JMIR Publications

ABSTRACT

Background:

Background:

Apolipoprotein E ε4 allele is a major genetic risk factor for Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI). Computer-based training programs can improve the cognitive performance of the elderly.

Objective:

Objective:

The effects of different web-based interventions and the APOE isoform-specific differences in training outcomes are investigated.

Methods:

Methods:

Using a Quasi-experimental study design, 202 MCI participants over 60 years old took part in three different intervention programs (Physical and cognitive-LLM, cognitive-AC or physical intervention-PTC) via an innovative-ICT exergaming platform. All participants underwent an extensive neuropsychological evaluation before and after the training, blood tests, and brain imaging.

Results:

Results:

All the interventions resulted in multiple statistically significant cognitive benefits after the intervention in episodic memory (CVLT1 test score LLM: P=0.041, AC: P<0.001), the working memory (Digit Span F&B test score AC: P=0.032, PTC: P=0.020 & P=0.006) and the long term memory (CVLTD test score LLM: P=0.018, AC: P=0.002 and PTC: P=0.021). There was no statistically significant difference between the intervention effects. APOEε4 carrier status moderates intervention effects as LLM intervention improved only their task-switching processing speed (Trail B test P=0.034) and PTC intervention improved only the working memory (Digit Span B P=0.034). No significant performance alteration was noted for the APOEε4+ cognitive-AC training group.

Conclusions:

Conclusion: None of the applied interventions could be identified as the optimal one, it is suggested though that the combined Cognitive and Physical Training via “Exergaming” may be more effective for the high-risk MCI ΑPOE ε4+ subgroup.