Attitudes Toward Computers Moderate the Effect of Computerized Cognitive Trainings in Oldest-Old Senior Living Center Residents

Abstract

Background and objectives: Computerized cognitive interventions (CCIs) have been increasingly implemented among older adults with mild cognitive impairment (MCI). However, older individuals' attitudes toward technology may limit CCI engagement. This exploratory-developmental study examined whether a "multi-functional interactive computer system" (MICS), which provides pleasurable activities via computer, would improve attitudes toward computers and in turn increase the efficacy of a subsequent CCI.

Research design and methods: A phase one double-blind trial randomized 49 seniors with MCI to a MICS + CCI condition or a CCI-only condition. Attitudes toward technology use was assessed using The Attitudes Toward Computers Questionnaire (ATCQ), and cognition was assessed using episodic memory and executive function composite scores at baseline, the ends of MICS and CCI phases, and 3-month follow-up.

Results: The MICS + CCI group did not show significantly greater improvement in cognition than the CCI only group. Secondary analyses indicated that improvement in executive function from baseline occurred in both groups. Participants who did show improved attitudes toward computers, whether through MICS or simply computer exposure itself, showed improvement in executive function.

Discussion and implication: Participants in the MICS + CCI group used MICS less than expected. A more structured and supervised approach may be needed to facilitate MICS exposure. Improved attitudes toward computers regardless of MICS exposure may benefit candidates for CCI.

Trial registration: ClinicalTrials.gov NCT03292705.

Keywords: Computerized cognitive intervention; attitudes toward computers; cognition; mild cognitive impairment.

Conflict of interest statement

No Conflicts of Interest.

Copyright © 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1.

CONSORT diagram.

Figure 2.

Latent class result for classifying ATCQ over time.

Figure 3.

Trajectories of episodic memory and executive function over time by ATCQ latent class. No latent-class difference in episodic memory. There was a significant time×group interaction effect in executive function: improved ATCQ class showed significantly greater improvement in executive function but note in Stable ATCQ class.