Feasibility of a pocket-PC based cognitive control intervention in dementia spousal caregivers

Abstract

Objectives: Spousal caregivers of patients with dementia are in need of interventions to bolster their quality of life. Computer-based, self-administered cognitive training is an innovative approach to target spousal caregiver distress and coping. We tested the feasibility of administering one such intervention with minimal clinician intervention.

Methods: Twenty-seven elderly adults (>64 years old), who each were the primary caregiver for a spouse with dementia, were recruited through the Memory Disorders Clinic of the Alzheimer Disease Research Center in Pittsburgh, PA. Spousal caregivers were instructed to use a handheld computer version of the Adaptive Paced Visual Serial Attention Task (APVSAT) at least three times per week for four weeks as part of a larger caregiver intervention trial (P01 AG020677). Feasibility was explored by examining the frequency of APVSAT usage.

Results: Results suggest that self-directed cognitive training is feasible for spousal caregivers of dementia patients. The mean usage of the APVSAT was 42 (SD = 28.58). Performance increased from the beginning to the end of the trial, and usage was not affected by stress, worry, or poor sleep quality.

Conclusion: Findings suggest the potential utility of cognitive training via handheld computer for spousal caregivers of dementia patients to improve problem solving, coping and adaptation, planning, and persevering with goal-directed tasks.

Trial registration: ClinicalTrials.gov NCT00178568.

Keywords: cognitive control training; dementia spousal caregivers; handheld computer intervention; neurobehavioral intervention.

Figures

Figure 1. Handheld APVSAT

The Adaptive Paced Visual Serial Addition Task (APVSAT). When using the APVSAT, a pocket-PC based application, participants see a series of digits and are asked to add each new digit to the digit that preceded it (i.e., sum the most recently seen two digits—not keep a running sum). Difficulty is manipulated by increasing the speed with which items are presented.

Figure 2. Distribution of APVSAT Use

The distribution of uses of the APVSAT throughout the 28-day study period. Red bars indicate that significantly more than half of the participants (N>14) used the intervention at the represented frequency (Fisher’s exact p<.05>

Figure 3

Figures 3a and 3b. Association between Use and Stress/Worry Illustrates the relationship between perceived stress and worry and APVSAT usage.

Figure 4. Change in Mean Interstimulus Interval among the 28 Day Adherence Group

The mean ISI (ms) significantly decreased from the beginning to the end of the intervention, suggesting that participants improved on the task.