The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study

Shefali Kumar, Jennifer LA Tran, Heidi Moseson, Caroline Tai, Jordan M Glenn, Erica N Madero, Caitlyn Krebs, Nicholas Bott, Jessie L Juusola, Shefali Kumar, Jennifer LA Tran, Heidi Moseson, Caroline Tai, Jordan M Glenn, Erica N Madero, Caitlyn Krebs, Nicholas Bott, Jessie L Juusola

Abstract

Background: Face-to-face multidomain lifestyle interventions have shown to be effective for improving or maintaining cognitive function in older adults at risk for dementia. Remotely delivered interventions could increase access to such solutions but first require evidence to support that these programs can successfully impact health outcomes.

Objective: The objective of this study was to evaluate the impact of a remotely delivered multidomain lifestyle intervention, the virtual cognitive health (VC Health) program, on the cognitive function and mental health of older adults with subjective cognitive decline (SCD).

Methods: A 52-week, prospective, single-arm, pre-post, remote nationwide clinical trial was conducted to measure the change in cognitive function, depression, and anxiety levels for older adults at risk of developing dementia who participated in the VC Health program. A Web-based study platform was used to screen, consent, and enroll participants across the United States. Participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and Web-based assessments (which included the Patient Health Questionnaire [PHQ-9] and Generalized Anxiety Disorder [GAD-7] surveys) at baseline and weeks 12, 24, and 52; all data were collected remotely. Changes in RBANS, PHQ-9, and GAD-7 were assessed using 2-tailed paired t tests and nonparametric signed-rank tests.

Results: Participants (N=82) were, on average, aged 64 years (range 60.0-74.9 years), 74% (61/82) female, 88% (72/82) white, and 67% (55/82) had a college degree or higher. At baseline, participants had a mean and median RBANS Total Index score of 95.9 (SD 11.1) and 95.5 (interquartile range, IQR=13). Participants experienced a mean and median increase of 5.8 (SD 7.4) and 6 (IQR=11) in RBANS Total Index score from baseline to week 52 (P<.001). Participants had a mean and median PHQ-9 score of 8.5 (SD 4.9) and 8 (IQR=6) at baseline and experienced a mean and median decrease of 3.8 (SD 4.1) and 4 (IQR=6) units in PHQ-9 score from baseline to week 52 (P<.001). At baseline, participants had a mean and median GAD-7 score of 6.2 (SD 4.5) and 5.5 (IQR=6) and experienced a mean and median decrease of 2.9 (SD 4.1) and 2 (IQR=5) units in GAD-7 score from baseline to week 52 (P<.001). Participants were engaged and very satisfied with various program components.

Conclusions: In this study, older adults with SCD who were at risk for dementia experienced statistically significant improvements in their cognitive function, depression, and anxiety levels. These findings serve as initial evidence for the overall feasibility and effectiveness of the VC Health program to improve or maintain cognitive function in older adults who are experiencing SCD. Further research should be conducted to understand the degree to which the improvements are attributable to specific components of the intervention.

Trial registration: ClinicalTrials.gov NCT02969460; https://ichgcp.net/clinical-trials-registry/NCT02969460 (Archived by WebCite at http://www.webcitation.org/73XOph9Qm).

Keywords: Alzheimer disease; cognitive impairment; dementia; mental health.

Conflict of interest statement

Conflicts of Interest: Neurotrack makes and owns the VC Health program examined in this study. NB, KC, JMG, and ENM are employed by Neurotrack and receive a salary and stock options. Evidation Health collected and analyzed all study data. SK, JT, HM, CT, and JLJ are employed by Evidation Health and have no financial interest in Neurotrack.

©Shefali Kumar, Jennifer LA Tran, Heidi Moseson, Caroline Tai, Jordan M Glenn, Erica N Madero, Caitlyn Krebs, Nicholas Bott, Jessie L Juusola. Originally published in JMIR Aging (http://aging.jmir.org), 09.11.2018.

Figures

Figure 1
Figure 1
Study diagram. RBANS: Repeatable Battery for the Assessment of Neuropsychological Status.
Figure 2
Figure 2
Change in mean Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Total Index score over time.
Figure 3
Figure 3
Change in Patient Health Questionnaire-9 (PHQ-9) scores over time.
Figure 4
Figure 4
Change in Generalized Anxiety Disorder-7 (GAD-7) scores over time.

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