Efficacy of a Web App for Cognitive Training (MeMo) Regarding Cognitive and Behavioral Performance in People With Neurocognitive Disorders: Randomized Controlled Trial

Abstract

Background Cognitive and behavioral symptoms are the clinical hallmarks of neurocognitive disorders. Cognitive training may be offered to reduce the risks of cognitive decline and dementia and to reduce behavioral symptoms, such as apathy. Information and communication technology approaches, including serious games, can be useful in improving the playful aspect of computerized cognitive training and providing motivating solutions in elderly patients. Objective The objective of this study was to assess the effectiveness of employing the MeMo (Memory Motivation) Web app with regard to cognitive and behavioral symptoms in patients with neurocognitive disorders. Methods MeMo is a Web app that can be used on any Web browser (computer or tablet). The training activities proposed in MeMo are divided into the following two parts: memory and mental flexibility/attention. The study included 46 individuals (mean age 79.4 years) with a diagnosis of neurocognitive disorders at the Institut Claude Pompidou Memory Center in Nice. This randomized controlled study compared the evolution of cognition and behavior between patients not using MeMo (control group) and patients using MeMo (MeMo group) for 12 weeks (four sessions per week). Patients underwent memory and attention tests, as well as an apathy assessment at baseline, week 12 (end of the training period), and week 24 (12 weeks after the end of the training sessions). In addition, to assess the impact of high and low game uses, the MeMo group was divided into patients who used MeMo according to the instructions (about once every 2 days; active MeMo group) and those who used it less (nonactive MeMo group). Results When comparing cognitive and behavioral scores among baseline, week 12, and week 24, mixed model analysis for each cognitive and behavioral score indicated no significant interaction between testing time and group. On comparing the active MeMo group (n=9) and nonactive MeMo group (n=13), there were significant differences in two attention tests (Trial Making Test A [P=.045] and correct Digit Symbol Substitution Test items [P=.045]) and in the Apathy Inventory (AI) (P=.02). Mixed analysis (time: baseline, week 12, and week 24 × number of active days) indicated only one significant interaction for the AI score (P=.01), with a significant increase in apathy in the nonactive MeMo group. Conclusions This study indicates that the cognitive and behavioral efficacies of MeMo, a Web-based training app, can be observed only with regular use of the app. Improvements were observed in attention and motivation. Trial Registration ClinicalTrials.gov NCT04142801; https://clinicaltrials.gov/ct2/show/NCT04142801

Ambient assisted living technology‐mediated interventions for older people and their informal carers in the context of healthy ageing: A scoping review

“…Calabrò et al 96 showed a significant improvement in the attention process and executive functioning among older participants. In Robert et al, 93 there were indications of steady results in cognitive performance, suggesting less or slowed deterioration. Park et al 92 showed improvements in memory, but otherwise, no differences compared to the control group who used a conventional computer‐based training program.…”

“…87 4.7 | Training and maintenance of cognitive ability 9% (n = 8) of included studies described interventions aiming to improve or preserve cognitive skills and functions and reduce depressive symptoms among older people. [89][90][91][92][93][94][95][96] The interventions used mobile, web-based or virtual reality gaming software, [89][90][91][92]95 wearable and monitoring sensors, 94 a web-based app, 93 and an exercise robot. 96 The system in Lazarou et al 94 also included a caregiver interface for sharing information.…”

“…Half of the studies were RCTs. 89,[91][92][93] Health outcomes among older participants were improvement in depression and Mini-Mental State Examination (MMSE) scores, 89 in ADL functioning and sleep 94 global cognition and executive functioning 90 and in executive functioning and verbal memory. 91 In the study conducted by Merilampi et al, 95 reported a decrease in caregiver burden post-intervention.…”

Digital therapeutics in neurology

“…"MeMo" is a Web-based app for memory, attention, and mental flexibility training. In a randomized controlled trial, its effects on cognitive and behavioral symptoms were explored in 46 patients with neurocognitive disorders (32 participants were diagnosed with probable Alzheimer's disease and 14 with mixed disorders) [47]. In detail, the study compared patients using and not using "MeMo" for 12 weeks (four sessions per week).…”

Impact of Pediatric Mobile Game Play on Healthy Eating Behavior: Randomized Controlled Trial

“…However, these limitations are not unique to this paper, as can be seen in recent game-related literature. For example, existing literature reporting studies with sample size of 46 [ 61 ], 20-minute game exposure time [ 62 ], or subjects recruited from a single institution [ 61 , 63 ] still provide novel and useful insights. Second, the fact that the actual food choices were made immediately after playing the game limits our observed effect to be the immediate effect.…”