Using Teleneuropsychology to Optimize Cognition in Healthy Aging: the Web-based Breakfast Game

Training Executive Control in Cognitively Healthy Aging: the Web-based Breakfast Game

Executive control processes involve initiate, coordinate, synchronize, and regulate elemental cognitive functions for the conduct of goal-directed behavior. The proposed research investigates whether exposure to a web-based training protocol designed to enhance executive control processes will improve cognitive performance in cognitively healthy older adults.

Study Overview

• Status: Completed
• Conditions: Healthy Aging
• Intervention / Treatment: Behavioral: Web-based training strategy; Behavioral: Web-based regular training (no strategy)

Detailed Description

The proposed research investigates whether exposure to a web-based training protocol designed to enhance executive control / multi-tasking abilities will improve cognitive performance in healthy older adults. Cognitively normal adults aged 60-75 will be randomized into two experimental groups: 1) Web-based game with training strategy; 2) Web-based game without training strategy (Active Control). All participants (groups 1 and 2) will be instructed to play the complex, high-demand online game, Breakfast Game, for 14 one-hour sessions over 5 weeks.

• Study Type: Interventional
• Enrollment (Actual): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10032
      • Columbia University Irving Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 60-75
• Willingness to adhere to training protocol
• Adequate English proficiency

Exclusion Criteria:

