Cognitive Training for Older Adults' Cognitive Health

Overseen By Hanzhang Xu, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

Disqualifiers: Bed-ridden, chemotherapy, life-threatening illnesses

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to develop and pilot test a mHealth intervention for cognitive training that is culturally and linguistically relevant to older Chinese Americans

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Cognitive Training Intervention, Cognitive Rehabilitation, Cognitive Therapy, Neurocognitive Training for older adults' cognitive health?

Research shows that cognitive rehabilitation, which includes retraining skills and teaching new strategies, is effective in improving attention, memory, and overall cognitive function in people with brain injuries. Additionally, cognitive training has been found to enhance memory and processing speed in older adults, helping to maintain and improve everyday abilities. ^{1 2 3 4 5}

Is cognitive training safe for humans?

Research on cognitive training, such as the RehaCom program for brain injury patients, shows it is generally safe, with some reports of mild side effects like mental fatigue, headache, and eye irritation. ^{6 7 8 9 10}

How is the Cognitive Training Intervention treatment different from other treatments for cognitive health in older adults?

Cognitive Training Intervention is unique because it focuses on guided practice of specific tasks to stimulate brain functions, promoting neuroplasticity (the brain's ability to reorganize itself) and potentially preventing cognitive decline. Unlike other treatments, it often involves technology-enabled exercises and can be tailored to individual needs, making it a promising option for maintaining cognitive health in older adults. ^{7 11 12 13 14}

Research Team

Hanzhang Xu, PhD

Principal Investigator

Duke University

Eligibility Criteria

This trial is for older Chinese Americans, aged 60 or above, who can see and hear well enough to use a smartphone or tablet. They should be fluent in Chinese and/or English, self-identify as Chinese, have no reported cognitive impairments or Alzheimer's disease-related dementias (ADRD), and must be able to consent. Those bed-ridden, undergoing chemotherapy for cancer, or with other life-threatening illnesses cannot participate.

Inclusion Criteria

Self-identify as Chinese

I am 60 years old or older.

I do not have any cognitive impairments and can make decisions for myself.

Exclusion Criteria

I am not confined to bed.

I am currently undergoing chemotherapy for cancer.

I do not have any other life-threatening illnesses.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete a series of cognitive training exercises on a smartphone/tablet for 12 weeks, involving 3-4 sessions per week

12 weeks

Sessions conducted remotely via app

Follow-up

Participants are monitored for changes in cognition, loneliness, anxiety, depressive symptoms, quality of life, and physical functioning

4 weeks

Treatment Details

Interventions

• Cognitive Training Intervention

Trial Overview The study aims to develop and test a mobile health (mHealth) app designed specifically for cognitive training that suits the cultural and linguistic needs of older Chinese Americans. The intervention involves using this app regularly over the course of the study.

Participant Groups

Group I: Cognitive Training Experimental Treatment 1 Intervention

Participants in the experimental arm will be provided a brochure that included information on basic knowledge of ADRD, signs and symptoms related to ADRD, the definition and the potential benefits of cognitively stimulating activities in maintaining cognitive function, and examples of cognitively stimulating activities. Participants in this arm will complete a series of cognitive training exercises on a smartphone/tablet. The anticipated training will last for 12 weeks and involve 3-4 sessions per week (20-30 min/ session).

Group II: Passive Control Active Control 1 Intervention

A passive control group will be included in this pilot trial. Participants in this passive control arm will be provided a brochure that included information on basic knowledge of ADRD, signs and symptoms related to ADRD, the definition and the potential benefits of cognitively stimulating activities in maintaining cognitive function, and examples of cognitively stimulating activities.

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

New York University

Collaborator

Trials

249

Recruited

229,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Findings from Research

Cognitive rehabilitation is a structured intervention that helps individuals recover cognitive skills after a brain injury, using tailored treatment plans based on thorough neuropsychological assessments.

It has been shown to be effective for a range of cognitive impairments, from mild to severe injuries, and can lead to significant improvements in cognitive abilities and overall psychosocial functioning at any time after the injury.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive rehabilitation following traumatic brain injury: assessment to treatment. Tsaousides, T., Gordon, WA.[2009]

In a study of 241 older adults in rehabilitation, all participants showed significant functional improvement in daily living activities, regardless of their cognitive status, indicating that rehabilitation can be beneficial for everyone.

However, those with lower cognitive scores experienced longer hospital stays and had higher rates of institutionalization and mortality, highlighting the need for tailored care in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does cognitive impairment affect rehabilitation outcome? Poynter, L., Kwan, J., Sayer, AA., et al.[2021]

Cognitive rehabilitation interventions are effective treatments for individuals with traumatic brain injury (TBI), helping to improve cognitive functions, emotional well-being, and overall daily functioning.

