Effectiveness of Virtual Interactive Working Memory Training for Elderly Patients With Mild Cognitive Impairment

Chou, Kuei-Ru; Chou, Kuei-Ru

Background: Memory training is a potential intervention for memory retention and dementia risk reduction in patients with mild cognitive impairment (MCI). Compared with traditional training methods, a virtual interactive working memory training (VIMT) program not only offers immediate feedback and objective data but also provides a relatively cost-effective and helpful method for self-management from the perspective of public health.

Objectives: The objective of this study was to examine the effect of VIMT, as an intervention, on the objective memory performance (i.e., working memory, immediate memory, and delayed memory), subjective memory complaints, and global cognitive function of patients with MCI.

Design: This study applied a double-blind, two-arm parallel-group, and randomized controlled design.

Setting: Elderly retirement center and senior community housing.

Participants: A total of 39 elderly patients with MCI were recruited (mean age: 78.5 ± 8.0 years; mean Mini-Mental Status Examination [MMSE] score: 25.5 ± 4.9; mean Montreal Cognitive Assessment [MoCA] score: 21.7 ± 6.9).

Intervention: The participants were randomly assigned to an experimental group (which underwent VIMT; n = 20) or an active control group (which participated in passive information activities, n = 19). Both groups received 45-min training sessions three times per week for 12 weeks (36 sessions in total).

Measurements: The primary outcome measures were objective memory performance (assessed using the Wechsler Memory Scale III [WMS-III]), which comprised three variables, namely working memory, immediate memory, and delayed memory. The secondary outcome measures were subjective memory complaints (assessed using the Multifactorial Memory Questionnaire [MMQ]) and global cognitive function (MMSE and MoCA). All variables were measured or tracked at the pretest, posttest, 3-month follow-up, and 6-month follow-up.

Results: VIMT engendered significant improvements in working memory and subjective memory complaints (strategy), which were superior to those observed in the active control group. Effect size analysis demonstrated that VIMT engendered large effect sizes on working memory, subjective memory complaints (strategy), and global cognitive function; moreover, the effects were long term.

Conclusion: The applied VIMT program provided the participants with memory strategies and skills and effectively delayed the decline in memory function and global cognitive function. Thus, this study suggests that this intervention should be incorporated into regular activities and long-term programs to provide comprehensive care services to elderly people, thus assisting them in delaying the progression of cognitive and memory loss.