Efficacy of computerized cognitive training using mobile devices to promote cognitive functioning in community-dwelling older adults with or without risk of mild cognitive impairment: A multi-centre longitudinal study

Abstract

Objective: To investigate the efficacy of a 5-month computerized cognitive training programme (CCT) "Exercise your Brain" using mobile devices in improving cognitive functioning in community-dwelling older adults with and without risk of mild cognitive impairment (MCI).

Methods: One hundred thirty-four older adults were recruited from 5-day activity centres for the older adults in Hong Kong using convenience sampling to participate in a 5-month CCT training. Participants were stratified into older adults with and without risk of MCI.

Results: There was significant improvement (p < 0.001) in MoCA 5-min for the whole sample after 5-month CCT (d = 0.72) and the effects were maintained at 3-month follow-up. The group at risk of MCI improved their cognitive functioning immediately after intervention more than the non-MCI group (p < 0.001, d = 1.37 vs d = 0.55). In the task-based performance, there was significant interaction effect between memory and calculation with and without risk of MCI when years of formal education was a covariate, and that the non-MCI group had the highest improvement in Judgement (6.23%) and memory (5.43%), compared with that (1.47% and 2.33%) in the group at risk of MCI. The risk-of-MCI group had the highest improvement in attention (2.67%) and eye-hand coordination (4.87%), compared with that of the healthy older adults.

Conclusion: Cognitive functioning in both older adults with or without risk of MCI was enhanced immediately after CCT using a mobile device and endured over a three-month follow-up. The training effect on the group at risk of MCI was significantly greater than that for the non-MCI group. With recent advances in mobile technology, remote cognitive training in terms of using mobile devices for older adults as primary and secondary preventions is applicable and practicable.

Keywords: Computerized cognitive training; mild cognitive impairment; mobile devices; older adults.

Figure 1.

Sample of “Exercise your Brain”. (a) Attention – find out the coin inside the inversed cans. (b) Eye-hand coordination – drop the recyclable objects to the correct collection bins. (c) Calculation – add up the price of the items at the grocery store without using the calculator. (d) Judgement – find out the missing pieces in the figure on the left hand side.

Figure 2.

CONSORT flow diagram.

Figure 3.

Improvement score for accuracy and total time used in task-based domain-specific performance after intervention. (A) changes in accuracy scores of domain-specific cognitive performance (%). (B) Changes in reaction time of domain-specific cognitive performance (sec.).