The goal of this research is to learn more about individual difference predictors when it comes to adherent behavior by looking at cognitive training in older adults across two phases to uncover motivational factors related to the intervention and the individual to understand why some people may abandon technology-based training over time. Before and after training a variety of outcome measures will be assessed based on an abstracted model of technology-based intervention adherence designed to predict factors that will have the greatest impact on adherence. Participants will also be exposed to different messages and strategies to promote adherence. In the first phase of the study participants will be provided with a recommended adherence schedule that will require them to engage in 40 hours of brain training over two months. This will be compared to adherent behavior during the second phase in which participants will be allowed to conform to their own adherence schedule engaging in as little or as much brain training as they want for one month. The inclusion of these two phases are guided by pilot data which suggest that individuals are willing to invest a significant amount of time each day playing brain games to remain in their own homes and independent longer. The time schedule for these two phases are based on a review and synthesis of the literature which explored individual difference factors across interventions of varying length and the corresponding drop-out rates from recruitment to debriefing. Effective treatments for cognitive decline have the potential to alleviate the costs associated with caring for older adults when cognitive changes no longer allow them to live independently, and preserved cognition late in life may mean fewer older adults in assisted care facilities, fewer older adults involved in automobile crashes, and perhaps fewer older adults experiencing dangerous medical errors due to the mismanagement of medication. The results of this study will serve to provide much needed information about adherence implications for predicting the adoption of, and adherence to, potentially effective treatments for cognitive decline.
As a result of increases in life-expectancy, and with it an associated increase in the occurrence of neurodegenerative diseases (Ferri et al., 2005; Brookmeyer et al., 2011; Reitz et al., 2011), identifying factors that might protect older adults from cognitive decline is of growing urgency. Literatures related to health behavior indicate that maintaining adherence can be extremely challenging (Tamblyn et al., 2014; Andrade et al., 1995); therefore, it is reasonable to expect that cognitive interventions will face the same, if not greater, challenges with respect to adoption and adherence. By exploring the factors that might influence adherence to technology-based cognitive training interventions, important questions can be answered to help determine whether these interventions are a viable solution for addressing the challenges of cognitive aging.
