Web‐enabled conversational interactions as a method to improve cognitive functions: Results of a 6‐week randomized controlled trial

Alzheimer's and Dementia: Translational Research and Clinical Interventions - Tập 1 - Trang 1-12 - 2015
Hiroko H. Dodge1,2,3, Jian Zhu4, Nora C. Mattek1,2, Molly Bowman1,2, Oscar Ybarra5, Katherine V. Wild1,2, David A. Loewenstein6, Jeffrey A. Kaye1,2,7
1Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR
2Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, OR
3Department of Neurology, Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI
4Department of Biostatistics, University of Michigan, Ann Arbor, MI
5Department of Psychology, University of Michigan, Ann Arbor, MI
6Department of Psychiatry and Behavioral Sciences and Center on Aging, University of Miami, Miller School of Medicine, Miami, FL
7Portland Veterans Affairs Medical Center, Portland, OR

Tóm tắt

AbstractIntroductionIncreasing social interaction could be a promising intervention for improving cognitive function. We examined the feasibility of a randomized controlled trial to assess whether conversation‐based cognitive stimulation through personal computers, webcams, and a user‐friendly interactive Internet interface had high adherence and a positive effect on cognitive function among older adults without dementia.MethodsDaily 30‐minute face‐to‐face communications were conducted during a 6‐week trial period in the intervention group. The control group received only a weekly telephone interview. The cognitive status of normal subjects and those with mild cognitive impairment was operationally defined as a global clinical dementia rating of 0 and 0.5, respectively. Age, sex, education, mini mental state examination score, and clinical dementia rating score were balancing factors in randomization. The subjects were recruited using mass‐mailing invitations. The pre‐ to postintervention differences in the cognitive test scores and loneliness scores were compared between the control and intervention groups using linear regression models.ResultsEighty‐three subjects participated (41 in the intervention group and 42 in the control group). Their mean ± standard deviation age was 80.5 ± 6.8 years. Adherence to the protocol was high. There was no dropout and mean percentage of days completed of the targeted trial days among the intervention group was 89% (range 77%–100%). Among the cognitively intact participants, the intervention group improved more than did the control group on a semantic fluency test (P = .003) at the post‐trial assessment and a phonemic fluency test (P = .004) at the 18‐week assessments. Among those with mild cognitive impairment, a trend (P = .04) toward improved psychomotor speed was observed in the intervention group.ConclusionDaily conversations by way of user‐friendly Internet communication programs demonstrated high adherence. Among the cognitively intact, the intervention group showed greater improvement in tests of language‐based executive functions. Increasing daily social contacts through communication technologies could offer cost‐effective home‐based prevention methods. Additional studies with a longer follow‐up duration are required to examine whether the intervention slows cognitive declines and delays the onset of dementia.

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Alzheimer's and Dementia: Translational Research and Clinical Interventions

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