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CLINICAL TRIAL article

Front. Psychiatry
Sec. Mood Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1509821
This article is part of the Research Topic Bipolar Disorder and Cognition: Cognitive Decline and Dementia View all 4 articles

BrainFit: Improving executive and subjective cognitive functioning in late-life mood disorders A double-blind randomized active-controlled study evaluating the effect of online cognitive training

Provisionally accepted
Mardien L. Oudega Mardien L. Oudega 1,2*Annemiek Dols Annemiek Dols 3Margot Wagenmakers Margot Wagenmakers 1Sigfried Schouws Sigfried Schouws 1Adriaan Hoogendoorn Adriaan Hoogendoorn 2Odile Van den Heuvel Odile Van den Heuvel 2,4Chris Vriend Chris Vriend 2,4Tanya Palsma Tanya Palsma 1
  • 1 GGZ inGeest, Amsterdam, Netherlands
  • 2 Amsterdam University Medical Center, Amsterdam, Netherlands
  • 3 University Medical Center Utrecht, Utrecht, Netherlands, Netherlands
  • 4 Department of Anatomy & Neurosciences, VU Medical Center, Amsterdam, Netherlands

The final, formatted version of the article will be published soon.

    Introduction: Unipolar and bipolar mood disorders in older adults are accompanied by cognitive impairment, including executive dysfunction, with severe impact on daily life. Up and till now, strategies to improve cognitive functioning in late-life mood disorders (LLMD) are sparse. Therefore, we aimed to assess the efficacy of adaptive, computerized cognitive training (CT) on executive and subjective cognitive functioning in LLMD.In this double-blind, randomized controlled study we enrolled patients over the age of 50 with partly remitted LLMD. Over 8 weeks, patients participated in 24 45-minute sessions of computerized multi-domain training (CT) or an active control condition (ACC) (nonspecific cognitive activity). The primary outcome was executive functioning based on the interference score on the STROOP task (not incorporated in the training). Secondary outcomes were subjective cognitive functioning, depressive symptoms and quality of life. Outcomes were assessed before and after training (T1), at a 3-month follow-up (T2) and analyzed with linear mixed-model analyses.Results: Thirty-eight patients were included in the study, 22 in the experimental CT and 16 in the ACC.Mean age was 67.3 years and 52.6% was female. Linear mixed-model analyses showed small within-group effect sizes, corresponding to no statistically significant improvement of executive functioning or depression severity in either group. In both groups we did observe an improvement on subjective cognitive functioning over time. From T0 to T1 the mean score of the Cognitive Functioning Questionnaire (CFQ) of the CT group decreased from 52.7 to 46.8 points (p=0.003) and the mean CFQ score of the ACC group decreased from 52.7 to 45.7 points (p<0.001). This effect remained in both groups at follow-up (T2); respectively p=0.002 and p<0.001.The patients in the AAC also showed an improvement of quality of life directly after the training (T1); i.e. the mean quality of life scores improved from 53 to 57 points (p=0.011), but this effect did not remain at follow-up.This study shows no beneficial effect of an 8-week computerized CT on the primary outcome, i.e, executive functioning. Subjective cognitive functioning did improve in both groups, indicating that frequent cognitive training is advantageous. Future studies with more intensive training could be designed to explore this further.

    Keywords: cognitive training, unipolar depressive disorder, Bipolar Disorder, executive functioning, cognitive impairment, Cognition, older adults, late-life mood-disorders

    Received: 11 Oct 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Oudega, Dols, Wagenmakers, Schouws, Hoogendoorn, Van den Heuvel, Vriend and Palsma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mardien L. Oudega, GGZ inGeest, Amsterdam, Netherlands

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.