BRI investigators ask: Can e-puzzles help people with Mild Cognitive Impairment?
02/15/2019
“You need to keep your mind sharp,” the old mantra goes.
“Use or lose it,” goes another one.
These expressions have drifted into the public consciousness, resulting in the wide popularity of puzzles such as Sudoku and WordSearch. Digital technology has also led to the development of other popular “brain games,” such as BrainHQ—designed with the express purpose of training one’s mind.
These types of activities might be good at keeping a healthy mind sharp, as some evidence suggests, but can they help people who are already having memory problems?
Frank Knoefel, MD, is an investigator with the Bruyère Research Institute and a clinician with the Bruyère Memory Program. Every day he deals with patients who are suffering from Mild Cognitive Impairment (MCI)—a condition that is often a precursor of Alzheimer’s or other dementias. “Some digital cognitive games and puzzles are promising in terms of helping healthy older adults keep their minds sharp,” he explains, “but not enough research has been done on mild cognitive impairment.”
Dr. Knoefel has been investigating the intersection between technology and memory for years. In this case, he went to work with fellow Bruyère investigators Vanessa Taler, PhD, and Rafik Goubran, PhD, to take the first step in determining whether cognitive games can help people with MCI. Their first order of business: figure out whether this kind of research is feasible.
“Studies that use brain training are quite intensive and since people with MCI
have difficulties remembering – doing complicated activities on a computer may be a challenge.” explains Dr. Knoefel, “We felt supervision at every brain training session would be essential to ensure the activities were being done correctly. Furthermore brain training activities should take several months to be effective, again increasing the complexity of this type of research. So the potential is high for participants to drop out.”
This is why Drs. Knoefel, Taler and Goubran recently performed a study focused on determining whether people with MCI are likely to last for the duration of a full-fledged trial involving cognitive puzzles.
The study simulated what a larger trial might look like. Dr. Knoefel and his colleagues recruited patients, got them to engage with digital puzzle versions of WordSearch and Sudoku designed by the engineering team at Carleton University, as well as the professional grade software from dynamicbrain.ca. As Drs. Knoefel, Taler and Goubran discovered, these types of studies are challenging. However they appear to be feasible in a structured setting. One of the major challenges was recruiting for the study. After six months, they managed to recruit only 20 participants. However once participants were committed, most of them followed through until the end.
So what does this mean for future studies?
It is possible to design a brain training study for older adults with MCI. The following are recommendations: 1) Have enough research staff to ensure that the participants are able to manage the computer activities and that there is contingency for sickness and other absence; 2) take into consideration if you want to have different sub-types of MCI included; and 3) make sure you have enough participants to be able to show meaningful change.