Computerized Structured Cognitive Training in Patients Affected by Early-Stage Alzheimer's Disease is Feasible and Effective: A Randomized Controlled Study

Introduction: Alzheimer's disease (AD) presents with significant neuropsychological deficits. Cognitive training in AD has recently started to demonstrate its efficacy. In this study, we implemented computerized cognitive training of a large group of early-stage AD patients, to identify its effects at a neuropsychological level and to investigate whether they were stable after 6 months. Method: Overall, 80 AD patients were randomized in two groups. Patients in the experimental group used a structured rehabilitative software three times a week for 12 consecutive weeks aimed at training memory, attention, executive function and language skills, whereas patients in the control group underwent a control intervention. Results: A Repeated Measures General Linear Model considering groups' performance at the three assessment points (before training, after training and at the 6-month follow-up) showed a significant interaction effect for: digit span forward (F-(2,F-74) = 2.785, p = 0.03) and backward (F-(2,F-74) = 3.183, p = 0.02), two-syllable words test (F-(2,F-74) = 3.491, p = 0.004), Rivermead Behavioural Memory Test immediate (F-(2,F-74) = 2.877, p = 0.03) and delayed (F-(2,F-74) = 3.783, p = 0.003), Token test (F-(2,F-74) = 4.783, p = 0.001), and Brixton test (F-(2,F-74) = 8.783, p < 0.001). For all of them, experimental group performed better than controls. Conclusions: Patients in the experimental group showed a significant improvement in various neuropsychological domains, and their achievements were stable after 6 months. This study suggests an useful computerized training in AD, and should prompt further investigations about the generalizability of patients' acquired skills to more ecologically oriented tasks.