Outcomes of a computer-based cognitive training (CoRe) in early phases of cognitive decline: a data-driven cluster analysis

Abstract

The present study aimed to identify clusters of cognitive profiles as well as to explore the effects of these clusters on demographic/individual characteristics and on improvements after a computer-based cognitive training (CCT) in early cognitive impairment. Fifty-seven subjects underwent to an adaptive CCT for 3 weeks (4 individual face-to-face sessions/week of 45 min) and were evaluated at baseline (T0), post-intervention (T1), and after 6 (T2) and 12 (T3) months. Clusters of cognitive profiles were explored with k-means analysis. The analysis revealed two clusters, which were composed by 27 and 30 patients characterized by lower (Cluster 1) and higher (Cluster 2) cognitive functioning. At T1, cognitive performance improved in both groups, but Cluster 1 gained more benefits in global cognitive functioning than Cluster 2. However, at T3, Cluster 2 remained stable in its clinical condition, whereas Cluster 1 showed a pronounced worsening. In conclusion, Cluster 1 profile was associated with a more marked but also short-lasting responsiveness to CCT, whereas patients fitting with Cluster 2 characteristics seemed to obtain more CCT benefits in terms of stability or even delay of cognitive/functional decline. These findings may have relevant implications in informing the timing and modality of delivery of CCT.

Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy

“…An adequate evaluation of the personalized options for each use is warranted. A remote supervised control may be implemented (Bernini et al, 2023a ). Specific adaptations, suitability investigations, and satisfaction experiences should be relevantly issued within this framework (Bernini et al, 2023b ).…”

Exploring the neural and behavioral correlates of cognitive telerehabilitation in mild cognitive impairment with three distinct approaches

“…This is a software for cognitive TR especially developed for the initial stages of decline (amnestic MCI, MCI-PD, mild AD). HomeCore has been developed starting from a validated in-person computer-based cognitive intervention (CoRe) the efficacy of which in the short and long term has been verified in outpatients’ hospital services also in combination with neuromodulatory techniques ( Alloni et al, 2017 , 2018 ; Bernini et al, 2019 , 2021 , 2023 ; Rodella et al, 2022 ). HomeCoRe is an adaptive patient-tailored treatment focused on training memory and logical-executive functions that provides a Weighted Score of performance for each exercise and each session to monitor patients’ progress remotely and to adjust automatically the level of exercise difficulty accordingly.…”

“…The software provides an easy-to -access platform that patients interact with via a touch screen. Usability and acceptance of HomeCoRe have already been tested in a small group of patients with MCI due to a neurodegenerative disease ( Bernini et al, 2023 ).…”

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

“…For instance, it has been shown in the field of Parkinson’s Disease (PD) that some socio-demographic variables, such as age and education, could be moderator of differences in the efficacy of an in-P CT ( Sanchez-Luengos et al, 2021 ). Also cognitive functioning prior to receive CT may predict the outcome of the intervention: lower cognitive profiles resulted associated to more marked (but short-lasting) responsiveness to a computer-based CT ( Bernini et al, 2023 ). Moreover, an active lifestyle may be a determining factor in cognitive rehabilitation given that it can help in increasing attendance and participation in sessions and achieving positive results, as demonstrated in older adults at risk of dementia receiving CT ( Küster et al, 2016 ).…”

“…In the last years, our group has devised and implemented a cognitive rehabilitation (CoRe) software for an in-person computerbased CT (Alloni et al, 2017(Alloni et al, , 2018. CoRe was effective in restoring lost brain function and slowing degenerative diseases in early cognitive decline, compared with traditional interventions (Bernini et al, 2019(Bernini et al, , 2021a(Bernini et al, , 2023Rodella et al, 2021). With a view to starting/continuing the CoRe program remotely (Quaglini et al, 2019), we have recently developed a "home" version (called HomeCoRe), able to provide a cognitive intervention directly at home (Bernini et al, 2021b,c).…”