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Development and Feasibility of the Bern Brain Training App for Older Adults with Subjective Cognitive Decline and Mild Cognitive Impairment: A Randomized Controlled Trial
ABSTRACT
Background:
Computerized cognitive training (CCT) aims to mitigate cognitive decline in subjective cognitive decline (SCD) and mild cognitive impairment (MCI).
Objective:
Describe the development and design of the Bern Brain Training (BBT), a tablet-based app to train cognitive functions and assess its feasibility, usability, and acceptability in different levels of cognitive impairment.
Methods:
Unity Game Engine and C# programming were employed to design 16 games targeting episodic, semantic, and working memory and spatial abilities. We assessed (1) feasibility (drop-outs, sessions played, completed sessions); (2) usability (number of help button presses); and (3) acceptability (game experience, perception of game efficacy). BBT training data (50 sessions, 10 weeks) from 116 participants with subjective cognitive decline (SCD, n=89), mild cognitive impairment (MCI, n=27) was analyzed.
Results:
Feasibility was high with 0% dropouts in the CCT interval, an adherence rate of 5.10 ± 0.69 (sessions per week) and 9.18±1.05 (weekly group sessions), and 91% completed sessions. Usability was good (help button pressed in 0.94% sessions). Acceptability (7-point Likert scale) was satisfying in ratings of entertainment (5.43±1.39), despite the BBT being perceived as challenging (5.52±1.22). The games were perceived as most efficient in training memory (M=5.7, SD=1.20) and thinking abilities (M=5.43, SD=1.18).
Conclusions:
The BBT is feasible in the supported home setting, with good usability and acceptability ratings, which is reflected in high adherence and perceived game experience and efficacy ratings across SCD and MCI populations. Future research should broaden BBT to include advanced impairment and care-home settings. Clinical Trial: This RCT was registered 1st of July 2020 at clinicaltrials.gov (Identifier NCT04452864), registration date 1 July 2020.
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