THE EFFECT OF ATTENTION PROCESS TRAINING (APT-II) ON COGNITIVE AND DAILY LIFE FUNCTIONING IN PATIENTS WITH A MILD COGNITIVE IMPAIRMENT: A RANDOMIZED CONTROLLED TRIAL

Abstract

Introduction. Older adults with mild cognitive impairment (MCI) are at increased risk of developing dementia even if they do not meet the criteria for dementia. Executive control of working memory, which is implicated in divided attention, is often impaired in this population, and such impairment is a strong predictor of dementia. Slowing the development of dementia by enhancing cognitive and brain plasticity represents a current and future challenge for clinicians and researchers. Cognitive rehabilitation allows patients to compensate for cognitive deficits with the ultimate goal of reducing the impact of such deficits on everyday life. We aim to examine the effectiveness and generalization of an attention and working memory training program (Attention Process Training or APT-II) in improving cognitive and everyday functioning in patients with MCI by means of a single-blind, randomized controlled trial.

Methods. Twenty-four MCI patients will be randomly assigned to either a "Cognitive Training with APT-II" group or a "Standard Care" group. Initially, patients will be administered a battery of standardized neuropsychological tests to ensure that they meet MCI criteria. The intervention will consist of a cognitive training program (APT-II) and will last 8 weeks (two sessions per week). One of the strengths of APT-II training is that it emphasizes the transfer of cognitive gains from training sessions to everyday life. To evaluate the treatment's effectiveness in improving cognitive and daily life functioning, cognitive and functional outcomes will be assessed just before, immediately after, 3 months after, and 6 months after the intervention program. A divided attention memory task performed in virtual reality will also be administered to evaluate the effects of APT-II training on the management of attentional resources in a relatively ecological situation.

Perspective. If our results indicate an improvement in the cognitive and daily life performance of older adults with MCI, this non-invasive, low-cost technique may deserve increased consideration as a therapeutic intervention to delay or reverse cognitive decline an diminish the risk of developing dementia in this population.

Trial registration. ClinicalTrials.gov, ID: NCT04606953, Registered on 28 October 2020.

Keywords. Working memory training (WMT), Mild cognitive impairment (MCI), Dementia, Cognitive rehabilitation, Attention