Deficits in cognitive control, those abilities that allows one to engage in complex, goal-directed behavior, factor prominently in the functional declines experienced by older adults (OAs). Given that the older human brain still has the capacity to adapt, there is a critical need put into practice evidence-based approaches to help keep these individuals cognitive healthy, productive, and independent. Achieving this goal requires the development of targeted, accessible interventions to slow or reverse declines in these cognitive control processes. However, while telemedicine and internet-based approaches have been shown to be as effective as in-person treatment, there is virtually no known information about the optimal protocols for implementing self-administered mobile cognitive assessments or interventions in community settings like a senior center, or the feasibility of even attempting such efforts. The goal of this R21 is to test the feasibility of a targeted digital health remediation program for the older adults in senior living communities to enhance cognitive control abilities based upon an initial characterization of these abilities. To test this approach, we will use both custom assessments and interventions that are designed to be 100% self-administered via mobile devices. We will collect data from 120 OAs from the Brookline Senior Living communities, the largest owner and operator of senior living communities across the United States (1000+ communities, 100,000+ residents) where the average age of residents are 85 years old. Participating individuals will complete cognitive assessments and be randomly assigned to one of three training groups: directed training (DT), non-directed training (NDT), or an expectancy-matched placebo control group (PC). The total training experience will encompass 6 weeks of training (3 days/week), with each training session lasting ~30 minutes. All groups will complete baseline and immediate follow-up assessments of cognitive and functional outcomes. Evidence of feasibility here using these unique methodological approaches would provide empirical evidence supporting the basis for a larger-scale implementation of such digital health technologies into senior community settings.
Deficits in cognitive control, those abilities that allows one to engage in complex, goal-directed behavior, factor prominently in the functional declines experienced by older adults. The goal of this R21 is to test the feasibility of launching a personalized digital health assessment and remediation program for the older adults in senior living communities based upon an initial characterization of these abilities. Evidence of feasibility here using these unique methodological approaches would provide empirical evidence supporting the basis for a larger- scale implementation of such digital health technologies into less controlled senior settings.
