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The investigators are adapting a tablet-based cognitive training program for Alzheimer's disease (AD) by focusing on specific cognitive components. It is aimed to demonstrate the feasibility, acceptability and usability of remote cognitive training in older adults with Mild Cognitive Impairment (MCI) and AD dementia. The study involves 36 participants in three groups, with a two-week intervention and focus groups for refinement.
The investigators aim to extend a tablet-computer-based cognitive training (CT), fully developed in house (KEK 2020-00630), and tailored specifically towards a "typical-AD" cognitive component. This cognitive component is defined through a principal-component analysis (PCA), on which the domains affected by AD (episodic memory, spatial processing, semantic memory) have high loadings. The investigators moreover train working memory training to facilitate transfer effects. By including carers (family members, friends, professional carers) in the focus groups and the integration of help buttons, the investigators expect high adherence. The CT will be based on our ongoing study assessing the CT in people at risk for AD and subjective cognitive decline.
The investigators plan a small feasibility study in three different groups with a total of 36 elderly participants including cognitively normal (N=12), MCI (N=12), and mild-moderate stage dementia due to AD (N=12).
The focus will be on qualitative content analyses based on the results from the focus groups. The results from the first focus group sessions serve the selection, adaptation, and improvement of the CT before it is implemented in the two-week intervention including daily 30-minutes training sessions. A second focus group after the intervention will serve to gain additional insights from users and carers to further improve the CT. To complement this information, the investigators will quantitatively compare specific game parameters related to feasibility (number of levels achieved, numbers of sessions finished, number of dropouts), usability (time until reaching level 1 - learn duration, numbers of help button presses), and acceptability (game evaluation) between the three treatment groups.
The investigators aim to demonstrate that remote CT is possible in older adults with Mild Cognitive Impairment (MCI) and diagnosed AD dementia at home and in the care home setting by extending an existing tablet-based CT app with additional (easier) training levels, additional and detailed introductory material to also allow cognitively more severely impaired participants to conduct the CT with as little external support as possible. This study is considered as Risk Category A. The study intervention consists of a tablet-based CT, which does not provide any known risks for the participants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HC - Healthy Control Group | Healthy, age- and sex-matched participants (cognitively normal) |
| |
| MCI - Mild Cognitive Impairment | Participants with MCI |
| |
| AD - Alzheimer's Disease | Participants with mild-moderate stage dementia due to AD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| App-based cognitive training | Device | The cognitive training is administered remotely for 2 weeks daily (10 sessions). The participants play all 12 games for 8 minutes in each session. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of tablet-based cognitive training | Compliance rate (i.e.number of sessions completed) | Assessed at the end of the 2-week intervention (Day 10) |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of tablet-based cognitive training | Number of levels achieved | Assessed at the end of the 2-week intervention (Day 10) |
| Usability | Time until accomplishment of the first level (learning time) |
| Measure | Description | Time Frame |
|---|---|---|
| Support 1 | The extent of support needed from study partners (diary notes) | Assessed at the end of the 2-week intervention (Day 10) |
| Support 2 | The number of sessions for which support was required (diary notes) |
Participants and study partners fulfilling all the following inclusion criteria are eligible for the study:
• Informed Consent as documented by signature
Study partners:
• Native or fluent German speaker
Participants:
Exclusion Criteria:
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Participants will be recruited by newspaper adverts and flyers after public talks. It is also intended to recruit visitors from the day clinic as well as patients from the Interdisciplinary Memory Clinic (IDMC) Bern (https://www.memory-clinic-bern.ch/) and the Domicil care home group (www.domicilbern.ch).
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| Name | Affiliation | Role |
|---|---|---|
| Anna-Katharine Brem | University Hospiltal of Old Age Psychiatry and Psychotherapy | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital of Old Age Psychiatry and Psychotherapy Bern | Bern | Canton of Bern | 3000 | Switzerland |
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| Label | URL |
|---|---|
| Related Info | View source |
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The investigators will share encrypted study data used for publications in an appropriate open access data base
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Assessed at the end of the 2-week intervention (Day 10) |
| Acceptability | Qualitative evaluation of the games in a semi-structured interview (Focus group discussion). For each game, the same questions will be addressed in an open discussion. | Assessed within two weeks after day 10 of the intervention |
| 2. Feasibility of tablet-based cognitive training | Number of drop-outs | Assessed at the end of the 2-week intervention (Day 10) |
| Assessed at the end of the 2-week intervention (Day 10) |
| Wellbeing | Influence on mood and wellbeing (questionnaire) | Assessed every day during the intervention, a couple of seconds before playing the games (answering the in-game question on the tablet precedes playing the scheduled session). |
| Evaluation of Games by Study Partner | Qualitative evaluation of the games in a semi-structured interview (Focus group discussion). For each game, the same questions will be addressed in an open discussion. | Assessed every day after (within couple of minutes) each game of the intervention was played. |
| Related Info | View source |
| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D003072 | Cognition Disorders |