The Effects of Integrated Attention Training for Older Chinese Adults With Subjective Cognitive Complaints: A Randomized Controlled Study

Abstract

Objective: Early intervention to reduce cognitive decline and preserve functioning is a compelling public health issue. Because impaired attention occurs early in the process of cognitive impairment, focusing training strategies upon attention may be a potential intervention to prevent further cognitive decline. We sought to test the effects on cognitive performance and daily functioning of a new cognitive training program that focuses on attention. Method: This single-blind randomized controlled trial lasted 6 months and included two phases. Assessments were conducted at baseline, at 3 months, and at 6 months. The study was performed in four community older adult centers. Ninety-three participants with subjective cognitive impairment without dementia were included. Forty-seven participants were randomized to the Integrated Attention Training Program (IATP), and 46 were randomized to the control group. The two arms of the study included the IATP (intervention group) and a health-related education program (active control group). Results: No significant interactions were identified between group and time for the Clinical Dementia Rating–Sum of Boxes and other secondary outcomes, except for the Digit Forward Score (p < .05; effect size, 0.057). When the preintervention and postintervention results were compared, the IATP group showed significant improvement in grand mean effect (p < .05) and accuracy (p < .05) in the Attention Network Test, Digit Backward Score (p < .05), Category Verbal Fluency Test (p < .05), and Trail Making Test A (p < .01) immediately after the intervention. These improvements were sustained 3 months after the intervention. Conclusion: The IATP showed domain-specific effects but had no effects on global cognition or functioning. It could not show a superior benefit in cognition and functioning when compared with non-specific mental stimulation in a group format. Further studies are needed to determine the role of attention in cognitive training.