Online Cognitive Training

Abstract

Research shows the risk for cognitive impairment and the rate of cognitive decline double after type 2 diabetes mellitus is diagnosed and can make self-management more difficult. Cognitive training has been found to be one way to improve self-management and cognitive function, and this article reports the adaptation of one such intervention to an online format. Ten adults with diabetes participated in an 8-week intervention that combined webinar classes with online computer game training. Perceived memory ability, executive function, self-management, and self-efficacy were measured. Evaluation of recruitment, data collection, and implementation demonstrated good feasibility and reduced barriers to engagement. Although the intervention did not result in significant changes in cognitive function, scores on all surveys improved. Adherence to diet, exercise, and foot care recommendations also improved. Most participants stated they preferred the intervention's online format to “traditional” in-person formats. Online technology in this 8-week intervention helped improve recruitment, retention, participant engagement, and use of cognitive strategies in people with type 2 diabetes mellitus. Overall, participants found the intervention helpful and said it reduced the time and travel burden associated with educational interventions. A larger randomized controlled trial is needed to further explore the intervention's potential impact over a longer period.

Feasibility and Acceptability of a Cognitive Training Study in Individuals with Type 2 Diabetes Mellitus

“…The improvements in executive function/working memory (SWM task), visual memory (PAL task), recognition memory (PRM task), and reaction time (RTI task) complement the findings observed in previous randomised controlled trials [42,44] and further add to the accumulating evidence pointing towards cognitive training as a potential effective strategy for targeting cognitive dysfunction in T2DM [42][43][44][45][46][47]. Whilst the magnitude of effect was small across most cognitive outcomes, a moderate to large improvement (0.7) was identified in spatial working memory, a core construct of executive function [114].…”

“…Only a limited number of trials exist that evaluate the impact of cognitive interventions in T2DM [42][43][44][45][46][47], of which only few explore the acceptability of these types of interventions. Our findings are consistent with recent evidence presented by Cuevas et al [91] suggesting individuals with T2DM may be motivated to participate in cognitive activities due to their concerns of developing dementia.…”

“…It is therefore important to identify strategies that are not only effective in improving cognition in T2DM, but most importantly, strategies that are feasible and acceptable, allowing for long-term behavioural compliance. Cognitive training interventions (i.e., mental exercises used to target one or more cognitive domains) have previously been identified as a potential strategy for targeting cognitive dysfunction [38][39][40], in which there is now growing evidence for their effective use in T2DM [41][42][43][44][45][46][47], particularly in relation to improving diabetes self-management [45,46]. There is a clear and important need for the development of these types of interventions, especially in the context of frameworks that advocate for strategies that assist in implementing and sustaining the skills, abilities, and knowledge required for optimal diabetes self-care [48,49].…”

Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes

“…Thus, our review included 5 RCTs 10,11,22 -24 and 4 quasi-experimental studies. 13,26 -28 The articles were published between 2013 and 2021. Among these 9 studies, 1370 participants were enrolled with sample sizes ranging from 10 to 456.…”

“…27 Two studies used online games, 1 of which used a point scoring system to promote competition and community. 11,26…”