Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 23, 2019
Date Accepted: Feb 4, 2020
Efficacy of a web application for cognitive training (MeMo) on cognitive and behavioral performance in people with neurocognitive disorders: a randomized clinical trial.
ABSTRACT
Background:
Cognitive and behavioral symptoms are the clinical hallmarks of Neurocognitive disorders. Cognitive training may be offered to reduce the risk of cognitive decline and/or dementia. Information and Communication Technologies (ICT) including Serious Games can be useful in improving playful aspect of computerized cognitive training and providing motivating solutions to elderly patients.
Objective:
The objective of the present study was to assess the effectiveness of employing the MeMo web application on cognitive and behavioral symptoms in patients suffering from Neurocognitive disorders.
Methods:
MeMo (Memory Motivation) is a web application that can be used on any web browser (computer or tablet). The training activities proposed in MeMo are divided in three parts; memory, mental flexibility and attention. 46 subjects (mean age 79.4 years) with a diagnosis of Neurocognitive disorders were recruited at the Institut Claude Pompidou Memory Center in Nice. This randomized controlled study compared the evolution of cognition and behavior between patients not using MeMo (control group), and patients using MeMo (Memo group) for 12 weeks, 4 sessions per week. Patients underwent memory and attention tests as well as an apathy assessment at baseline (BL), after 12 weeks (W12 = end of the training period) and after 24 weeks (W 24 = 12 week after the end of the training sessions). In addition, in order to assess the impact of high vs low game use, the population was divided in subjects who used MeMo according to the instructions (about once every 2 days; “Active MeMo subjects”) and those who used it less (Non-active MeMo subjects).
Results:
When comparing cognitive and behavioral scores between baseline, W12 and W24 mixed model analysis for each cognitive and behavioral score indicated no significant interaction between testing time and group. The Active Memo subjects (n = 9) compared to the “Non-active” MeMo subjects (n = 13) showed a significant improvement in 2 attention tests (TMT A (p = 0.045) and correct DSST items (p = 0.045)) and in the Apathy Inventory (p = 0.022). Mixed analysis (time BL, W12, W24 x number of active days) indicated only one significant interaction for the apathy inventory score (p value = 0.010) with a significant increase in apathy in the non-active subjects.
Conclusions:
This study indicates that the cognitive and behavioral efficacy of MeMo - a web-based training application – can be observed only with a regular use of the application. Improvement were observed concerning attention and motivation. Clinical Trial: NCT04142801
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