The Cognition and Flow Study: A Feasibility Randomized Controlled Trial of the Effects of Cognitive Training on Cerebral Blood Flow

Abstract

Background: Cognitive training (CT) has demonstrated benefits for healthy older adults (HG) and mild cognitive impairment (MCI), but the effects on vascular function are unknown. Objective: This is a feasibility trial investigating the effects of CT on cerebral blood flow velocity (CBFv). Methods: Twenty HG, 24 with Alzheimer’s disease (AD), and 12 with MCI were randomized to 12 weeks of multi-domain CT or control. Outcomes included: cognition (Addenbrooke’s Cognitive Examination III), mood, quality of life (QoL), physical, and neurovascular function (transcranial Doppler ultrasonography measured task activation of CBFv responses). Data are presented as mean difference (MD) and 95% confidence interval (CI). Results: 47 participants completed the trial. There were three dropouts from the training arm in the AD group, and one in the HG group. The intervention was acceptable and feasible to the majority of participants with a high completion rate (89%). The dropout rate was higher among participants with dementia. Few changes were identified on secondary analyses, but QoL was significantly improved in HG post-training (MD: 4.83 [95% CI: 1.13, 8.54]). CBFv response rate was not significantly different in HG (MD: 1.84 [95% CI: –4.81, 1.12]), but a significant increase was seen in the patient group (MD: 1.79 [95% CI: 0.005, 3.58]), requiring sample sizes of 56 and 84 participants respectively for a fully-powered trial. Conclusion: A 12-week CT program was acceptable and feasible in HG, AD, and MCI. CT may be associated with alterations in vascular physiology which require further investigation in an appropriately powered randomized controlled trial.

The Cognition and Flow Study (CogFlowS): A Mixed Method Evaluation of a Randomized Feasibility Trial of Cognitive Training in Dementia

“…Eligibility criteria and any changes to these are reported elsewhere [13]. The rst phase of the study was a quantitative randomised trial of a 12 week multi-domain CT programme provided by Lumosity©.…”

“…Non-normally distributed continuous data are presented as median (inter-quartile range [IQR]), and normally distributed as mean (standard deviation). For the purpose of this analysis, tests of statistical signi cance were not used, as these results have been published previously [13].…”

“…A full description of trial participants has been reported previously [13]. Participants were dichotomised into two groups: those that trained more than 20 hours over the study (high adherence, n = 20), and those that trained less than 20 hours over the study (low adherence, n = 5) or dropped-out (n = 3).…”

“…Through this mixed methods design, the overall objective of this analysis was to facilitate a targeted approach to CT programmes for healthy older adults and those living with dementia, and develop a set of key recommendations for the development of CT programmes speci cally for people living with dementia. The individual data for the quantitative and qualitative strands have been analysed and reported separately [13,14], and will not be re-reported here.…”

The Cognition and Flow Study (CogFlowS): A Mixed Method Evaluation of A Randomised Feasibility Trial of Cognitive Training in Dementia

“…Through this mixed methods design, the overall objective of this analysis was to facilitate a targeted approach to CT programmes for healthy older adults and those living with dementia, and develop a set of key recommendations for the development of CT programmes speci cally for people living with dementia. The individual data for the quantitative and qualitative strands have been analysed and reported separately [13,14], and will not be re-reported here.…”