Development of Computer-AidedCognitive Training Program for Elderly and Its Effectivenessthrougha 6 Months Group Intervention Study

Abstract

Since the increasing population of aging, cognitive training is focused as one of the non-pharmacological preventive approach of cognitive decline. Although the accumulation of the knowledge, they hardly reflect to the programs for clinical use. We developed a task set named "Atama-no-dojo," designed to activate multiple cognitive functions and enhance motivational incentives. The objective of our study is to confirm the effect of our program through a 6 months group intervention program. The intervention program conducted in a day service center for 6 months in the duration of 45 minutes per day, 4 days per month for a total of 25 sessions. Participants worked to the tasks on the screen all together with filling in the answering sheet. Neuropsychological tests, SF36 and GDS were assessed at pre-/post-intervention periods. Participants filled in a questionnaire about impression to the program at the last training session. Fourteen women (82.2 ± 2.9 years old) were analyzed and significant changes were found in the improvement of memory, attention, inhibition, GDS and some items of SF36. All participants recognized the program as fun and wanted to continue. Some of the participants' positive impressions to the program correlated to cognitive improvement. The improved cognitive functions by 6 months intervention of "Atama-no-dojo" were mainly related to prefrontal cortex and the motivational incentives seemed supported the effect of task contents. We recognized the importance of task difficulty setting and motivational incentives to reduce frustration from working on difficult tasks and enhance the effects of improvement from activating brain function.

Methodological Designs Applied in the Development of Computer-Based Training Programs for the Cognitive Rehabilitation in People with Mild Cognitive Impairment (MCI) and Mild Dementia. Systematic Review

“…Of the 13 studies included in this systematic review, 11 (84.6%) used a user-centered design (UCD) [34][35][36][37][38]41,42,[44][45][46] or HCD [43] for the development of the cognitive rehabilitation programs or games. According to ISO9241-210 [21], UCD and HCD are equivalent terms.…”

“…The study by Cruz, Pais J. [40] had a dropout rate of 40%; Han, Oh [41] reported a 30% dropout rate; Otsuka, Tanemura [42] reported 26.3% dropout; and Boulay, Benveniste [38] had a 28.6% dropout rate. The main reasons for dropout were failure to regularly attend the training sessions, difficulty in using the device, development of psychiatric disorders, visual impairment, and hospitalization ( Table 1).…”

“…Regarding the diagnosis of the sample population of the studies included in this review, seven (53.9%) studies recruited people diagnosed with MCI [34,35,[41][42][43]45,46], four (30.8%) studies worked with people diagnosed with mild dementia [22,37,38,44], and two (15.4%) studies included a pooled sample of people diagnosed with MCI and mild dementia [36,40]. Four (30.8%) studies included healthy comparison subjects [34][35][36]44], two (15.4%) studies included people with other types of diagnoses in their sample (e.g., traumatic brain injury (TBI) or Lewy body dementia (LBD)) [40,44], and one (7.7%) study worked with people with moderate and severe stage dementia [43] ( Table 1).…”

“…Of the 13 studies included in this review, four (30.8%) recruited their sample from hospitals [35,37,38,41], two (15.4%) from memory clinics [36,40], two (15.4%) from day centers or care centers [42,43], one (7.7%) from nursing homes [22], two (15.4%) from medical centers or institutions associated with universities [34,44], and two (15.4%) from other centers [45,46] (Table 1). Table 2 describes the specification of the methodological design used by each of the studies in accordance with the international standards proposed by ISO9241-210 [21] for the development of programs: (1) understanding and specifying the CTX of use (type, characteristics and tasks of users, and physical or social environment), (2) specifying the user requirements, (3) producing design solutions, and (4) evaluating the design.…”

“…Four (30.8%) studies were based on observation of their users [36][37][38]42] and all the studies (N = 13) reviewed the literature as a means to understand the CTX of use (Table 2) in terms of type, user characteristics (or needs and deficits) and tasks, and physical or social environment of people with MCI or mild dementia. Accordingly, all studies specified the characteristics of the users or target population and the CTX of use of the program or game to be developed, i.e., the application environment and tasks (Table 1).…”