N/A N=49 Randomized Single-blind Prevention

Applying a Person-Centered Approach to Enhance Cognitive Training in Senior Living Community Residents With Mild Cognitive Impairment

Mild Cognitive Impairment

Bottom Line

View on ClinicalTrials.gov: NCT03292705 ↗

Enrolled (actual)

Serious AEs

0.0%

Results posted

Feb 2026

Primary outcome: Primary: Mean Change in ADL Score From Baseline to Week 10 — 0.00; -0.29 score on a scale

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: PEP (Behavioral); CCI (Behavioral)
Age: Adult, Older Adult · 60+ yrs
Sex: All
Sponsor: University of Rochester
Primary completion: Apr 2019

Outcome Measures

Outcome	Result	p-value
PRIMARY Mean Change in ADL Score From Baseline to Week 10	0.00; -0.29	—
PRIMARY Mean Change in ADL Score From Baseline to Week 23	1.18; -0.10	—
PRIMARY Mean Executive Function Measured by Examiner	0.20; 0.13	—
PRIMARY Mean Executive Function Measured by Examiner	0.20; 0.13	—
PRIMARY Mean Executive Function Measured by Examiner	0.20; 0.13	—
SECONDARY Mean Change in Attitudes Toward Computers Questionnaire	0.18; 0.80	—
SECONDARY Mean Change in Attitudes Toward Computers Questionnaire	0.18; 0.80	—
SECONDARY Mean Change in Attitudes Toward Computers Questionnaire	0.18; 0.80	—
SECONDARY Mean Change in Brief Visuospatial Memory Test	-0.05; 0.40	—
SECONDARY Mean Change in Brief Visuospatial Memory Test	-0.05; 0.40	—
SECONDARY Mean Change in Brief Visuospatial Memory Test	-0.05; 0.40	—
SECONDARY Mean Change in EPCCE Sum Score From Baseline to Week 4	-0.55; -1.00	—
SECONDARY Mean Change in EPCCE Sum Score From Baseline to Week 10	-0.09; 0.33	—
SECONDARY Mean Change in EPCCE Sum Score From Baseline to Week 23	0.32; 0.35	—
SECONDARY Mean Change in UFOV Score From Baseline to Week 10	-53.93; 37.22	—
SECONDARY Mean Change in UFOV Score From Baseline to Week 23	-57.14; -33.71	—
SECONDARY Mean Change in Activities of Daily Living-Prevention Instrument	1.18; -0.10	—

Summary

Computerized cognitive interventions (CCIs) have been increasingly widely implemented among older adults with mild cognitive impairment (MCI). However, the efficacy of CCIs in maintaining or improving older adults' cognitive and functional health has been modest and highly variable. Older individuals' attitudes toward technology use may help explain some of the variability in CCI effects. The goal of this R21 is to generate proof-of-concept for an intervention that may improve attitudes toward computers among those with MCI, in turn improving engagement with and efficacy of a subsequent CCI. Person-centered care-that is, integrating individuals' preferences throughout the process of intervention--has improved intervention engagement among older persons, including those with MCI. A recent intervention predicated on this person-centered approach is called "personalized engagement program" (PEP). PEP involves a database of individualized computer-led leisure activities. The investigators' recent pilot data in senior living facilities suggest that PEP promotes psychological well-being among older persons with MCI, and may shift computers from dauntingly complex or personally irrelevant devices to familiar, enjoyable technology. These results are consistent with a number of theories indicating that exposure to pleasurable experiences with an object or task improves several dimensions of attitudes, including affective and cognitive components, as well as behavior and motivation. Grounded in both this pilot data and the theory around it, the investigators seek to take the next step in an arc of research ultimately intended to improve the efficacy of CCIs. A small randomized controlled trial (RCT) is proposed to assess whether an initial period of PEP, followed by a standard CCI, improves a) attitudes toward computers, b) engagement with the CCI, and c) cognitive outcomes, compared to an attention control period followed by CCI. Our design involving stratified random assignment of 50 assisted living residents with MCI from 4 senior living facilities to these two groups. The initial phase involves 4 weeks of either attention control or PEP, a "dose" suggested by prior work on attitude change and computers, followed by 6 weeks of CCI for both groups (a period our prior work indicates is sufficient for change in key cognitive domains among this population). This application is the first of which we are aware striving to augment CCIs, which are now ubiquitous, by addressing an attitudinal or affective element of the person, which are often ignored in the cognitive intervention literature. The adjuvant of PEP also answers increasing calls for "personalized" or "person-centered" behavioral interventions with older persons.

Eligibility Criteria

Inclusion Criteria

18 ≤ MoCA ≤ 26
RAVLT Delayed Recall Total Score ≤ 6 (or 1.5 SD below age-corrected norms)
mild or no active depressive symptoms
intact or mild deficits in IADL functioning
if on AD medication (i.e., Memantine or cholinesterase inhibitors), antidepressant, or anxiolytics, no changes of doses in the 3 months prior to recruitment;
age ≥60 years
English-speaking
adequate visual and hearing acuity for testing
intact decision making capacity.

Exclusion Criteria

current enrollment in another cognitive improvement study;
uncontrollable major depression: or other psychopathology identified by staff or medical records;
having active legal guardian (indicating impaired capacity for decision making);
medical history of AD or other types of dementia

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Data sourced from ClinicalTrials.gov (NCT03292705). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.