Effects of Training Dose on Computerized Cognitive Training in Patients With Cognitive Impairment

Study Overview
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Brief Summary
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The goal of this observational study is to explore the optimal dose of computerized cognitive training in patients with cognitive impairment. The main questions it aims to answer are: Is there an optimal dose of computerized cognitive training for patients with cognitive impairment? Is the optimal dose different in patients in different age populations? Participants enrolled in the study took a reported computerized cognitive training program and the training data were analyzed for exploring the optimal dose. The researchers will compare the different dose groups to see if there is an optimal dose for the highest improvement in cognitive abilities. The researchers will additionally compare two age groups (aged younger than 60y or aged 60y and older) to see if the optimal doses in the two groups are different.

Detailed Description
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Background: Computerized Cognitive Training (CCT) is a form of digital therapeutics that uses computerized cognitive tasks to train patients with cognitive impairment caused by various neurological or psychiatric diseases. CCT has been shown to slow the progression of cognitive impairment in early-stage dementia, particularly in working memory. However, there is a lack of research on the optimal training dose for people with cognitive impairment. Previous meta-analyses have explored the types, delivery methods, and training dose of cognitive training in healthy older adults and those with dementia risk factors, but not in those with cognitive impairment. Objectives: The study aimed to explore the dose-response relationship of CCT and estimate the optimal daily and weekly dose for people with cognitive impairment. Participants and methods: the study is a retrospective cohort study and will enroll 21845 patients with cognitive impairment. The exposures in the study are different doses of cognitive training in a week and the outcome is the improvement in cognitive abilities in a week. The weeks with the same training dose of different patients will be classified into one group of exposure. The mixed effects model will be used to estimate the optimal dose.

Official Title
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Effects of Training Dose on Computerized Cognitive Training in People With Cognitive Impairment: A Large-population Retrospective Study

Conditions
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Cognitive Impairment, Mild, Dementia

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with cognitive impairment. Patients who took computerized cognitive training in 2017-2021. Exclusion Criteria: age < 40 years training duration < 2 weeks with moderate to severe dementia, prevalent cardiovascular diseases, cancer, unstable systemic diseases, or psychiatric diseases

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Training weeks are classified into 13 groups by daily dose<br>The daily dose is calculated by averaging training time per training day in a week without taking non-training days into account. Training weeks with the same daily dose of different patients will be classified into one group. Training weeks are classified into 13 groups with 5min as an interval (from 0-5min per day to 60min and above per day). Outcomes will be compared among different daily dose groups. | Other: No intervention<br>* No intervention because it is a retrospective study for outcomes<br>|
| Training weeks are classified into 16 groups by weekly dose<br>The weekly dose is measured by the cumulative training time in a week. Training weeks with the same weekly dose of different patients will be classified into one group. Training weeks are classified into 16 groups with 15min as an interval (from 0-15min per week to 225min and above per week). Outcomes will be compared among different weekly dose groups. | Other: No intervention<br>* No intervention because it is a retrospective study for outcomes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cognitive abilities between the adjacent weeks | Cognitive ability is measured on the final day of training each week. The cognitive ability throughout a week is calculated based on the overall performance of cognitive training. The overall training performance is an averaged performance integrating the performance of all cognitive training tasks targeting different cognitive domains (e.g., thinking, memory, perception, attention, executive function). The performance of a certain training task is standardized according to normative scores from 0 to 100. Change in cognitive abilities is quantified as the disparity of cognitive abilities between the adjacent weeks (the measurement will be executed everyweek repeatedly). | baseline and 1 week |