These interventions not only enhance awareness of injury-related deficits but also promote community involvement and reduce the risk of secondary disabilities, highlighting their comprehensive role in recovery after TBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role and impact of cognitive rehabilitation. Dams-O'Connor, K., Gordon, WA.[2022]

The RehaCom computerized cognitive training program significantly improved attention and memory functions in 50 brain injury patients after 60 training sessions, with all patients showing enhanced performance in the targeted areas.

The program was well-tolerated, with no reported negative effects such as mental fatigue, headache, or eye irritation, indicating its safety for use in rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury. Fernández, E., Bringas, ML., Salazar, S., et al.[2022]

The SmartTapestry device, tested on 53 participants (29 healthy and 24 with mild cognitive impairment), effectively combines physical activity with cognitive training, showing a strong correlation with traditional cognitive tasks.

This innovative approach suggests that cognitive-physical training tools can enhance cognitive function while being used at home, potentially improving treatment efficacy for cognitive impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can physical and cognitive training based on episodic memory be combined in a new protocol for daily training? Maselli, M., Fiorini, L., Cecchi, F., et al.[2020]

Cognitive training intervention (CTI) significantly improved global cognitive function in healthy elderly participants after 12 weeks, with a mean difference score of 0.57 compared to a wait-list group, indicating its efficacy.

However, there was no lasting carry-over effect observed at 24 weeks, suggesting that while CTI can provide short-term benefits, its effects may not be sustained over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Cognitive Training in Healthy Community Residing Thai Elderly: A Randomized Controlled Trial. Phanasathit, M., Nimnuan, C., Lohsoonthorn, V.[2023]

Cognitive training has been shown to significantly improve subjective cognitive function and certain objective cognitive skills, such as working memory and episodic memory, in breast cancer patients experiencing cognitive changes, based on a systematic review of 9 randomized controlled trials involving 666 patients.

Despite these improvements, cognitive training did not lead to significant changes in attention, short-term memory, executive function, or psychological outcomes like anxiety and depression, indicating that while cognitive training can be beneficial, it may not address all cognitive and emotional challenges faced by these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of cognitive training on patients with breast cancer reporting cognitive changes: a systematic review and meta-analysis. Yan, X., Wei, S., Liu, Q.[2023]

Cognitive training using serious games showed positive interactions and outcomes for patients with cognitive impairment in a pilot study involving 14 participants, indicating potential benefits for cognition and mood.

However, participant retention was a challenge, with only half continuing after five weeks due to factors like patient turnover and difficulties in integrating the training into daily routines, highlighting the importance of facilitator support and individualized program adjustments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[User friendliness of computer-based cognitive training for psychogeriatric patients with mild to moderate cognitive impairments]. van der Ploeg, ES., Hoorweg, A., van der Lee, J.[2016]

References

1. United States pubmed.ncbi.nlm.nih.gov

Cognitive rehabilitation following traumatic brain injury: assessment to treatment. [2009]

2. United States pubmed.ncbi.nlm.nih.gov

Speed of processing training in the ACTIVE study: how much is needed and who benefits? [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Does cognitive impairment affect rehabilitation outcome? [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Nonpharmacological cognitive interventions in aging and dementia. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Role and impact of cognitive rehabilitation. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Clinical impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury. [2022]

7. Germany pubmed.ncbi.nlm.nih.gov

Can physical and cognitive training based on episodic memory be combined in a new protocol for daily training? [2020]

8. New Zealand pubmed.ncbi.nlm.nih.gov

The Effects of Cognitive Training in Healthy Community Residing Thai Elderly: A Randomized Controlled Trial. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

The Effects of Integrated Attention Training for Older Chinese Adults With Subjective Cognitive Complaints: A Randomized Controlled Study. [2019]

10. England pubmed.ncbi.nlm.nih.gov

Effect of cognitive training on patients with breast cancer reporting cognitive changes: a systematic review and meta-analysis. [2023]

11. England pubmed.ncbi.nlm.nih.gov

Early intervention for cognitive decline: can cognitive training be used as a selective prevention technique? [2022]

12. England pubmed.ncbi.nlm.nih.gov

Computerised cognitive training for maintaining cognitive function in cognitively healthy people in late life. [2023]

13. United States pubmed.ncbi.nlm.nih.gov

Minding the aging brain: technology-enabled cognitive training for healthy elders. [2021]

14. Netherlands pubmed.ncbi.nlm.nih.gov

[User friendliness of computer-based cognitive training for psychogeriatric patients with mild to moderate cognitive impairments]. [2016]