The impact of cognitive training on cognitive outcomes following coronary artery bypass grafting surgery in older adults.

The HappyNeuron Pro cognitive training platform will be utilised to deliver the cognitive training within the study. There will be two cognitive training intervention time points throughout the study. The first is pre-surgery, starting immediately after completing their baseline session, and involve approximately 2 weeks of training. The second intervention will begin 1-month after the participant has had their surgery and will involve 12 weeks of cognitive training. The same participants who complete pre-surgery cognitive training will complete post-surgery intervention. The cognitive training intervention will be in addition to normal care pre and post-surgery, and the intervention will be conducted outside of any needed hospital visits so not to disrupt normal care. Within the cognitive training program, each session has been planned and is identical across participants (each session equally trains targeted domains; pyscho-motor speed, attention, memory and executive function). However, the program is still personalised as each exercise has 9 levels and allows participants to level up through the exercises at different rates (consistent high performance increases the level, consistent low performance results in levelling down). For participants randomised into the cognitive training, the training intervention will be home-based and conducted on either a participant’s personal laptop or on a supplied University laptop. The duration of the sessions will be 45 minutes of completed cognitive training (if break wanted/needed then extend session. E.g. 3 minute break; session extends to 48 minutes). The session frequency pre-surgery will be every other day (3.5 times a week), post-surgery this frequency will be decreased to 3 times a week. Pre-surgery cognitive training: The initial session will be instructed and supervised, with an emphasis being placed on participant understanding and competence of system use. Participants will complete 45 minutes of cognitive training every other day over a two week period following baseline testing (total of approximately 7 sessions). Post-surgery cognitive training: This second program will last for a longer duration (compared to pre-surgery) of 12 weeks. Between their pre- and post-surgery interventions participants will be prohibited from using their cognitive training log in. The initial session will yet again be supervised. The post-surgery intervention will be conducted for twelve weeks with 45 minute sessions three times a week (total of 27 hours). Following the completion of the intervention, participants will be informed and prohibited from using the cognitive training system until the commencement of the final follow-up session (3 years post-surgery). To support participants with their cognitive training and to help with adherence, multiple strategies have been put in place. Firstly weekly, face-to-face interventions will be offered to the participants to support any person who may be having difficulties. If individual participants require further support, multiple face-to-face sessions/ phone calls or other support will be organised. Weekly phone calls will also be made to check in on participants, and allow them to ask any questions. An instruction booklet will be provided to participants with information of how to use the program and outline technical troubleshooting. Within the booklet contact information of the cognitive training members of the research team is provided for any further questions. The members of the research team have been trained by Dr Amit Lampit, a cognitive training expert with experience in running large cognitive training interventions.