Robert Philippe, Manera Valeria, Derreumaux Alexandre, Ferrandez Y Montesino Marion, Leone Elsa, Fabre Roxane, Bourgeois Jeremy
Cognition Behaviour Technology Lab, Université Côte d'Azur, Nice, France.
Association Innovation Alzheimer, Nice, France.
J Med Internet Res. 2020 Mar 11;22(3):e17167. doi: 10.2196/17167.
Cognitive and behavioral symptoms are the clinical hallmarks of neurocognitive disorders. Cognitive training may be offered to reduce the risks of cognitive decline and dementia and to reduce behavioral symptoms, such as apathy. Information and communication technology approaches, including serious games, can be useful in improving the playful aspect of computerized cognitive training and providing motivating solutions in elderly patients.
The objective of this study was to assess the effectiveness of employing the MeMo (Memory Motivation) Web app with regard to cognitive and behavioral symptoms in patients with neurocognitive disorders.
MeMo is a Web app that can be used on any Web browser (computer or tablet). The training activities proposed in MeMo are divided into the following two parts: memory and mental flexibility/attention. The study included 46 individuals (mean age 79.4 years) with a diagnosis of neurocognitive disorders at the Institut Claude Pompidou Memory Center in Nice. This randomized controlled study compared the evolution of cognition and behavior between patients not using MeMo (control group) and patients using MeMo (MeMo group) for 12 weeks (four sessions per week). Patients underwent memory and attention tests, as well as an apathy assessment at baseline, week 12 (end of the training period), and week 24 (12 weeks after the end of the training sessions). In addition, to assess the impact of high and low game uses, the MeMo group was divided into patients who used MeMo according to the instructions (about once every 2 days; active MeMo group) and those who used it less (nonactive MeMo group).
When comparing cognitive and behavioral scores among baseline, week 12, and week 24, mixed model analysis for each cognitive and behavioral score indicated no significant interaction between testing time and group. On comparing the active MeMo group (n=9) and nonactive MeMo group (n=13), there were significant differences in two attention tests (Trial Making Test A [P=.045] and correct Digit Symbol Substitution Test items [P=.045]) and in the Apathy Inventory (AI) (P=.02). Mixed analysis (time: baseline, week 12, and week 24 × number of active days) indicated only one significant interaction for the AI score (P=.01), with a significant increase in apathy in the nonactive MeMo group.
This study indicates that the cognitive and behavioral efficacies of MeMo, a Web-based training app, can be observed only with regular use of the app. Improvements were observed in attention and motivation.
ClinicalTrials.gov NCT04142801; https://clinicaltrials.gov/ct2/show/NCT04142801.
认知和行为症状是神经认知障碍的临床特征。认知训练可用于降低认知衰退和痴呆的风险，并减轻诸如冷漠等行为症状。包括严肃游戏在内的信息通信技术方法，有助于提升计算机化认知训练的趣味性，并为老年患者提供激励性解决方案。
本研究旨在评估使用MeMo（记忆激励）网络应用程序对神经认知障碍患者认知和行为症状的有效性。
MeMo是一款可在任何网络浏览器（计算机或平板电脑）上使用的网络应用程序。MeMo中提出的训练活动分为以下两部分：记忆和心理灵活性/注意力。该研究纳入了46名在尼斯的克劳德·蓬皮杜记忆中心被诊断为神经认知障碍的个体（平均年龄79.4岁）。这项随机对照研究比较了未使用MeMo的患者（对照组）和使用MeMo的患者（MeMo组）在12周内（每周四节）认知和行为的变化。患者在基线、第12周（训练期结束时）和第24周（训练课程结束后12周）接受记忆和注意力测试以及冷漠评估。此外，为了评估高频率和低频率使用游戏的影响，MeMo组被分为按照说明使用MeMo的患者（大约每两天一次；活跃MeMo组）和使用频率较低的患者（不活跃MeMo组）。
在比较基线、第12周和第24周的认知和行为评分时，对每个认知和行为评分的混合模型分析表明测试时间和组之间没有显著交互作用。在比较活跃MeMo组（n = 9）和不活跃MeMo组（n = 13）时，两项注意力测试（连线测验A [P = 0.045]和数字符号替换测试正确项目数[P = 0.045]）以及冷漠量表（AI）存在显著差异（P = 0.02）。混合分析（时间：基线、第12周和第24周×活跃天数）表明仅AI评分存在一个显著交互作用（P = 0.01），不活跃MeMo组的冷漠程度显著增加。
本研究表明，基于网络的训练应用程序MeMo只有在定期使用时才能观察到其对认知和行为的疗效。在注意力和动机方面观察到了改善。
ClinicalTrials.gov NCT04142801；https://clinicaltrials.gov/ct2/show/NCT04142801。
