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Does computerized cognitive training improve diabetes self-management and cognition? A randomized control trial of middle-aged and older veterans with type 2 diabetes

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ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2022.110149

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Cognitive decline; Computerized cognitive training; Diabetes self-management; Intact cognition; Mild cognitive impairment; Veterans

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This study compared an adaptive computerized cognitive training intervention with a non-adaptive version in type 2 diabetes patients. Contrary to the hypothesis, only memory showed improvement in the adaptive arm. Post-hoc analysis combining the two arms revealed that computer-related activities may improve diabetes self-management and other outcomes.
Aims: This randomized control trial compared an adaptive computerized cognitive training intervention with a non-adaptive version. The primary hypothesis predicted better diabetes self-management in type 2 diabetes patients at 6 months post-intervention than baseline in the adaptive arm, with seven secondary outcomes.Methods: Intent-to-treat analysis of veterans without dementia aged 55+ from the Bronx, NY and Ann Arbor, MI (N = 90/per arm) used linear mixed model analyses.Results: Contrary to the hypothesis, only memory showed more improvement in the adaptive arm (p < 0.01). Post-hoc analyses combined the two arms; self-management improved at six-months post-intervention (p < 0.001). Memory, executive functions/attention, prospective memory, diastolic blood pressure, and systolic blood pressure improved (p < 0.05); hemoglobin A1c and medication adherence did not improve significantly.Conclusions: The adaptive computerized cognitive training was not substantially better than non-adaptive, but may improve memory. Post-hoc results for the combined arms suggest computer-related activities may improve diabetes self-management and other outcomes for middle-aged and older patients with type 2 diabetes. Practice effects or awareness of being studied cannot be ruled out.

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