The Effectiveness of GRADIOR: A Neuropsychological Rehabilitation Program for People with Mild Cognitive Impairment and Mild Dementia. Results of a Randomized Controlled Trial After 4 and 12 Months of Treatment

Background: Computer-based cognitive training programs have been developed with promising results on the maintenance/improvement of cognitive performance in people with dementia. Objective: The objective was to evaluate the effectiveness of the cognitive rehabilitation program GRADIOR in people with mild cognitive impairment and mild dementia. Method: This study was a single-blind multicenter randomized clinical trial. Participants were recruited from hospitals/day centers. The experimental group (EG) and control group (CG) received computer-based cognitive training (CCT) and routine daily care, respectively. Outcome measures at T-0: baseline, T-1: at 4 months, T-2: at 12 months were compared within and between-groups. Results: Significant differences or important effect sizes were detected at the intragroup and intergroup level for most variables, observing a trend of improvement and/or maintenance at 4 months by Visual Reasoning of Cambridge Cognitive Examination (CAMCOG), Digit and Arithmetic of WAIS-III, Semantic Verbal Fluency, Mini-Mental State Exam (MMSE), Trail Making Test (TMT)-A-Mistakes and at 12 months by Visual Reasoning of CAMCOG, Digit Symbol of WAIS-III, TMT-B-mistakes, Visual Memory of Rivermead Behavioural Memory Test, Lexical Verbal Fluency-P, Yesavage's Geriatric Depression Scale (GDS), TMT-A-time scales whose objective was to evaluate some executive functions and/or the memory. The CG presented a worsening trend for most of the measures towards 12 months. There was also a significant interaction between time and group for MMSE (F = 8.971; p =0.03; eta(2) = 0.019) and the GDS (F = 3.414; p =0.04; eta(2) = 0.041), as well as small effect sizes for TMT-A-time (F = 1.641; p =0.21; eta(2) = 0.021) and TMT-A-mistakes (F =0.908; p =0.41; eta(2 ) = 0.019). Conclusion: CCT with GRADIOR has been proved to benefit cognitive functions (ISRCTN:15742788).

Automated summary

This study evaluated the effectiveness of the cognitive rehabilitation program GRADIOR in people with mild cognitive impairment and mild dementia. The results showed that the program improved and maintained cognitive functions in most participants, while the control group showed a worsening trend for most measures at 12 months.