Online Grammatical Reasoning Training for Older Adults (START)

Impact of Short-term Intensive Online Grammatical Reasoning Training on Cognition and Function in Adults Over 50: An Online Randomised Controlled Trial

The START study will investigate the impact of playing a Grammatical Reasoning brain training task on overall brain function (cognition) and day-to-day function in people over 50.

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Study Overview

• Status: Completed
• Conditions: Healthy Aging
• Intervention / Treatment: Other: Grammatical Reasoning; Other: Card Pairs

Detailed Description

The study builds on existing work that has shown very promising results with brain training approaches in older adults. There is good evidence that playing brain training games leads to improvements in brain functions including memory and reasoning. There is also a suggestion that regular involvement in brain training games might help reduce the risk of cognitive decline and dementia later in life. It appears that reasoning, or problem-solving, is particularly important as it is one of the first abilities to decline with age. This study will use this evidence to target reasoning in a specific brain training task. It will also explore the potential role of genetic factors in how people perform in the task.

The study will compare the impact of a Grammatical Reasoning Task (START) with a control task consisting of simple picture-matching. Over 7000 participants will be randomly allocated to either START or the control and will be asked to play the task as often as they wish for a period of six weeks. Both tasks will be delivered entirely online so people will access the study from home on their computers. This will be achieved through our dedicated online research platform, PROTECT, which hosts a cohort of over 20,000 older adults who have provided DNA samples as part of a longitudinal study.

This study will measure the impact of the training on cognition and Instrumental Activities of Daily Living. Assessments will be completed online at baseline, two/six weeks and six months. Overall, this study aims to generate exciting new data about how brain training could be included in guidance on healthy ageing

• Study Type: Interventional
• Enrollment (Actual): 6544
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Exeter, United Kingdom, EX1 2LU
    • University of Exeter Medical School

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adults over 50
• Access to a computer with a keyboard and the internet
• Participant registered on the PROTECT study

Exclusion Criteria:

• Diagnosis of dementia

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Grammatical Reasoning; This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks.	Other: Grammatical Reasoning; START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.; Other Names: START
Other: Control - Card Pairs; The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects.	Other: Card Pairs; A basic picture-matching task.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Executive Function From Baseline	Measured by the validated task-switching test of Trailmaking B. This is a well established computerised test of executive function. On a computer screen participants are presented with 24 circles with either numbers (0-13) or letters (A-L). They must select the circles in the correct numerical and alphabetic order, alternating numbers and letters each time (e.g. 1, A, 2, B, 3, C etc). The test is completed when all the circles have been correctly selected. The test outputs a total score. A higher score indicates a better performance. A negative mean score indicates a decline in performance. The range of scoring for this test is 0 - 300,000. Data reported here are for mean change per group form baseline to six weeks	Baseline to Six weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Numerical Working Memory From Six Weeks	Digit Span test for numerical working memory. Partifcipants complete a computerised task. They must remember increasingly long strings of digits and repeat them back. Scores are based on correct responses. Higher score means better performance. Score range is 0 - 20	Baseline to six weeks
Change in Working Memory From Baseline	Measured through a computerised version of the Paired Associate Learning task in which participants must remember the location of a symbol behind a series of boxes on a screen, and accurately identify the correct location when prompted. Scores are based on accuracy. Higher score indicates better performance. Data reported here shows mean change from baseline. Range of scores is 0 - 16	Baseline to six weeks
Change in Reaction Time From Baseline	Measured through a Simple Reaction time test as part of the Wesnes Cognition Ltd CogTrackTM system. Participants are shown a target symbol on the screen and must react by pressing the keyboard / touching the screen (depending on the device being used) when the target appears. Output is measured in milliseconds as a reaction time variable. Lower scores are better; higher scores are worse. Range of scores is 100 - 30,000	Baseline to six weeks
Change in Episodic Memory From Baseline	Measured with the Delayed Picture Recognition task in which participants recall a series of images shown earlier in the cognitive test battery. The test outputs percentage of correct answers as the measure. A higher score shows a better outcome. Range output is 0 - 100	Baseline to six weeks
Change in Overall Composite Measure of Global Cognition	This is a composite measure of overall cognition that is created by normalising the outputs from all other cognitive tests to give a total score out of 100. The data shown here is the change in total score from baseline to six weeks. Range is 0 - 100. A higher score indicates a better outcome	Baseline to six weeks

Collaborators and Investigators

• Sponsor: University of Exeter
• Collaborators: King's College London; South London and Maudsley NHS Foundation Trust; Wesnes Cognition Ltd
• Investigators: Principal Investigator: Anne Corbett, BSc MRes PhD, University of Exeter Medical School

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2017
• Primary Completion (Actual): May 31, 2018
• Study Completion (Actual): November 30, 2018

Study Registration Dates

• First Submitted: July 30, 2018
• First Submitted That Met QC Criteria: September 3, 2018
• First Posted (Actual): September 7, 2018

Study Record Updates

• Last Update Posted (Actual): May 4, 2026
• Last Update Submitted That Met QC Criteria: April 29, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 216941

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) that underlie results in a publication or for secondary data analysis purposes.
• IPD Sharing Time Frame: 1st February 2026 for 5 years
• IPD Sharing Access Criteria: Any research organisation wishing to use the data for analytical purposes without commercial or for-profit activity, subject to approval
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No