JMIR Publications

ABSTRACT

Background:

Cognitive training for older adults is crucial before cognitive impairment emerges. During periods of social distancing like the COVID-19 pandemic, cognitive stimuli are lacking. Online dual-task training is proposed as a solution to address these needs.

Objective:

To explore the feasibility, acceptance, and potential effects of online group-based dual-task training as an intervention for enhancing cognitive function among community-dwelling older adults.

Methods:

A randomized controlled feasibility study was conducted with 76 participants in Hong Kong, randomly assigned to the intervention and attention control groups in a ratio of 2:1 (n=50 and 26, respectively). The intervention group underwent 60-minute online dual-task training sessions twice a week for 12 weeks, incorporating cognitive components (upper limb/finger movement, arithmetic operation, and verbal fluency) and physical components (chair-based exercises) developed through co-design approach. The attention control group received online health talks. Outcomes related to the feasibility and acceptance included class attendance and self-reported satisfaction. Main outcomes related to potential effects included Memory Inventory in Chinese (MIC) and Montreal Cognitive Assessment 5-Minutes (Hong Kong Version) (HK-MoCA 5-min) at baseline, 6-week (mid-intervention), 12-week (post-intervention) and 18-week (follow-up). Descriptive statistics and linear mixed effects models were used. Effect size was described in Cohen’s d. Qualitative feedback was collected from 12 informants and analyzed by content analysis.

Results:

About 74.0% of the participants in the intervention group and 61.5% in the control group attended over 70% of the classes. Among the intervention group, 81.8% were satisfied and 84.1% would recommend the training to others. Improvement in the MIC was observed at mid-intervention, post-intervention, and follow-up, with medium-to-large effect size (d=0.65, 0.43 and 0.85, respectively). Adjusting for baseline values, the between-group differences in HK-MoCA 5-min attained a small-to-medium effect size at mid-intervention (d=0.34) and post-intervention (d=0.23). Qualitative feedback highlighted the time-saving and convenient aspects of online dual-task training, with participants finding the sessions challenging and enjoyable, and reporting benefits across cognitive, physical, and psychosocial domains. However, a preference for traditional in-person training was noted among older adults despite the advantages of online training.

Conclusions:

Online dual-task training is a feasible intervention accepted by the older adults, with potential benefits in cognitive abilities. Online training may complement in-person sessions. Further investigation in terms of a full-scale randomized controlled trial is warranted to comprehensively explore its effects and address areas for improvement. Clinical Trial: The trial was registered at ClinicalTrials.gov (NCT05573646).