JMIR Publications

ABSTRACT

Background:

Cognitive training may enhance cognition and support brain health during aging, but few trials have evaluated readily accessible chatbot-based programs with neuroimaging outcomes.

Objective:

To evaluate whether a 12-week chatbot-based cognitive training program improves cognitive performance and white matter microstructural integrity in cognitively unimpaired older adults.

Methods:

In a single-blind randomized controlled trial, 72 cognitively unimpaired older adults were assigned to chatbot-based cognitive training (30 minutes/day, 5 days/week for 12 weeks; n=37) or a no-intervention control group (n=35). Diffusion tensor imaging at baseline and 12 weeks quantified fractional anisotropy in predefined white matter tracts. Cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery. Groups were comparable at baseline.

Results:

After 12 weeks, the training group showed significantly less fractional anisotropy reduction than controls in the bilateral tapetum and right posterior thalamic radiation, surviving false discovery rate control (q<0.05). The training group also demonstrated improvement in paired associates learning, an episodic memory measure (p=0.040). Improvement in paired associates learning was positively associated with fractional anisotropy change in the right posterior thalamic radiation and right sagittal stratum (false discovery rate–adjusted q=0.038 for each).

Conclusions:

A 12-week chatbot-based cognitive training program may support episodic memory and the relative maintenance of white matter microstructural organization in selected pathways in cognitively unimpaired older adults, consistent with a brain-maintenance framework. Clinical Trial: Clinical Research Information Service (CRiS), Republic of Korea: KCT0004630