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Randomized Controlled Trial
. 2024 Jul-Sep;38(3):227-234.
doi: 10.1097/WAD.0000000000000639. Epub 2024 Aug 5.

Predictors of Improvement after Cognitive Training in Mild Cognitive Impairment: Insights from the Cognitive Training and Neuroplasticity in Mild Cognitive Impairment Trial

Min Qian  1 , Jeffrey Motter  2   3 , Emily Deehan  4 , Jamie Graff  2   3 , Alisa Adhikari  5 , P Murali Doraiswamy  5   6 , Terry E Goldberg  2   3 , Devangere P Devanand  2   3
Affiliations
Randomized Controlled Trial

Predictors of Improvement after Cognitive Training in Mild Cognitive Impairment: Insights from the Cognitive Training and Neuroplasticity in Mild Cognitive Impairment Trial

Min Qian et al. Alzheimer Dis Assoc Disord. 2024 Jul-Sep.

Abstract

Objective: Cognitive training may benefit older adults with mild cognitive impairment (MCI), but the prognostic factors are not well-established.

Methods: This study analyzed data from a 78-week trial with 107 participants with MCI, comparing computerized cognitive training (CCT) and computerized crossword puzzle training (CPT). Outcomes were changes in cognitive and functional measures from baseline. Linear mixed-effect models were used to identify prognostic factors for each intervention.

Results: Baseline neuropsychological composite z-score was positively associated with cognitive and functional improvements for both interventions in univariable models, retaining significance in the final multivariable model for functional outcome in CPT ( P < 0.001). Apolipoprotein E e4 carriers had worse cognitive ( P = 0.023) and functional ( P = 0.001) outcomes than noncarriers for CPT but not CCT. African Americans showed greater functional improvements than non-African Americans in both CPT ( P = 0.001) and CCT ( P = 0.010). Better baseline odor identification was correlated with cognitive improvements in CPT ( P = 0.006) and functional improvements in CCT ( P < 0.001).

Conclusion: Baseline cognitive test performance, African American background, and odor identification ability are potential prognostic factors for improved outcomes with cognitive interventions in older adults with MCI. Apolipoprotein E e4 is associated with poor outcomes. Replication of these findings may improve the selection of cognitive interventions for individuals with MCI.

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Conflict of interest statement

M.Q. received research grants from the National Science Foundation and National Institutes of Health (NIH). D.P.D. has received research grants from the National Institutes on Aging and Alzheimer’s Association and has served as a consultant on scientific advisory boards to Acadia, Corium, GSK, TauRx, and a DSMB for BioXcel. P.M.D. has received research grants from the NIH, DARPA, DOD, ONR, Salix, Avanir, Avid, Cure Alzhaimer’s Fund, Karen L. Wrenn Trust, US Highbush Blueberry Council, and Steve Aoki Foundation, and advisory/board fees from Apollo, Clearview, Lumos, Prospira, Keel Digital, Otsuka, Compass, Sermo, Nutricia, UMethod, and Transposon. He is a co-inventor of patents for the diagnosis or treatment of Alzheimer’s disease and a patent for infection detection. Also, owns shares in UMethod, Alzheon, Transposon, and MarvelBiome, the products of which are not discussed here. The remaining authors have received grant support from the NIH and declare no conflicts of interest.

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