• Low test scores (below 26 on the Montreal Cognitive Assessment)
• Known history of cognitive impairment, dementia, stroke, seizure disorder, or other neuropsychiatric condition judged to impact cognitive performance.
• Taking medications known to influence cognitive performance.
• Sensory (e.g. visual, auditory) or physical (e.g. severe arthritic, orthopedic, neurologic) impairment incompatible with use of a standard computer workstation.
• Enrolled in a concurrent study that could affect the outcome of this study.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Strategy Training; Participants will play the Breakfast Game with training strategy.	Behavioral: Web-based training strategy; Participants will undergo a web-based training protocol where they will play an online game that simulates a breakfast environment and will perform everyday activities as "cooking" and "setting tables" in a multi-tasking fashion. Participants will learn to play the game using specific strategies, in order to optimize the performance.; Other Names: Experimental intervention
Active Comparator: Regular Approach; Participants will play the Breakfast Game without training strategy.	Behavioral: Web-based regular training (no strategy); Participants will undergo a web-based training protocol where they will play an online game that simulates a breakfast environment and will perform everyday activities as "cooking" and "setting tables" in a multi-tasking fashion. Participants will learn to play the game under regular game instructions.; Other Names: Control intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in the Breakfast Game Performance: Number of Tables Set Score	Change in the total number of tables set. In the computerized task, participants are asked to set tables for four guests. When finished, one point is given. Higher scores represent a better outcome. This metric represents a change in the score = the higher means improvement in the performance. The total score ranges between 0 and 12; the total change score ranged from -3 to +3.	Assessed at training session 1, week 1; training session 12, approximately 6 weeks. Data is reported for the change between session 1 and 12
Changes in the Breakfast Game Performance: Cooking Time Range of Stop Times Scores	Change in cooking time (milliseconds) between food items. In the computerized task, participants are asked to cook different food types. Scores reflect the difference between the first and last food item that was stopped cooking. Lower scores (closest to zero) represent a better outcome. This metric represents a change in the score = the lower means improvement on the performance. The total score ranges between 0.3 and 315; the total change score ranges from -40 to +40.	Assessed at training session 1, week 1; training session 12, approximately 6 weeks. Data is reported for the change between session 1 and 12
Change in Breakfast Game Performance: Cooking Time Discrepancy Scores	Change in cooking time (milliseconds) in each food type. In the computerized task, participants are asked to cook different food types. Scores reflect the average absolute values of the difference between the required and actual cooking time of each item. Lower scores (closest to zero) represent a better outcome. This metric represents a change in the score = the lower means improvement in the performance. The total score ranges between 0.3 and 175; The total change score ranges from -20 to +20.	Assessed at training session 1, week 1; training session 12, approximately 6 weeks. Data is reported for the change between session 1 and 12
Transfer to Complex Executive/Attention Control Measure (Proximal Outcome).	Accuracy on the Alphanumeric Task. This metric represents a change in the score. The higher the means more improvement in the performance. The total change score ranged from -0.1 to +0.1	Within the 2 weeks before intervention starts; and the 6th week, after the last (12th) training session. (Measure represent change between pre and post training)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Transfer to Executive Functions Composite Z-Score (Distal Outcome)	The Executive Functions Composite Z-Score represents an ability based on performance in four tests: Letter-Number Sequencing, Wisconsin Card Sorting Test, Stroop, and Useful Field of View. Each of these test measures aspects of executive functions, including: divided attention, working memory, inhibitory control, and cognitive flexibility. To calculate the Executive Functions Composite Score, Z-score values were computed in each of the four tests. We then averaged the Z-scores into a single Z-score measure. The central value (Z-score of 0) represents the average performance of the sample in each test. Standard deviation above the mean (higher Z-score values) represents better performance. The total Z-score ranged between -7 and 5. (Values not used for clinical diagnosis, sample cognitively healthy). This metric represents CHANGE in the Executive Functions Composite Score = the higher values represent more improvement in the performance. The total change score ranged from -2 + 2.	Within the 2 weeks before intervention starts; and the 6th week, after the last (12th) training session. (Measure represent change between pre and post training)
Transfer to the General Self-efficacy Scale (Distal Outcome)	Scores on a scale that measures perception about self-efficacy. Total score ranges between 10 and 40, with a higher score indicating more self-efficacy. The change in the scale ranged from -4 to 9. This metric represents a change in the score = the higher means improvement in the performance.	Within the 2 weeks before intervention starts; and the 6th week, after the last (12th) training session. (Measure represent change between pre and post training)
Transfer to Beck Depression Inventory (Distal Outcome)	Score on a scale that measures depression symptoms. Total score ranges between 0 and 63, with a higher score indicating more depression symptoms. The change in the scale ranged from +3 to -9.	Within the 2 weeks before intervention starts; and the 6th week, after the last (12th) training session. (Measure represent change between pre and post training)
Transfer to Beck Anxiety Inventory (Distal Outcome)	Score on a scale that measures anxiety symptoms. Total score ranges between 0 and 63, with a higher score indicating more anxiety symptoms. The change in the scale ranged from +6 to -6.	Within the 2 weeks before intervention starts, and the 6th week, after the last (13th) training session. (Measure represent the change between pre and post training)
Transfer to Cognition-Leisure Questionnaire (Distal Outcome)	Score on a scale reflecting engagement/frequency in leisure & cognitive activities. Total score ranges between 0 and 80, with a higher score indicating more frequency in leisure/cognitive activities. The change in the scale ranged from -9 to 9.	Within the 2 weeks before intervention starts, and the 6th week, after the last (12th) training session. (Measure represent the change between pre and post training)

Collaborators and Investigators

• Sponsor: Columbia University
• Collaborators: National Institute on Aging (NIA)
• Investigators: Principal Investigator: Sharon Sanz Simon, PhD, Columbia University

Study record dates

Study Major Dates

• Study Start (Actual): January 17, 2023
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): July 30, 2024

Study Registration Dates

• First Submitted: July 25, 2022
• First Submitted That Met QC Criteria: August 16, 2022
• First Posted (Actual): August 18, 2022

Study Record Updates

• Last Update Posted (Actual): March 19, 2026
• Last Update Submitted That Met QC Criteria: March 18, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: cognition; cognitive decline; cognitive training; video game; cognitive enhancement; computerized; executive control; non-pharmacological intervention; computer-based; teleneuropsychology; attention control; multi-tasking
• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction
• Other Study ID Numbers: AAAT4773; 1K99AG078561-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data for all primary and secondary outcome measures will be made available.
• IPD Sharing Time Frame: Data will be available within 6 months of study completion.
• IPD Sharing Access Criteria: Data access requests will be reviewed by the principal investigator.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

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