The current study examines the efficiency of a home-based computerized cognitive training (CT) intervention targeting older adults with diabetes.The primary aim of the study is to evaluate the effects of CCT on cognitive and disease management in non-demented older diabetes adults. Investigators will also evaluate the effect of the intervention on a range of secondary outcomes, including mood, caregiver burden, self-efficacy, and for a small sub-sample, on brain activity as reflected in changes in task-related blood-flow on fMRI.
Evidence suggests a link between diabetes-related processes and increased risk of cognitive decline and dementia in older adults. Optimal disease self-management may be key in the prevention of cognitive decline among older diabetic patients, but this may be compromised due to sub-clinical cognitive impairment. In the current study, 120 community-dwelling, non-demented participants aged 65 and over, with a diagnosis of Type 2 diabetes will be randomly assigned either to an 8-week, home-based individually-tailored CCT program with adaptive difficulty level, and regular performance feedback, or to an 8-week, home-based active control (AC) condition, involving training on a generic CCT program with fixed difficulty level and without performance feedback. Both intervention groups also include a range of theory-informed behavior change techniques (BCTs), including self-efficacy management, self-monitoring and goal-setting in order to enhance treatment fidelity, and to maximize treatment compliance and adherence. In both groups, participants train approx. 30 min. per day, 3 times per-week for 8-weeks. Participants undergo a comprehensive evaluation of all outcomes at baseline, immediately after the intervention, and at a 6-month follow-up, with 1-week booster training completed 3 months from completion of the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
85
Joseph Sagol Neuroscience Center, Sheba Medical Center
Ramat Gan, Australian National University, Israel
Change from baseline in global cognition as reflected in a composite cognitive score at 9 weeks
Time frame: 9 weeks
Change from baseline in diabetes self management as reflected in the diabetes self-management questionnaire
Time frame: 9 weeks
Change in domain-specific cognitive abilities (memory, non-memory) measured by composite scores from the neuropsychological test battery, at 9 weeks
Time frame: 9 weeks(immediately post-intervention)
Change in domain-specific cognitive abilities (memory, non-memory) measured by composite scores from the neuropsychological test battery, at 35 weeks
Time frame: 35 weeks (6 months follow up)
Change in meta-memory (subjective ratings of memory performance) as reflect on the Meta-Memory Questionnaire at 9 weeks
Time frame: 9 weeks
Change in meta-memory (subjective ratings of memory performance), as reflect on the Meta-Memory Questionnaire, at 35 weeks
Time frame: 35 weeks (6 months follow up)
Change in self-reported mood-related symptoms on the geriatric depression scale at 9 weeks
Time frame: 9 weeks
Change in self-reported mood-related symptoms on the geriatric depression scale at 35 weeks
Time frame: 35 weeks (6 months follow up)
Change in informant-reported care-giving burden on the Zarit Burden Interview at 9 weeks
Time frame: 9 weeks
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Change in informant-reported care-giving burden on the Zarit Burden Interview at 35 weeks
Time frame: 35 weeks (6 months follow up)
Change in blood sugar levels on a blood glucose test at 35 weeks
Time frame: 35 weeks
Change from baseline in global cognition as reflected in a composite cognitive score at 35 weeks
Time frame: 35 weeks
Change from baseline in diabetes self-management as reflected in scores on the diabetes self-management questionnaire at 35 weeks
Time frame: 35 weeks