Computerized cognitive training for older adults at higher dementia risk due to diabetes: findings from a randomized controlled trial.

BACKGROUND: To evaluate the effects of adaptive and tailored computerized cognitive training [CCT] on cognition and disease self-management in older adults with diabetes.

METHODS: Single-blind trial. Eighty-four community-dwelling older adults with diabetes were randomized into a tailored and adaptive computerized cognitive training [TA-CCT] or a generic, non-tailored or adaptive CCT condition [GCCT]. Both groups trained for 8-weeks on the commercially-available CogniFit program and were supported by a range of behavior change techniques [BCTs]. Participants in each condition were further randomized into a global or cognition-specific self-efficacy [SE] intervention, or to a no-SE condition. The primary outcome was global cognition immediately following the intervention. Secondary outcomes included diabetes self-management, meta-memory, mood, and self-efficacy. Assessments were conducted at baseline, immediately after the training, and at a 6-month follow-up.

RESULTS: Adherence and retention were lower in the GCCT condition, but the self-efficacy intervention was not associated with adherence. Moderate improvements in performance on a global cognitive composite at the post-treatment assessments were observed in both cognitive training conditions, with further small improvement observed at the 6-month follow-up. Results for diabetes self-management showed a modest improvement on self-rated diabetes care for both intervention conditions following the treatment, which was maintained at the 6-month follow-up.

CONCLUSIONS: Our findings suggest that older adults at higher dementia risk due to diabetes can show improvements in both cognition and disease self-management following home-based multi-domain computerized cognitive training. These findings also suggest that adaptive difficulty and individual task tailoring may not be critical components of such interventions.