In person versus remote cognitive rehabilitation in patients with subjective cognitive decline or neurocognitive disorders: what factors drive patient’s preference?

Abstract

BackgroundTo date, there is still a lack of consensus for identifying the ideal candidate for cognitive telerehabilitation (TR). The main goal of the present study is to identify the factors associated to the preference for either TR or in-person cognitive training (CT) programs in older adults at risk of dementia or with early cognitive impairment.MethodsA sample of 56 participants with subjective cognitive decline or neurocognitive disorders eligible for CT were enrolled at the Dementia Research Center and Neurorehabilitation Unit of IRCCS Mondino Foundation. All individuals underwent a baseline assessment to capture their complete profile, including cognitive reserve and lifestyle habits, sociodemographic characteristics, cognitive functioning, and mental health. Patients were then asked their preference for TR or in-person CT, before being randomized to either treatment as per protocol procedures. Statistical analyses included explorative descriptive approach, logistic regression, and non-parametric models to explore the overall contribution of each variable.ResultsThe two (TR and in-person) preference groups were similar for cognitive functioning and mental health status. Socio-demographic and lifestyle profiles seem to be the most important factors to influence the preference in terms of the area under the curve (AUC) of the models. The two preference groups differed in terms of socio-demographic characteristics (e.g., level of technological skills, age, and distance from the clinic). Furthermore, participants who selected the TR modality of CT had significantly higher levels of cognitive reserve and adopted more protective lifestyle habits (e.g., regular physical activity, Mediterranean diet) when compared to those who preferred in-person CT.DiscussionThese findings highlight that the preference to receive CT delivered by TR or in person is a complex issue and is influenced by a variety of factors, mostly related to lifestyle habits and sociodemographic characteristics. Availability of profiles of patients that may be more attracted to one or the other modality of TR may help promote shared decision-making to enhance patient experience and outcomes.

Exploring cognitive reserve’s influence: unveiling the dynamics of digital telerehabilitation in Parkinson’s Disease Resilience

“…Previous studies revealed the role of demographics, clinical conditions and psychosocial variables in modulating rehabilitation outcomes 1 – 4 . Besides these factors, the latest evidence supported the role of life-long stimulating activities in influencing patients’ attitudes and responses to non-pharmacological interventions in neurological disorders 4 – 10 . Especially, patients with higher education, higher cognitive commitment to working activities, and spending more time in stimulating leisure activities may rely on greater cognitive and neural reserve during a rehabilitation program.…”

“…Life-long exposure to cognitively stimulating activities seems to have a role in enhancing the treatment beneficial effects on both cognitive and motor functions, probably due to the engagement of multimodal domains (e.g. 5 , 10 ). In particular, cognitively stimulating leisure activities such as social activities (for example, going to museums and traveling), and physical activities (for example, sports and dancing), involve the motor-cognitive functions interplay.…”

Exploring cognitive reserve's influence: unveiling the dynamics of digital telerehabilitation in Parkinson's Disease Resilience

“…Previous studies revealed the role of demographics, clinical conditions and psychosocial variables in modulating rehabilitation outcomes [1][2][3][4] . Besides these factors, latest evidence supported the role of life-long stimulating activities in in uencing patients' attitude and response to nonpharmacological interventions in neurological disorders [4][5][6][7][8][9][10] . Especially, patients with higher education, higher cognitive commitment in working activities and spending more time in stimulating leisure activities may rely on greater cognitive and neural reserve during a rehabilitation program.…”

“…Especially, patients with higher education, higher cognitive commitment in working activities and spending more time in stimulating leisure activities may rely on greater cognitive and neural reserve during a rehabilitation program. The life-long exposure to cognitive stimulating activities seems to have a role in enhancing the treatment bene cial effects on both cognitive and motor functions, probably due to the engagement of multimodal domains (e.g., 5,6,10 ). In particular, cognitive stimulating leisure activities such as social activities (for example, going to museums, travelling), and physical activities (for example, sports, dancing), involve the motorcognitive functions interplay.…”