Effects of Adaptive Difficulty Computerized Cognitive Training on Cognitive Function Improvement in Older Adults With Mild Cognitive Impairment

With the rapid aging of the global population, mild cognitive impairment (MCI) has become a critical stage for dementia prevention and early intervention. Cognitive training is recognized as one of the most effective non-pharmacological interventions for individuals with MCI. Among various approaches, adaptive computerized cognitive training (CCT) can dynamically adjust task difficulty according to an individual's performance, thereby improving training personalization, engagement, and adherence. However, evidence regarding the optimal maintenance training frequency and the long-term sustainability of cognitive benefits remains limited.

This study adopts a quasi-experimental design and will recruit community-dwelling adults aged 60 years and older with MCI from three communities in Shenyang, Liaoning Province, China. All participants will complete a 12-week adaptive computerized cognitive training program using the Heling Brain Planet WeChat mini-program, with training sessions lasting 30 minutes, three times per week. After the initial intervention, participants will be assigned to either a high-frequency maintenance training group, which will continue training three times per week, or a training discontinuation group, which will receive routine community health management only. Follow-up cognitive assessments will be conducted after the intervention and during the follow-up period.

The primary outcome will be global cognitive function assessed by the Montreal Cognitive Assessment (MoCA). Secondary outcomes will include memory (Auditory Verbal Learning Test, AVLT), attention (Trail Making Test Part A, TMT-A), executive function (Stroop Color-Word Test), language (Boston Naming Test, BNT), visuospatial ability (Clock Drawing Test, CDT), and activities of daily living (ADL). The effects of different maintenance training frequencies on cognitive improvement and the persistence of intervention benefits will be compared.

This study is expected to evaluate the effectiveness of adaptive computerized cognitive training for improving cognitive function in community-dwelling older adults with MCI and to determine whether continued maintenance training can prolong cognitive benefits. The findings will provide evidence for optimizing community-based digital cognitive training programs and developing sustainable intervention strategies for the long-term management of older adults with MCI.

Inclusion criteria

• Age >= 60 years;
• Planning to reside in the community for at least 12 months, with no intention to move into a nursing home;
• No clinical diagnosis of dementia;
• Meeting the diagnostic criteria for mild cognitive impairment (MCI) as defined in the Chinese Expert Consensus on the Diagnosis and Treatment of Alzheimer's Disease-Related Mild Cognitive Impairment (2021), The cut-off scores for the Beijing version of the Montreal Cognitive Assessment (MoCA) were adjusted for educational level: <=13 for junior high school or below, <=19 for high school, and <=24 for college education or above. Mini-Mental State Examination (MMSE) score >= 24; Activities of Daily Living (ADL) score <23.
• Able to use a mobile application (mini program) to perform cognitive training.

Exclusion criteria

• Individuals unable to complete the questionnaires due to hearing or visual impairments;
• Those with other organic diseases of the central nervous system, such as brain tumors, epilepsy, or Parkinson's disease;
• Those diagnosed with severe mental disorders, such as schizophrenia, depression, or anxiety disorders.