Enhancing Cognitive Control Abilities Using Mobile Technology in a Senior Living Community

Study Overview
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Brief Summary
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The goal of this study is to test the feasibility of launching a personalized digital health assessment and remediation program for the older adults in senior living communities based upon an initial characterization of these abilities. Evidence of feasibility here using these unique methodological approaches would provide empirical evidence supporting the basis for a larger-scale implementation of such digital health technologies into less controlled senior settings.

Official Title
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Enhancing Cognitive Control Abilities Using Mobile Technology in a Senior Living Community

Conditions
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Aging, Cognitive Change

Intervention / Treatment
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* Behavioral: Adaptive Cognitive Control Trainer (ACCT)
* Behavioral: Active Control App


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be living at a Senior Living Community have own iPad and/or smartphone, native-English speaker. Participation across a spectrum of cognitive abilities is desired for this study, specifically for older adults in a community setting. Exclusion Criteria: Do not have any physical or cognitive limitations that would clearly prevent them from utilizing these applications as intended

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Adaptive Cognitive Control Trainer (ACCT)<br>There are three modules within the game, each training a different aspect of cognitive control (attention, goal management, working memory): a visual search task for attention abilities, a spatial span task for working memory, and a task switching paradigm for goal management abilities. There are also 3 different levels of difficulty associated with each module; advancing to the next level delivers an advanced challenge that enhances the difficulty in performing the given cognitive task. Participants advance to the next level of difficulty following 6 training sessions occurring over 2 weeks, with the total training experience being 6 weeks of training (3 days/week), with each training session lasting 36 minutes (not including self-paced breaks). | Behavioral: Adaptive Cognitive Control Trainer (ACCT)<br>* Module 1: Attention=> This module demands an active scan of the screen in search for a target, much like traditional visual search tasks. Participants quickly identify the direction that a probe target is facing (up, down, left, right), and are aided by the presence of directional cue indicating where the location of the target will appear. Module 2: Goal Management=> Requires participants to rapidly switch their focus based on distinct rules. Participants are presented with exemplar objects along with a target, and are asked to indicate which exemplar presented is most like the target. Module 3: Working Memory=> Engages spatial working memory resources similar to the Corsi block task. Participants memorize the location of objects on screen followed by a 5-7 second delay period, with a correct response leading to a greater number of potential targets to be memorized on the next trial (and vice versa).<br>|
| Active Comparator: Active Control Group<br>An active control application will be used for this arm. The total training experience here will also be for 6 weeks (3 days/week), with each training session lasting  30 minutes (not including self-paced breaks). Here an app that is matched in terms of expectancy of benefits compared to our training groups will be determined by questioning 100 naïve individuals to predict their expected improvement on each cognitive domain across a multitude of possible applications. | Behavioral: Active Control App<br>* The app used here is undergoing expectancy-matching at the present time, will be updated with the final app characteristics when completed out of a list of several possibilities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Change on Adaptive Cognitive Evaluation (ACE) from Baseline at 6 weeks | ACE is a custom mobile cognitive health assessment battery that presents paradigms typically used in standard cognitive neuroscience laboratories. Here the investigators will assess a measure of (1) Attention (2) Working memory, and (3) Goal management in the ACE software. We will assess response time, accuracy, and response time variability in each case, with faster/more accurate/less variable performance being indicative of improved cognitive control. | At Baseline and post intervention at the 6 week mark | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Change on Everyday Cognition Scale (ECog) from Baseline at 6 weeks | The Everyday Cognition Scale (ECog) measures the ability to perform everyday tasks that demand memory, language, visuospatial abilities, planning, organization, and divided attention. The ECog consists of a global and domain scores for each of the previously described categories, and is scored as follows: 1= better or no change compared to 10 years earlier, 2= questionable/occasionally worse compared to 10 years earlier, 3= consistently a little worse compared to 10 years earlier, 4= consistently much worse compared to 10 years earlier. Thus, the lower the overall score is on this measure at both the global and domain score level, the better one is performing with respect to their cognition. | At Baseline and post intervention at the 6 week mark | 
| Mean Change on Cognitive Failures Questionnaire (CFQ) from Baseline at 6 weeks | The Cognitive Failures Questionnaire (CFQ) assesses participant distractibility. The CFQ score ranges from 0 to 100, with the lower the overall score is on this measure, the better one is performing with respect to their cognition. | At Baseline and post intervention at the 6 week mark | 
| Mean Change on General health and well-being (SF-36) from Baseline at 6 weeks | The general health and well-being (SF-36) score assesses participant health. The SF-36 score ranges from 0 to 100. The higher the overall score is on this measure, the better one is performing with respect to their health and well-being. | At Baseline and post intervention at the 6 week mark |