The Effects of Cognitive Training in Healthy Community Residing Thai Elderly: A Randomized Controlled Trial

Abstract

Purpose

Cognitive training intervention (CTI) is defined as any mechanism of action of a non-pharmacological procedure provided to improve cognitive function. CTI in healthy elderly has the potential to improve cognitive function; however, the effects of interactive computerized-CTI in old ages have been inconclusive. The present study aimed to determine the effects of low-technology CTI in community-based populations.

Patients and Methods

The study was a 2-arm parallel single-blinded randomized controlled intervention trial. The main outcome measured global cognitive function utilizing the Thai Mental State Examination (TMSE); the minor outcomes were cognitive subdomains and psychosocial outcomes (ie, quality of life and depression). The primary endpoint assessed the treatment effect at the 12th week (T1), while the secondary endpoint evaluated the carry-over effect at the 24th week (T2).

Results

Eighty-six eligible participants were recruited from a senior society on the edge of Bangkok. At baseline (T0), the mean age and TMSE score among CTI (n = 44) and wait-list (n = 42) groups were similar (age; 66.66 ± 5.52 and 67.52 ± 6.46; TMSE; 28.84 ± 1.38 and 28.83 ± 1.12, respectively). For the CTI group, the mean number of cognitive training sessions was 14.82 ± 7.62. By using intention-to-treat analysis at the primary endpoint, the mean difference score of TMSE in the CTI group was significantly higher than the wait-list group (∆TMSE_{between group} at T1-T0 = 0.57; 95% CI = 0.07 to 1.08), while the effect size was 0.48. At the secondary endpoint, there was no significant difference observed between the CTI and wait-list groups (∆TMSE_{between group} at T2-T0 = 0.33; 95% CI = −0.23 to 0.88), while the effect size was 0.25. The cognitive subdomains and psychosocial outcomes were discovered with no significant difference.

Conclusion

CTI showed significant treatment effect for improvement in global cognitive function in healthy Thai elderly but did not demonstrate carry-over effect. This study provided preliminary evidence of the feasibility of implementing low-technology CTI in middle-income countries.

Keywords:

• cognitive functions
• community
• elderly
• healthy
• randomized controlled trial

Data Sharing Statement

The data that support the findings of this study are available from now and ending 5 years following the article’s publication, at protocols.io on the following link: dx.doi.org/10.17504/protocols.io.36wgqj92kvk5/v1.

Acknowledgments

The authors would like to acknowledge officers from the Elderly Center of Nakornnonthaburi Municipal and Mrs Morakot Buathang, the director of the Public Health and Environment Division, Bureau of Public Health and Environment, Nakornnonthaburi Municipal for their support throughout the completion of this research study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was funded by the National Research Council of Thailand (NRCT): FY2017 Thesis Grant for Doctoral Degree Students and the 90th Anniversary of Chulalongkorn University Fund, Batch 33 (4/2016).