A comparison of the effects between 2 computerized cognitive training programs, Bettercog and COMCOG, on elderly patients with MCI and mild dementia A single-blind randomized controlled study

Background: A computerized cognitive rehabilitation program can be used to treat patients with mild cognitive impairment or dementia. We developed a new computerized cognitive rehabilitation program (Bettercog) that contained various treatment programs for cognitive training for mild cognitive impairment or dementia. This study was conducted to compare the clinical efficacy of Bettercog and computer-assisted cognitive rehabilitation (COMCOG) that has had clinical efficacy previously proven in patients with mild cognitive impairment or dementia. Methods: Randomized, single-blind comparison pilot study of 20 elderly patients with cognitive decline-eight men and 12 women - with an average age of 74.3 years. Bettercog trains not only memory and attention but also orientation, calculation, executive function, language, comprehension, and spatiotemporal abilities. To retain subjects' interest, pictures, animations, and game elements were introduced. The subjects were divided into COMCOG and Bettercog groups by random assignment and underwent 12 sessions of a computerized cognitive rehabilitation program for three weeks. In a separate space, an independent clinical psychologist conducted the Seoul Neuropsychological Screening Battery 2nd edition (SNSB-II), Korean Mini-Mental State Examination (K-MMSE), Clinical Dementia Rating (CDR), and the Korean version of the Modified Barthel Index (K-MBI) before and after treatment. Results: There was no significant difference between the two groups in baseline age, sex, illiteracy, years of education, and scores on the K-MMSE, CDR, SNSB-II, and K-MBI. In the posttreatment cognitive assessment, the K-MMSE scores of patients treated with Bettercog improved from 19.2 +/- 3.9 to 21.3 +/- 4.0 (P=.005). In the memory domain of the SNSB-II, the percentile score improved from 15.3 +/- 24.5 to 24.2 +/- 30.7 (P=.026). However, there was no statistically significant difference in the final K-MMSE, CDR, and SNSB-II scores between the two treatment groups. In both groups, K-MBI scores improved statistically significantly after treatment. Conclusions: Through this preliminary study, we verified that the newly developed computerized cognitive rehabilitation program is effective in improving cognitive function. However, 12 sessions are not enough to administer a variety of cognitive rehabilitation content to patients. It is, therefore, necessary to conduct a large-scale study using a computerized cognitive rehabilitation program that has various cognitive content.