, Vitakey, Sermo, Lilly, Nutricia, and Transposon. PMD is a co-inventor on patents for the diagnosis or treatment of Alzheimer disease and a patent for infection detection. PMD owns shares in several biotechnology companies whose products are not discussed here. Other authors have received grant support from NIH and report no other competing interests. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. A data sharing statement provided by the authors is available with the full text of this article at NEJM.org.

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