Content area
Background
Developing efficient cognitive training programs for the older population is a major public health goal due to its potential benefits on cognition and quality of life. A promising training approach is emphasis change, which can benefit executive/attention control and multitasking abilities. The aim of this digital pilot randomized controlled trial was to assess the effects of the emphasis change using a new web‐based platform that simulates real‐life multitasking demands, the Breakfast Game.
Method
A community‐based sample of 38 cognitively healthy participants (M = 65.8, SD = 3.6), highly educated (M = 16.4, SD = 2.0) were randomized between two conditions: 1) Emphasis Change (EC): participants were instructed to place particular emphasis on specific aspects of the game; and 2) Active Control (AC) – gameplay with standard instructions. Participants underwent 13 online sessions using the Breakfast Game. Each session lasted one hour and occurred 3 times a week at participants’ homes. Five out of the 13 sessions were supervised via videoconference. Participants completed a neuropsychological assessment via videoconference at baseline and after the intervention (clinicaltrials.gov ID: NCT05506852).
Result
At baseline, participants from both conditions showed similar levels of cognitive performance and computer literacy (p > .05). The trial presented high adherence (94.5%) and retention rates (89%), with a loss of 2 participants per group. Both groups show a learning curve, with time effects in the game outcomes (p < .05). A time‐by‐group interaction (p = .04) was observed for one game accuracy measure (e.g., range of stop times), indicating greater training gain in the EC group. Regarding the transfer effects, there were time‐by‐group interactions (p = .02; p = .03) in the primary outcome (Alphanumeric Task), showing greater improvement in the EC in modulating their attention allocation. There was a modest effect in the secondary transfer outcome, the executive functions composite score (p = .03), mainly driven by working memory and divided attention tasks. There were no changes in the self‐efficacy and mood measures.
Conclusion
Online emphasis change training using the Breakfast Game is feasible with modest effects and promising benefits on divided attention/executive control in older adults. Further research should improve the features of the Breakfast Game and clarify the dose‐response relationship.
Details
Public health;
Games;
Executive control;
Older people;
Cognition;
Efficacy;
Quality of life;
Changes;
Multitasking;
Health care;
Attention;
Breakfast;
Short term memory;
Digital literacy;
Divided attention;
Training;
Neuropsychological assessment;
Clinical trials;
Cognitive skills training;
Executive function;
Emotions;
Adults;
Cognitive ability;
Educational programs;
Groups;
Learning transfer
1 Fordham University, New York, NY, USA,
2 Columbia University Irving Medical Center, New York, NY, USA,
3 Columbia University, New York, NY, USA,
4 Technion ‐ Israel Institute of Technology, Haifa, Israel,
5 Herbert and Jacqueline Krieger Klein Alzheimer's Research Center at Rutgers Brain Health Institute, New Brunswick, NJ, USA,
6 New York State Psychiatric Institute, New York, NY, USA,, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA,
7 Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada,
8 University of Michigan, Ann Arbor, MI, USA,
9 Columbia University Vagelos Collège of Physicians and Surgeons, New York, NY, USA,
10 Herbert and Jacqueline Krieger Klein Alzheimer's Research Center at Rutgers Brain Health Institute, New Brunswick, NJ, USA,, New Jersey Medical School, Rutgers University, Newark, NJ, USA,