Improvements in performance based measures of functional capacity and cognition after computerized functional skills training in older people with mild cognitive impairment and healthy comparators.

With no pharmacological treatments for Mild Cognitive impairment (MCI), computerized training strategies have been attempted. A computerized skills training intervention, FUNSAT, previously produced training-related gains in cognition in MCI and in comparators with normal cognition (NC). A new remotely delivered version of FUNSAT was administered to a new sample of participants with NC and MCI. Outcomes measures included cognition (BAC) and functional capacity (VRFCAT) to examine training transfer. Participants with MCI (n = 92) and NC (n = 72) trained for up to 12 weeks on FUNSAT. Half the MCI participants started with 3 weeks of computerized cognitive training (CCT). Baseline, post-training, and 30-day follow-up scores on cognition and functional capacity were compared. Participants improved on both cognition (d = 0.80) and functional capacity (d = 0.64), with no differences in training gains across MCI and NC, although treatment with CCT in MCI was associated with similar gains with fewer FUNSAT training sessions. This is the first treatment study in MCI to demonstrate transfer to untrained measures of functional capacity. NC improved in cognition and functional capacity with skills training alone. These findings have implications for other conditions, such as schizophrenia, where functional capacity is a treatment target.

Improvements in Cognitive Performance With Computerized Training in Older People With and Without Cognitive Impairment: Synergistic Effects of Skills-Focused and Cognitive-Focused Strategies.

OBJECTIVES: Both cognitively impaired (CI) and nonimpaired (NC) older people have challenges in performing everyday tasks. Previous skills training efforts in NC individuals have led to improvements in both functional skills and cognitive functioning. We evaluated the cognitive benefits of combining computerized cognitive training (CCT) with a computer-based functional skills assessment and training (CFSAT) program in a sample of CI and NC older adults. DESIGN: Randomized parallel clinical trial with two treatment conditions: up to 24 sessions of CFSAT training alone or CFSAT plus speed focused CCT. PARTICIPANTS: NC (n = 62) and CI (n = 55) older adults, ranging in age from 60-86 years (M = 73.12), primarily female (90%), and ethnically diverse (21% Hispanic, 52% African American). Participants were divided based on Montreal Cognitive Assessment scores and cognitive complaints. SETTING: Three different community centers in Miami, FL. MEASUREMENTS: The Brief Assessment of Cognition, app version, was used to measure cognitive performance across six different cognitive domains before and after training. RESULTS: All six cognitive domains improved from baseline. Multivariate analyses found the effects of the combined CFSAT and CCT to be superior. The interaction of training condition and cognitive status was not statistically significant, indicating no global impact of cognitive status on improvements in cognition across training conditions. CONCLUSIONS: CFSAT training was associated with cognitive benefits, particularly in CI participants. The combined intervention led to greater improvements. Consistent with results of previous studies, there is considerable evidence of cognitive plasticity in older adults, including those with CI.