Computerized cognitive training for older diabetic adults at risk of dementia: Study protocol for a randomized controlled trial

Marketplace and Literature Review of Spanish Language Mental Health Apps

Language differences between patients and providers remains a barrier to accessing health care, especially mental health services. One potential solution to reduce inequities for patients that speak different languages and improve their access to care is through the delivery of healthcare through mobile technology. Given that the Latinx community serves as the largest ethnic minority in the United States, this two-phased review examines Spanish app development, feasibility and efficacy. Phase 1 explored the commercial marketplace for apps available in Spanish, while phase 2 involved a literature review of published research centered around the creation, functions, and usability of these apps using the PubMed and Google Scholar electronic databases. Of the apps available on the database, only 14.5% of them had Spanish operability. The literature search uncovered 629 results, of which 12 research articles that tested or described 10 apps met the inclusion criteria. Of the 10 apps studied in this literature review, only four apps were translated to Spanish. Our study reveals that despite increasing interest in Spanish-language apps to address mental health, the commercial marketplace is not currently meeting the demand.

Computerized Cognitive Training for Older Adults at Higher Dementia Risk due to Diabetes: Findings From a Randomized Controlled Trial

BACKGROUND

To evaluate the effects of adaptive and tailored computerized cognitive training on cognition and disease self-management in older adults with diabetes.

METHODS

This was a single-blind trial. Eighty-four community-dwelling older adults with diabetes were randomized into a tailored and adaptive computerized cognitive training or a generic, non-tailored or adaptive computerized cognitive training condition. Both groups trained for 8 weeks on the commercially available CogniFit program and were supported by a range of behavior change techniques. Participants in each condition were further randomized into a global or cognition-specific self-efficacy intervention, or to a no self-efficacy condition. The primary outcome was global cognition immediately following the intervention. Secondary outcomes included diabetes self-management, meta-memory, mood, and self-efficacy. Assessments were conducted at baseline, immediately after the training, and at a 6-month follow-up.

RESULTS

Adherence and retention were lower in the generic computerized cognitive training condition, but the self-efficacy intervention was not associated with adherence. Moderate improvements in performance on a global cognitive composite at the posttreatment assessments were observed in both cognitive training conditions, with further small improvement observed at the 6-month follow-up. Results for diabetes self-management showed a modest improvement on self-rated diabetes care for both intervention conditions following the treatment, which was maintained at the 6-month follow-up.

CONCLUSIONS

Our findings suggest that older adults at higher dementia risk due to diabetes can show improvements in both cognition and disease self-management following home-based multidomain computerized cognitive training. These findings also suggest that adaptive difficulty and individual task tailoring may not be critical components of such interventions.

TRIAL REGISTRATION

NCT02709629.