Susan J Pressler1, Miyeon Jung2, Irmina Gradus-Pizlo3, Marita G Titler4, Dean G Smith5, Sujuan Gao6, Kittie Reid Lake2, Heather Burney6, David G Clark7, Kelly L Wierenga2, Susan G Dorsey8, Bruno Giordani9. 1. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, Indiana. Electronic address: sjpress@iu.edu. 2. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, Indiana. 3. University of California Irvine School of Medicine, 333 City Boulevard, West, Suite 400, Orange, California. 4. University of Michigan School of Nursing, 400 North Ingalls Street, Ann Arbor, Michigan. 5. Louisiana State University School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, Louisiana. 6. Indiana University School of Medicine, Department of Biostatistics, 410 West 10th Street, Suite 3000, Indianapolis, Indiana. 7. Indiana University School of Medicine, 355 W. 16th Street, Suite 4020, Indianapolis, Indiana. 8. University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, Maryland. 9. University of Michigan Department of Psychiatry and Michigan's Alzheimer's Disease Research Center, Suite C, 2101 Commonwealth Boulevard, Ann Arbor, Michigan.
Abstract
BACKGROUND: The objective of this 3-arm randomized controlled trial was to evaluate the efficacy of computerized cognitive training (CCT) in improving primary outcomes of delayed-recall memory and serum brain-derived neurotrophic factor (BDNF) levels; and the secondary outcomes were working memory, instrumental activities of daily living (IADLs) and health-related quality of life (HRQL) in patients with heart failure (HF). METHODS AND RESULTS: Patients (n = 256) were randomly assigned to 8 weeks of CCT using BrainHQ, computerized crossword puzzles active control intervention, and usual care. All patients received weekly nurse-enhancement interventions. Data were collected at enrollment and baseline visits and at 10 weeks and 4 and 8 months. In mixed effects models, there were no statistically significant group or group-by-time differences in outcomes. There were statistically significant differences over time in all outcomes in all groups. Patients improved over time on measures of delayed-recall memory, working memory, IADLs, and HRQL and had decreased serum BDNF. CONCLUSIONS: CCT did not improve outcomes compared with the active control intervention and usual care. Nurse-enhancement interventions may have led to improved outcomes over time. Future studies are needed to test nurse-enhancement interventions in combination with other cognitive interventions to improve memory in persons with HF.
BACKGROUND: The objective of this 3-arm randomized controlled trial was to evaluate the efficacy of computerized cognitive training (CCT) in improving primary outcomes of delayed-recall memory and serum brain-derived neurotrophic factor (BDNF) levels; and the secondary outcomes were working memory, instrumental activities of daily living (IADLs) and health-related quality of life (HRQL) in patients with heart failure (HF). METHODS AND RESULTS: Patients (n = 256) were randomly assigned to 8 weeks of CCT using BrainHQ, computerized crossword puzzles active control intervention, and usual care. All patients received weekly nurse-enhancement interventions. Data were collected at enrollment and baseline visits and at 10 weeks and 4 and 8 months. In mixed effects models, there were no statistically significant group or group-by-time differences in outcomes. There were statistically significant differences over time in all outcomes in all groups. Patients improved over time on measures of delayed-recall memory, working memory, IADLs, and HRQL and had decreased serum BDNF. CONCLUSIONS: CCT did not improve outcomes compared with the active control intervention and usual care. Nurse-enhancement interventions may have led to improved outcomes over time. Future studies are needed to test nurse-enhancement interventions in combination with other cognitive interventions to improve memory in persons with HF.
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