Remote Technologies in Early Stages of Alzheimer's Disease

Remote Technologies in Early Stages of Alzheimer's Disease: Feasibility, Usability, and Acceptance of an App-based Cognitive Training

The investigators are adapting a tablet-based cognitive training program for Alzheimer's disease (AD) by focusing on specific cognitive components. It is aimed to demonstrate the feasibility, acceptability and usability of remote cognitive training in older adults with Mild Cognitive Impairment (MCI) and AD dementia. The study involves 36 participants in three groups, with a two-week intervention and focus groups for refinement.

Study Overview

• Status: Active, not recruiting
• Conditions: Alzheimer Disease; Mild Cognitive Impairment; Old Age; Dementia; Serious Games; Remote Cognitive Training; App-based Cognitive Training
• Intervention / Treatment: Device: App-based cognitive training

Detailed Description

The investigators aim to extend a tablet-computer-based cognitive training (CT), fully developed in house (KEK 2020-00630), and tailored specifically towards a "typical-AD" cognitive component. This cognitive component is defined through a principal-component analysis (PCA), on which the domains affected by AD (episodic memory, spatial processing, semantic memory) have high loadings. The investigators moreover train working memory training to facilitate transfer effects. By including carers (family members, friends, professional carers) in the focus groups and the integration of help buttons, the investigators expect high adherence. The CT will be based on our ongoing study assessing the CT in people at risk for AD and subjective cognitive decline.

The investigators plan a small feasibility study in three different groups with a total of 36 elderly participants including cognitively normal (N=12), MCI (N=12), and mild-moderate stage dementia due to AD (N=12).

The focus will be on qualitative content analyses based on the results from the focus groups. The results from the first focus group sessions serve the selection, adaptation, and improvement of the CT before it is implemented in the two-week intervention including daily 30-minutes training sessions. A second focus group after the intervention will serve to gain additional insights from users and carers to further improve the CT. To complement this information, the investigators will quantitatively compare specific game parameters related to feasibility (number of levels achieved, numbers of sessions finished, number of dropouts), usability (time until reaching level 1 - learn duration, numbers of help button presses), and acceptability (game evaluation) between the three treatment groups.

The investigators aim to demonstrate that remote CT is possible in older adults with Mild Cognitive Impairment (MCI) and diagnosed AD dementia at home and in the care home setting by extending an existing tablet-based CT app with additional (easier) training levels, additional and detailed introductory material to also allow cognitively more severely impaired participants to conduct the CT with as little external support as possible. This study is considered as Risk Category A. The study intervention consists of a tablet-based CT, which does not provide any known risks for the participants.

• Study Type: Observational
• Enrollment (Estimated): 36

Contacts and Locations

Study Locations

• Switzerland
  • Bern, Switzerland, 3000
    • University Hospital of Old Age Psychiatry and Psychotherapy Bern

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited by newspaper adverts and flyers after public talks. It is also intended to recruit visitors from the day clinic as well as patients from the Interdisciplinary Memory Clinic (IDMC) Bern (https://www.memory-clinic-bern.ch/) and the Domicil care home group (www.domicilbern.ch).

Description

Participants and study partners fulfilling all the following inclusion criteria are eligible for the study:

• Informed Consent as documented by signature

Study partners:

• Native or fluent German speaker

Participants:

• Are able to give their consent to participate in the study
• Age between 70 and 95 years
• Native or fluent German speaker
• Normal or corrected to normal vision and hearing
• Ability to visit the study location repeatedly
• MoCA score > 11

Exclusion Criteria:

• Substance abuse
• Severe neurological or psychiatric conditions (of note: patients with mild depressive symptoms not fulfilling the criteria for major depressive disorder will be recruited into the sample to better represent clinical reality)

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
HC - Healthy Control Group; Healthy, age- and sex-matched participants (cognitively normal)	Device: App-based cognitive training; The cognitive training is administered remotely for 2 weeks daily (10 sessions). The participants play all 12 games for 8 minutes in each session.
MCI - Mild Cognitive Impairment; Participants with MCI	Device: App-based cognitive training; The cognitive training is administered remotely for 2 weeks daily (10 sessions). The participants play all 12 games for 8 minutes in each session.
AD - Alzheimer's Disease; Participants with mild-moderate stage dementia due to AD	Device: App-based cognitive training; The cognitive training is administered remotely for 2 weeks daily (10 sessions). The participants play all 12 games for 8 minutes in each session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of tablet-based cognitive training	Compliance rate (i.e.number of sessions completed)	Assessed at the end of the 2-week intervention (Day 10)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of tablet-based cognitive training	Number of levels achieved	Assessed at the end of the 2-week intervention (Day 10)
Usability	Time until accomplishment of the first level (learning time)	Assessed at the end of the 2-week intervention (Day 10)
Acceptability	Qualitative evaluation of the games in a semi-structured interview (Focus group discussion). For each game, the same questions will be addressed in an open discussion.	Assessed within two weeks after day 10 of the intervention
2. Feasibility of tablet-based cognitive training	Number of drop-outs	Assessed at the end of the 2-week intervention (Day 10)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Support 1	The extent of support needed from study partners (diary notes)	Assessed at the end of the 2-week intervention (Day 10)
Support 2	The number of sessions for which support was required (diary notes)	Assessed at the end of the 2-week intervention (Day 10)
Wellbeing	Influence on mood and wellbeing (questionnaire)	Assessed every day during the intervention, a couple of seconds before playing the games (answering the in-game question on the tablet precedes playing the scheduled session).
Evaluation of Games by Study Partner	Qualitative evaluation of the games in a semi-structured interview (Focus group discussion). For each game, the same questions will be addressed in an open discussion.	Assessed every day after (within couple of minutes) each game of the intervention was played.

Collaborators and Investigators

• Sponsor: University of Bern
• Investigators: Study Chair: Anna-Katharine Brem, University Hospiltal of Old Age Psychiatry and Psychotherapy

Publications and helpful links

Helpful Links

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Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2023
• Primary Completion (Estimated): April 30, 2026
• Study Completion (Estimated): April 30, 2026

Study Registration Dates

• First Submitted: November 17, 2025
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Alzheimer's Disease; Cognitive training; Old Age Psychiatry; Remote technology
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Dementia; Tauopathies; Neurodegenerative Diseases; Cognitive Dysfunction; Alzheimer Disease
• Other Study ID Numbers: ALZ-RCT-BREM

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The investigators will share encrypted study data used for publications in an appropriate open access data base

Drug and device information, study documents

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