Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT) Trial: Rationale, design, and baseline characteristics

• Published in: Contemporary clinical trials 2019-03, Vol.78, p.76-87
• Main Authors: Yoon, Jong-Sung, Roque, Nelson A., Andringa, Ronald, Harrell, Erin R., Lewis, Katharine G., Vitale, Thomas, Charness, Neil, Boot, Walter R.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Aging; Attention; Automobile Driving; Clinical trial; Cognition; Cognitive intervention; Comparative effectiveness; Female; Humans; IADL; Internet; Male; Memory; Occupational Therapy - methods; Problem Solving; Randomized Controlled Trials as Topic; Research Design; Socioeconomic Factors; Video Games
• ISSN: 1551-7144; 1559-2030
• DOI: 10.1016/j.cct.2019.01.014

Age-related perceptual and cognitive declines are associated with difficulties performing everyday tasks required to remain independent. Encouraging improvements in cognitive abilities have been shown for various short-term interventions but there is little evidence for direct impact on independence. This project compares the effect of broad and directed (narrow) technology-based training on basic perceptual and cognitive abilities in older adults and on the performance of simulated tasks of daily living including driving and fraud avoidance. Participants (N = 230, Mean age = 72) were randomly assigned to one of four training conditions: broad training using either (1) a web-based brain game suite, Brain HQ, or (2) a strategy video game, Rise of Nations, or to directed training for (3) Instrumental Activities of Daily Living (IADL) training using web-based programs for both driving and fraud avoidance training, or (4) to an active control condition of puzzle solving. Training took approximately 15–20 h for each intervention condition across four weeks. Before training began, participants received baseline ability tests of perception, attention, memory, cognition, and IADL, including a driving simulator test for hazard perception, and a financial fraud recognition test. They were tested again on these measures following training completion (post-test). A one-year follow-up from training completion is also scheduled. The baseline results support that randomization was successful across the intervention conditions. We discuss challenges and potential solutions for using technology-based interventions with older adults. We also discuss how the current trial addressed methodological limitations of previous intervention studies. NCT03141281