A Comparison of the Efficacy of Different Rehabilitation Strategies in Mild Cognitive Impairment

Overview

The aim of this study is to conduct a comparative analysis of the effects of two different rehabilitation approaches on cognitive and functional outcomes in older adults diagnosed with mild cognitive impairment (MCI). The study compares two widely used approaches in the field of cognitive rehabilitation: Computer-Based Cognitive Rehabilitation (CBCR) and Dual-Task Training (DTT). The planned study will be conducted using a randomized controlled, parallel-group experimental design, in which individuals aged 65 and older diagnosed with MCI will be assigned to two intervention groups via computer-assisted randomization. Both groups will receive training for eight weeks, twice a week for 45 minutes each session, under the supervision of a specialist physical therapist. Pre- and post-intervention assessments will measure general cognitive function, executive function, fall risk, dual-task performance, functional independence, fear of falling, and physical activity level. This study is based on the assumption that cognitive decline is not limited to neuropsychological performance alone but is closely related to motor performance, safe mobility, and quality of life. The findings are expected to contribute to clinical decision-making processes by providing evidence-based data on which rehabilitation approach is more effective and feasible for older adults with HBB.

Mild cognitive impairment (MCI) is defined as mild cognitive decline that occurs as a natural consequence of aging. MCI generally represents a transitional stage between healthy aging and dementia. The recognition of MCI as a high-risk intermediate step leading to Alzheimer's disease and other forms of dementia makes early intervention approaches for MCI a priority. Preserving cognitive capacity encompasses not only mental functions but also areas that directly impact quality of life, such as fall risk, functional independence, and physical activity levels. The literature demonstrates that cognitive decline is associated with reduced walking speed, impaired balance control, and decreased ability to perform activities of daily living. Furthermore, a decline in cognitive performance increases the fear of falling, which in turn limits an individual's participation in physical activity and leads to a sedentary lifestyle. The literature indicates that physical activity levels decrease alongside cognitive decline in older adults. Low physical activity levels also increase the risk of falls and limit the ability to maintain independent living.Dual-task training and computer-based cognitive rehabilitation are two important intervention methods developed for cognitive impairments. Dual-task training aims to enhance cognitive-motor integration across multiple domains-including attention, executive functions, processing speed, spatial-visual perception, and postural control-by requiring the simultaneous performance of both cognitive and motor tasks. Dual-task training may also have positive effects on balance, fall risk, and gait in addition to cognitive functions. Computer-assisted cognitive rehabilitation programs, on the other hand, are digital intervention approaches that focus on cognitive domains such as memory, attention, processing speed, and problem-solving; they are individually adaptable and provide systematic progress. It has been reported that these programs have a direct effect on the improvement of cognitive functions. Studies investigating the specific effects of both approaches are available in the literature; however, there are no studies in the literature comparing the effects of these two intervention methods on cognitive function, functional independence, fall risk, fear of falling, and physical activity levels. Therefore, a comparative evaluation of the effects of different intervention strategies not only on cognitive functions but also on quality-of-life parameters such as fall risk, fear of falling, physical activity level, and functional independence would make significant contributions to determining the approaches to be preferred in clinical practice.Therefore, a comparative evaluation of the effects of different intervention strategies not only on cognitive functions but also on quality-of-life parameters such as fall risk, fear of falling, physical activity level, and functional independence will make a significant contribution to determining the preferred approaches in clinical practice. The aim of this study is to comparatively examine the effects of dual-task training and computer-based cognitive rehabilitation on cognitive functions, fall risk, functional independence, physical activity level, and fear of falling in older adults with mild cognitive impairment (MCI). By analyzing the effectiveness of both intervention methods on the relevant parameters based on quantitative data, the study aims to identify an effective and feasible intervention approach for preventing or slowing cognitive decline in older adults.