None listed
Conditions
Brief summary
The primary aim of this project is to evaluate the effect of cognitive training has on cognitive performance in older people with mild to moderate dementia. Additionally we will examine the effect cognitive training has on physical and functional performance and quality of life (participant and carer), as well as adherence to the intervention. Eighty community-dwelling older people with mild to moderate dementia will be recruited from routine health services and randomised to either intervention or control. Participants will be over 60 years old and have a carer with a minimum of 3.5 hours face-to-face contact each week. Consent will be gained from both the participant and their carer/person responsible. The intervention will consist of six months of home-based cognitive training. The cognitive training will target executive function, processing speed and attention. Both the participant and the carer/person responsible will be trained in how to use the program. Participants will be encouraged to train three times per week for 10 – 30 minutes depending on cognitive ability. The control group will receive usual care and healthy living information. Participants will be assessed at baseline, at six months (at completion of CT for intervention group) and at 12 months (six months after completion of CT for the intervention group). Falls will be recorded prospectively for 12 months using diaries (with the assistance of carers) and telephone calls. This study will provide valuable evidence in relation to the effect of cognitive training on cognitive, physical and functional performance measures in community-dwelling older people with dementia. Further, this study will also act as a pilot/feasibility study for a future study more suitably powered to determine whether cognitive training can reduce falls in community-dwelling older people with dementia.
Interventions
The cognitive training group will be provided with a custom made response box and computer to enable them to undertake cognitive training at home for six months . Both the participant and the carer/person responsible will be trained in how to use the equipment and program during an installation visit (approximately 2 hours) conducted by a trained research assistant. Telephone support (in relation to the cognitive training program) will be available to all participant/carers during business hours
The cognitive training group will be provided with a custom made response box and computer to enable them to undertake cognitive training at home for six months . Both the participant and the carer/person responsible will be trained in how to use the equipment and program during an installation visit (approximately 2 hours) conducted by a trained research assistant. Telephone support (in relation to the cognitive training program) will be available to all participant/carers during business hours. The cognitive training will be delivered in the form of computer games which are designed to train executive functions including: visuo-spatial skills, task switching, inhibition and attention. These games are based on popular arcade games such as: Dance Dance Revolution, Tetris, Snake and Space Invaders. Instructions on how to play each game will be provided with on screen text and video demonstrations. The cognitive training program is progressive and each game has three levels (easy, moderate, hard). Participants will be encouraged to train at least three times per week for 10 – 30 minutes per session (total recommended dose 90 minutes). Carer involvement in the intervention will depend on the individual participant capabilities e.g. some participants may be able to navigate the system/program independently, others may need prompts to carry out the training and some may need supervision/assistance during each session. The amount of carer involvement will be decided in consultation with the participant and carer during the installation/training visit and follow-up home visit.. One follow-up visit is scheduled at two weeks after the initial training/installation visit to provide further training, support and troubleshooting (approximately 30 - 60 minutes) and will be conducted by a trained research assistant. Depending on the participants’ need, one further home visit will be performed by a trained research assistant (as required; approximately 30 - 60 minutes), approximately four weeks after the initial training/installation visit. The cognitive training system will automatically record adherence, this will include the number of sessions and time of each session. Telephone calls to encourage adherence will be provided monthly.
Sponsors
Dr Morag Taylor
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Community-dwelling participants with mild-moderate dementia aged 60+ years, with a willing carer/person responsible who has a minimum of 3.5h face-to-face contact each week. Mild to moderate dementia will be determined by specialist diagnosis or/and Mini-Mental State Examination (MMSE) <24 and/or Addenbrooke’s Cognitive Examination III score of <83.
Exclusion criteria
Severe dementia (MMSE<11), progressive neurological conditions other than dementia, acute/severe psychiatric conditions, unable to speak English, blindness, delirium, current participation in another research trial and living in a residential aged care facility.
Outcome results
None listed