ASSESSMENT OF COGNITIVE TRAINING IN PEOPLE WITH MILD TO MODERATE DEMENTIA
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Abstract
The main goal is to see how computer game play experiences can affect cognitive, social, behavioral, and psychological functioning in a population of older adults with mild-to-moderate dementia. Participants engaged in various cognitive games from the Posit Science Corporation’s (San Francisco, CA) computer game-based cognitive training software. The theory driving these computer games is neuroplasticity, as it is seen in healthy older adults that computer games can help to reverse negative plasticity that is typically associated with older age and dementia. This experiment also examined how social interaction can affect cognitive training effects in those with mild to moderate dementia. The participants were divided into two different groups where one had high social interaction with the researcher and the other had low social interaction with the researcher. Cognitive function was measured with the Montreal Cognitive Assessment and Repeatable Battery of Assessment of Neuropsychological Status, the occurrence of behavioral and psychological symptoms with the Neuropsychiatric Inventory, and finally quality of life with the Quality of Life-Alzheimer’s Disease scale (Cummings, 1997; Duff et al., 2008; Nasreddine et al., 2005; Thorgrimsen et al., 2003). Computer game training sessions were also measured qualitatively using the guidelines found in the Observational Measurement of Engagement tool (Cohen-Mansfield, Dakheel-Ali, & Marx, 2009). Alzheimer’s disease is a devastating illness affecting millions of Americans today, because there is no cure yet for this disease it is important to look at alternate ways of treating the symptoms associated with it. Alzheimer’s disease is a progressive diffuse neural degradation resulting in declines in cognition, especially memory, and this results in cognitive and social withdrawal. Those with Alzheimer’s are increasingly being housed full-time or in a day care basis where symptoms of cognitive and social withdrawal can be exacerbated by lack of staff resources to provide stimulating environments. This research is important because not much is known about how computer game-based cognitive training will affect those with dementia, especially in regards to social, cognitive, and behavioral/psychological domains. It also isn’t known if the games could be easily implemented, with a minimum of one-to-one staff interaction, or whether these individuals can effectively engage in the computer games in an autonomous manner. In this study it is hypothesized that those with cognitive training and high social interaction will see stability in cognitive status and an improvement in behavioral and psychological symptoms, while those with low social interaction will only see stability in cognitive status. To assess these hypotheses, we tested a sample (n=8) of individuals with mild to moderate dementia, as indicated by their Montreal Cognitive Assessment score. These scores were confirmed as six of the participants already had a formal diagnosis of some type of dementia by a doctor. These participants engaged in twelve sessions of computer-based game training on a battery of computer games found to lead to cognitive improvement in healthy older adult samples through Posit Science. Keywords: Alzheimer’s disease, cognitive training, social interaction, behavioral and psychological symptoms