Cognitive training using a novel memory game on an iPad in patients with amnestic mild cognitive impairment (aMCI)

Background: Cognitive training is effective in patients with mild cognitive impairment (MCI), but does not typically address the motivational deficits associated with older populations with memory difficulties.

Method: Randomised controlled trial of cognitive training using a novel memory game on an iPad in 42 patients with a diagnosis of amnestic MCI (aMCI) assigned to either the Cognitive Training (n=21; eight hours of gameplay over four weeks) or Control (n=21; clinic visits as usual) groups.

Results: Significant Time-by-Pattern-by-Group interactions were found for cognitive performance in terms of the number of errors made and trials needed on the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning task (CANTAB PAL) (p=.044; p=.027). Significant Time-by-Group interactions were also found for the CANTAB PAL first trial memory score (p=.002), Mini-Mental State Examination (MMSE; p=.036), the Brief Visuospatial Memory Test (BVMT-R p=.032) and the Apathy Evaluation Scale (AES; p=.026). Within-group comparisons revealed highly specific effects of cognitive training on episodic memory. The Cognitive Training group maintained high levels of enjoyment and motivation to continue after each hour of gameplay, with self-confidence and self-rated memory ability improving over time.

Conclusions: Episodic memory robustly improved in the Cognitive Training group. ‘Gamified’ cognitive training may also enhance visuospatial abilities in patients with aMCI. ‘Gamification’ maximizes engagement with cognitive training by increasing motivation and could complement pharmacological treatments for aMCI and mild Alzheimer’s disease. Larger, more controlled trials are needed to replicate and extend these findings.