None listed
Conditions
Brief summary
The use of cognitive training to target neuropsychological dysfunction in ‘at-risk’ patients including individuals with depression, and/or with subjective or objective cognitive impairment (including those with diagnosed mild cognitive impairment) represents a promising therapeutic option in the absence of any existing treatment. However, there remains a paucity of cognitive training programs being offered in public mental health settings, and in the context of a global pandemic, face-to-face interventions remain suspended. While our group has recently demonstrated feasibility, tolerability and acceptability for our group-based, face-to-face cognitive training program, due to the restrictions resulting from the current pandemic, we have been unable to continue to offer this valuable intervention to vulnerable older people. There is now an urgent need to evaluate whether we can deliver this intervention in a virtual mode for 'at-risk' older adults, who are now presenting in increased numbers due to the pandemic.
Interventions
The CT intervention, Virtual Club Connect, has previously been adapted from an evidence-based program and will comprise of two-hour weekly CT group sessions for 10 consecutive weeks including psychoeducation and computer-based CT. The group Virtual Club Connect sessions will have a maximum of 8 participants per group and be run via Zoom video conferencing. They will follow the format below:
I. Psychoeducation (50 minutes): this component will include education on the following topics: the brain,
The CT intervention, Virtual Club Connect, has previously been adapted from an evidence-based program and will comprise of two-hour weekly CT group sessions for 10 consecutive weeks including psychoeducation and computer-based CT. The group Virtual Club Connect sessions will have a maximum of 8 participants per group and be run via Zoom video conferencing. They will follow the format below: I. Psychoeducation (50 minutes): this component will include education on the following topics: the brain, attention and processing speed, learning and memory, executive function, vascular risk factors, diet and exercise, depression and anxiety, and sleep. All material will be delivered by multidisciplinary specialists (Clinical Neuropsychologists, Old Age Psychiatrists etc). Participants will receive a booklet with the slides to be presented at each session. II. 10-minute break: clinicians will encourage a break, where clinicians will leave the virtual room. This affords an opportunity for informal relationship-building and social support. III. CT (50 minutes): The CT intervention will be delivered by Clinical Neuropsychologists and other clinicians within the Older People’s Mental Health Service. The computer-based CT will use Posit Science’s BrainHQ training program (https://www.brainhq.com/). Each participant will be provided with a unique log-in and access the BrainHQ website using their internet browser. Participants will engage in cognitive training activities (i.e. games, activities, puzzles etc.) on BrainHQ on their individual devices at the same time, while remaining in the zoom meeting with a facilitator present. This will ensure regular, supervised computer-based CT time, will allow for troubleshooting of specific CT exercises, and enable participants to access the known benefits of computer-based CT virtually. Adherence will be monitored and measured each week, using a session attendance checklist.
Sponsors
St Vincent's Hospital, Sydney
Study design
Allocation
Randomised controlled trial
Primary purpose
Prevention
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria: Participants eligible for Virtual Club Connect must comply with all the following criteria: 1. Willingness to give written informed consent, 2. Be aged 65 years or older, 3. Live within the St Vincent’s Hospital catchment area, or the Prince of Wales Mental Health catchment area 4. Have current subjective cognitive complaints, scoring 3 or more on the Questionnaire of Cognitive Complaints AND/OR have current depressive symptoms, scoring 6 or more of the Geriatric Depression Scale-15, assessed over the telephone, 5. Have access to a desktop computer or laptop, webcam and internet at home that supports software required to participate in the study, and 6. Be willing and able to commit to attending for the duration of the program. If a participant does not attend for >2 sessions (outside of unforeseen or unanticipated circumstances (e.g. illness)), their ongoing participation will be discussed with them.
Exclusion criteria
Exclusion criteria: Participants will be excluded from participating if they have: 1. An established diagnosis of dementia, with impairment in activities of daily living, 2. A score of <14 on the telephone version of the Montreal Cognitive Assessment (t-MoCA) 3. Severe major depression with impaired activities of daily living, or current harmful or dependent substance use (i.e. more than recommended daily intake based on national guidelines), or current or history of a non-affective psychiatric disorder (e.g. schizophrenia etc.) that would preclude their ability to engage in a group-based CT program, 4. Had electroconvulsive therapy within the six months prior to baseline assessment, and 5. Insufficient English skills to participant in psychometric testing or in group-based CT.
Outcome results
None listed