Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease

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Publicado en:Alzheimer's & Dementia vol. 21 (Dec 1, 2025)
Autor principal: Brill, Esther
Otros Autores: Holfelder, Alexa Frederike, Falkner, Michael, Krebs, Christine R., Brem, Anna‐Katharine, Klöppel, Stefan
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John Wiley & Sons, Inc.
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Acceso en línea:Citation/Abstract
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022 |a 1552-5260 
022 |a 1552-5279 
024 7 |a 10.1002/alz70857_102105  |2 doi 
035 |a 3286757212 
045 0 |b d20251201 
100 1 |a Brill, Esther  |u University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Bern, Switzerland, 
245 1 |a Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease 
260 |b John Wiley & Sons, Inc.  |c Dec 1, 2025 
513 |a Journal Article 
520 3 |a Background Subjective cognitive decline (SCD) and Mild Cognitive Impairment (MCI) have predictive value towards Alzheimer's Disease and lend themselves as target for non‐pharmacological preventive interventions such as serious game‐based computerized cognitive training (CCT). However, investigations of CCT show heterogenous results in slowing age‐and disease‐related cognitive decline and adherence to training protocols remain a challenge. The aim of this RCT was to comprehensively evaluate CCTs’ effectiveness, integrating control conditions and neurophysiological as well as blood‐based biomarkers. Method In this bi‐centric RCT with parallel groups, 155 participants (mean age 72.2) with cognitive impairment ranging from SCD to MCI were randomized to three arms, comparing CCT to an active control condition (watching documentaries) and a waitlist control condition. Both active arms entailed a three‐month intervention period comprising a total of 60 at‐home sessions (5 sessions per week) and weekly on‐site group meetings. To assess longitudinal effects, the intervention group only completed additional 6 months of at‐home training with monthly on‐site booster sessions. Biological effects were measured by amyloid blood markers and magnetic resonance imaging obtained before and after training. Result Significant improvement over time was observed in aggregated domain specific composite scores of episodic and semantic memory and spatial abilities. However, there was no significant interaction between groups and timepoints. Adherence to the training protocol was consistently high across timepoints and groups (4.87 sessions per week). Voxel‐based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness. Significant cognitive and subjective improvements were observed after long‐term training. Conclusion This RCT indicates no specific advantages of a three‐month CCT intervention on cognitive or biological outcomes. However, the consistently high adherence rates observed in this study highlight the importance of designing interventions that align with personal relevance and individual values, particularly in subjects with SCD and MCI who demonstrated high motivation to engage in healthy aging behaviors. Further, positive effects were observed subjectively and after long‐term CCT, warranting the inclusion of CCT in multicomponent interventions. 
653 |a Relevance 
653 |a Adherence 
653 |a Intervention 
653 |a Semantic memory 
653 |a Alzheimer's disease 
653 |a Training 
653 |a Subjectivity 
653 |a Politics 
653 |a Blood 
653 |a Magnetic resonance imaging 
653 |a Games 
653 |a Cognition 
653 |a Cognitive ability 
653 |a Cognitive impairment 
653 |a Aging 
653 |a Cognitive skills training 
653 |a Motivation 
653 |a Biological markers 
653 |a Disease 
653 |a Computerization 
653 |a Groups 
700 1 |a Holfelder, Alexa Frederike  |u University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Bern, Switzerland, 
700 1 |a Falkner, Michael  |u ARTORG, University of Bern, Bern, Switzerland, 
700 1 |a Krebs, Christine R.  |u University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Bern, Switzerland, 
700 1 |a Brem, Anna‐Katharine  |u King's College London, London, United Kingdom, 
700 1 |a Klöppel, Stefan  |u University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Bern, Switzerland, 
773 0 |t Alzheimer's & Dementia  |g vol. 21 (Dec 1, 2025) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3286757212/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3286757212/fulltext/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3286757212/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch