Guimarães Anna Luiza, Lin Feng V, Panizzutti Rogerio, Turnbull Adam
Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
Ageing Res Rev. 2025 Feb;104:102650. doi: 10.1016/j.arr.2024.102650. Epub 2025 Jan 2.
Computerized cognitive training (CCT) is a frontline therapy to prevent or slow age-related cognitive decline. A prerequisite for CCT research to provide clinically relevant improvements in cognition is to understand effective engagement, i.e., the pattern of energy investment that ensures CCT effectiveness. Even though previous studies have assessed whether particular variables (e.g., gamification) predict engagement and/or CCT effectiveness, the field lacks a systematic approach to understanding effective engagement. Here, by comprehensively reviewing and evaluating engagement and adjacent literature, we propose a standardized measurement and operational framework to promote effective engagement with CCT targeting cognitive decline in older adults. We suggest that promoting effective engagement with CCT has two key steps: 1) comprehensively measuring engagement with CCT and 2) identifying which aspects of engagement are essential to achieve the pre-specified outcome of clinically relevant improvements in cognition. The proposed measurement and operational framework of effective engagement will allow future research to maximize older adults' engagement with CCT to slow/prevent age-related cognitive decline.
计算机化认知训练（CCT）是预防或减缓与年龄相关的认知衰退的一线疗法。CCT研究要在临床上实现认知方面的相关改善，其前提是要了解有效参与度，即确保CCT有效性的能量投入模式。尽管先前的研究已经评估了特定变量（如游戏化）是否能预测参与度和/或CCT有效性，但该领域缺乏一种系统的方法来理解有效参与度。在此，通过全面回顾和评估参与度及相关文献，我们提出了一个标准化的测量和操作框架，以促进针对老年人认知衰退的CCT的有效参与度。我们认为，促进CCT的有效参与度有两个关键步骤：1）全面测量对CCT的参与度；2）确定参与度的哪些方面对于实现临床上认知相关改善的预先指定结果至关重要。所提出的有效参与度的测量和操作框架将使未来的研究能够最大限度地提高老年人对CCT的参与度，以减缓/预防与年龄相关的认知衰退。
