Improvement in executive function for older adults through smartphone apps: a randomized clinical trial comparing language learning and brain training

Figures & data

Table 1. Demographics of participants in the three experimental groups, showing mean, standard deviation, and p-value from a 3 × 1 ANOVA testing for between-group differences.

	Duolingo	BrainHQ	Control	p-value
n	28	24	24
# females	18	17	16	0.88
Age	69.57 (2.97)	70.08 (2.89)	70.00 (2.62)	0.78
Years Education	17.07 (2.88)	17.75 (3.48)	16.94 (2.26)	0.58
MoCA	27.14 (2.21)	26.75 (2.35)	26.38 (2.58)	0.51
LSBQ	1.73 (1.07)	1.83 (1.02)	2.02 (1.08)	0.61
Days between tests	116.86 (116.86)	117.75 (8.25)	120.71 (14.74)	0.42
WEBcape*	92.46 (85.31)	74.58 (97.42)	100.41 (93.17)	0.62
* control group n = 22

Table 2. Effect sizes for changes in test scores in each group, in raw time (milliseconds) and as Cohen’s d (see text for details of computation). Effect sizes with d > .4 are bolded.

N-back Reaction time, 0-back	Effect size (msec)		Cohen’s d
Control post-pre	−8.21		−0.10
BrainHQ post-pre	−56.83		−0.66
Duolingo post-pre	−11.41		−0.13
BrainHQ vs. Control post-pre	−48.62		−0.97
Duolingo vs. Control post-pre	−3.20		−0.06
N-back Reaction time, 1 and 2 back	Effect size (msec)		Cohen’s d
Control post-pre	−7.81		−0.06
BrainHQ post-pre	−88.45		−0.72
Duolingo post-pre	−47.16		−0.38
BrainHQ vs. Control post-pre	−80.64		−0.82
Duolingo vs. Control post-pre	−39.35		−0.40
N-back accuracy (d-prime), 2-back	Effect size (d-prime)		Cohen’s d
Control post-pre	0.20		0.26
BrainHQ post-pre	0.54		0.72
Duolingo post-pre	0.57		0.76
BrainHQ vs. Control post-pre	0.35		0.61
Duolingo vs. Control post-pre	0.37		0.65
Simon Task Reaction Time, Center	Effect size (msec)		Cohen’s d
Control post-pre	−74.62		−0.56
BrainHQ post-pre	−147.26		−1.10
Duolingo post-pre	−61.86		−0.46
BrainHQ vs. Control post-pre	−72.64		−0.58
Duolingo vs. Control post-pre	12.76		0.10
Simon Task Reaction Time, Side	Effect size (msec)		Cohen’s d
Control post-pre	−40.04		−0.30
BrainHQ post-pre	−167.96		−1.28
Duolingo post-pre	−78.41		−0.60
BrainHQ vs. Control post-pre	−127.91		−1.48
Duolingo vs. Control post-pre	−38.36		−0.44
Color Patch Naming, total time	Effect size (sec)		Cohen’s d
Control post-pre	−1.00		−0.18
BrainHQ post-pre	−2.58		−0.46
Duolingo post-pre	−1.39		−0.25
BrainHQ vs. Control post-pre	−1.58		−0.34
Duolingo vs. Control post-pre	−0.39		−0.08
Incongruent Color Word Naming, total time		Effect size (sec)	Cohen’s d
Control post-pre	−2.25		−0.17
BrainHQ post-pre	−9.00		−0.70
Duolingo post-pre	−6.61		−0.51
BrainHQ vs. Control post-pre	−6.75		−0.85
Duolingo vs. Control post-pre	−4.36		−0.55

Table 3. Summary of findings showing differences in improvement by groups for the outcome measures.

Task	Condition	Process	Outcome
N-back	RT 0-back (Control)	Speed	BHQ > DL = CTL
	RT 1-back & 2-back	Speed + WM	BHQ ≳ DL ≳ CTL, BHQ>CTL
	ACC 2-back	WM	BHQ = DL > CTL
Simon task	RT center (Control)	Speed	BHQ > DL = CTL
	RT side	Speed + EF	BHQ > DL ≳ CTL
Color-word interference	Color patch naming (Control)	–	n.s.
	Incongruent color naming	EF	BHQ = DL > CTL

“ = ”: no significant difference, effect size d < 0.4

“>”: significant difference, effect size d > 0.4

“≳”: non-significant difference, effect size d > 0.4

RT = Reaction Time, ACC = Accuracy, WM = Working Memory, EF = Executive Function, BHQ = BrainHQ, DL = Duolingo, CTL = Control Group

Figure 1. Performance in the N-back task. A) Reaction time to all trials, both target and non-target. B) Accuracy expressed as D-prime, a measure of response discrimination combining targets and non-targets. For all figures, error bars represent 95% confidence interval of the mean averaged across subjects (after averaging across trials within subject).

Figure 2. Reaction time for the Simon task, across all conditions.

Figure 3. Total time to complete the control and conflict-inducing conditions of the DKEFS Color-Word Interference Test. A) Color patch naming. B) Incongruent color word naming.