Online Group-Based Dual-Task Training to Improve Cognitive Function of Community-Dwelling Older Adults: Randomized Controlled Feasibility Study.

BACKGROUND

Cognitive training for older adults is crucial before cognitive impairment emerges. During periods of social distancing like the COVID-19 pandemic, cognitive stimuli are lacking. Online dual-task training is proposed as a solution to address these needs.

OBJECTIVE

We aimed to explore the feasibility, acceptance, and potential effects of online group-based dual-task training as an intervention for enhancing cognitive function among community-dwelling older adults.

METHODS

A randomized controlled feasibility study was conducted with 76 participants in Hong Kong, randomly assigned to the intervention and attention control groups in a ratio of 2:1 (n=50, 66% and n=26, 34%, respectively). The intervention group underwent 60-minute online dual-task training sessions twice a week for 12 weeks, incorporating cognitive components (upper limb and finger movement, arithmetic operation, and verbal fluency) and physical components (chair-based exercises) developed through a co-design approach. The attention control group received online health talks. Outcomes related to feasibility and acceptance included class attendance and self-reported satisfaction. Main outcomes related to potential effects included the Memory Inventory in Chinese and the Montreal Cognitive Assessment 5 Minutes (Hong Kong Version) at baseline, 6 weeks (midintervention), 12 weeks (postintervention) and 18 weeks (follow-up). Descriptive statistics and linear mixed effects models were used. Effect size was described with Cohen d. Qualitative feedback was collected from 12 informants and analyzed by thematic analysis.

RESULTS

About 72% (36/50) of the participants in the intervention group and 62% (16/26) in the control group attended over 75% of the classes. In total, 44 (88%) participants from the intervention group provided acceptance feedback; 82% (36/44) were satisfied and 84% (37/44) would recommend the training to others. Improvement in the Memory Inventory in Chinese score in the intervention group was observed at midintervention, postintervention, and follow-up, with a medium-to-large effect size (d=0.65, 0.43 and 0.85, respectively). Adjusting for baseline values, the between-group differences in the Montreal Cognitive Assessment 5 Minutes (Hong Kong Version) score attained a small-to-medium effect size at midintervention (d=0.34) and postintervention (d=0.23). Qualitative feedback highlighted the timesaving and convenient aspects of online dual-task training, with participants finding the sessions challenging and enjoyable, and reporting benefits across cognitive, physical, and psychosocial domains. However, a preference for traditional in-person training was noted among the older adults despite the advantages of online training.

CONCLUSIONS

Online dual-task training is a feasible intervention accepted by the older adults, with potential benefits in cognitive abilities. Online training may complement in-person sessions. Further investigation in a full-scale randomized controlled trial is warranted to comprehensively explore its effects and address areas for improvement.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05573646; https://clinicaltrials.gov/study/NCT05573646.