An Examination of Visual Perceptual Training

Study Overview
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Brief Summary
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Perceptual-cognitive training (PCT) is a computerized software game has been shown to improve sport performance in young elite athletes and even to aid in recovery speeds post-concussion. PCT may represent a unique type of training that could ultimately enhance cognitive performance or quality of life in all populations. What is not clear is whether PCT is beneficial to older adults with subjective memory complaints (SMCs). SMCs in older adults are an early risk indicator for Alzheimer's disease, making older adults with SMCs a target population for proactive interventions. The aim of this study was to determine if PCT can serve as a proactive intervention and enhance cognitive abilities in older adults with SMCs. The results of this research protocol introduce a new way of prevention from cognitive decline in healthy older adults and may introduce a new training programs for age-related memory disorder.

Detailed Description
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This study was approved by the University of Victoria Human Research Ethics Board (Protocol Number 17-167) and all participants provided their informed written consent prior to participating in this study. In order to reduce the placebo effect, the participants were randomly divided into the experimental and control groups. Participants from both the experimental and control groups received a total of three neuropsychological assessments over a three month period (i.e. baseline, 7 weeks, 11 weeks). Considering that an essential methodological component of the training studies is the use of standardized neuropsychological tests, validated and reliable measures such as STROOP TEST, DIGIT SPAN TEST, TRAIL MAKING TEST, VERBAL FLUENCY TESTS, CALIFORNIA VERBAL LEARNING TEST Second Edition (i.e., standard and alternate forms), were used at different time points. Each assessment was 50-60 minutes in duration and was administered by an expert neuropsychology resident. The first assessment was administered at baseline . Then, the experimental group underwent seven weeks of perceptual cognitive training, while the control group completed seven weeks without formal training. The treatment for the PCT group consisted of 14 sessions of training each lasting 25-30 min, twice per week for seven weeks. After the seven-week time period, a second neuropsychological assessment was performed on both groups. After eleven weeks, a follow-up assessment was conducted to verify whether the benefits of cognitive training endure over time.

Official Title
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An Examination of Visual Perceptual Training in Older Adults With Subjective Memory Complaints

Conditions
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Age-Related Memory Disorders

Intervention / Treatment
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* Behavioral: Perceptual Cognitive Training (PCT)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 60 and over; Have subjective cognitive complaints; The results of the screening test Mini Mental State Examination (MMSE) should be ≥ 24 (this test is used only at baseline visit to verify if the participant might be included in the sample or not). Exclusion Criteria: Presence of medical diagnosis of a Major Neurocognitive Disorder (e.g. Alzheimer's disease, front temporal lobe dementia, Lewy Body dementia, vascular dementia), Presence of sensory deficits (e.g. colour blindness, monocular/binocular blindness, macular degeneration), Presence of psychiatric disorders (i.e. depression, anxiety), The participants with scores under 24 at MMSE screening test will be excluded and sent to the family doctor (i.e. to minimize the risk of including people with pre-clinical dementia).

Ages Eligible for Study
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Minimum Age: 60 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: Prevention
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cohort C<br>Older adults over the age of 60 years old with subjective memory complaints that underwent: the first cognitive assessment (Baseline), intervention is fourteen sessions of Perceptual Cognitive Training (PCT) for seven weeks, a post-treatment cognitive assessment (Week 7), and a follow up cognitive assessment (Week 11) | Behavioral: Perceptual Cognitive Training (PCT)<br>* Perceptual Cognitive Training (PCT) will be performed by having individuals work with a visual perceptual training software program called NeuroTracker. This device uses Multiple Object Tracking at increasing difficulties to develop high-level brain functions critical to recovery & cognitive health. By increasing in difficulty with each correct response and decreasing in difficulty when mistakes are made, brain function is constantly challenged. Each session (6 mins) delivers a series of mini-tests where the patient needs to remember key targets, then track them moving among distractors for several seconds and then identify them. Simple to do, but always challenging, NeuroTracker adaptively optimizes difficulty to each patient's level, maximizing cognitive stimulation every step of the way.<br>|
| No Intervention: Cohort D<br>Older adults over the age of 60 years old with subjective memory complaints that underwent: the first cognitive assessment (baseline), seven weeks of no intervention, a post-treatment cognitive assessment (week 7), and a follow up cognitive assessment (week 11) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in memory performance in older adults with SMCs | Assessed by CALIFORNIA VERBAL LEARNING TEST | First neuropsychological assessment (Baseline). After seven week period both groups underwent the second neuropsychological assessment (Week 7). After eleven weeks a follow-up assessment was conducted (Week 11). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in processing speed in older adults with SMCs | Assessed by Delis-Kaplan Executive Function System™ (D-KEFS™). | First neuropsychological assessment (Baseline). After seven week period both groups underwent the second neuropsychological assessment (Week 7). After eleven weeks a follow-up assessment was conducted (Week 11). | 
| Change in cognitive flexibility in older adults with SMCs | Assessed by Delis-Kaplan Executive Function System™ (D-KEFS™) | First neuropsychological assessment (Baseline). After seven week period both groups underwent the second neuropsychological assessment (Week 7). After eleven weeks a follow-up assessment was conducted (Week 11). | 
| Change in cognitive flexibility in older adults with SMCs | Assessed by Stroop Test | First neuropsychological assessment (Baseline). After seven week period both groups underwent the second neuropsychological assessment (Week 7). After eleven weeks a follow-up assessment was conducted (Week 11). | 
| Change in working memory in in older adults with SMCs | Assessed by Digit Span Test | First neuropsychological assessment (Baseline). After seven week period both groups underwent the second neuropsychological assessment (Week 7). After eleven weeks a follow-up assessment was conducted (Week 11). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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memory, visual spatial training, multiple object tracking, Elderly