P1‐054: Mobile Cognitive Intervention in Older Veterans With Traumatic Brain Injury: Results From the Brave (brain Aging in Veterans) Training Pilot Study
Year: 2019
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Traumatic brain injury (TBI) is associated with cognitive deficits, especially attentional difficulties, slowed processing speed, and executive dysfunction. Remote TBI is associated with increased risk of dementia in older adulthood. We investigated whether a mobile videogame-like intervention can be used to improve cognition in older Veterans with TBI. 89 older Veterans (ages 60-85; 97% male, 70% Caucasian) enrolled in the Brain Aging in Veterans (BRAVE) Training study, a pilot randomized controlled trial for older Veterans with history of multiple mild TBIs or ≥1 moderate TBI. After baseline, 84 participants were randomized to: 1) an intervention group who played Project:EVO (EVO-Multi), a multitasking videogame-like iPad app designed to improve executive control, for about 30 minutes a day, ≥5 days a week for 4 weeks; 2) an active comparison group who played an iPad word search game (EVO-Words) following a similar schedule, and 3) a No-Contact control group. Outcome assessments, including neuropsychological testing, were administered by blinded assessors at Baseline, Post-Test (4 weeks after Baseline), and Follow-Up visits (3 months after Post-Test). In intention-to-treat analyses, we used Generalized Estimating Equations to compare overall mean change between groups over time on cognitive domain composites (Attention, Working Memory, Processing Speed, Executive Function, Verbal Memory). There was a Group x Time interaction for Attention (p = .02), such that EVO-Multi showed improvement over time (p = .001), while there was no significant change over time in the EVO-Words (p = .13) or No Contact (p = .74) groups. Effect sizes for between group change (Cohen's d) ranged from small to medium at Post-Test (EVO-Multi vs. EVO-Words: d = .48; EVO-Multi vs. No Contact: d = .19), and were medium-sized at Follow-Up (EVO-Multi vs. EVO-Words: d = .55; EVO-Multi vs. No Contact: d = .46). No other Group x Time interactions were significant. Results of this pilot study suggest EVO-Multi, an iPad-based cognitive intervention, is associated with improved attention in older Veterans with TBI, even three months after intervention completion. The potential of this intervention to improve cognitive health in older Veterans with TBI should be further investigated in a larger trial.
Source: Alzheimer s & Dementia
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2980549565