Effects of a 12-Week Hybrid Analog–Digital Cognitive Training on Cognitively Unimpaired Older Adults: A Pilot Single-Blind Randomized Controlled Trial
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Background and Purpose: Global population aging heightens concern about cognitive decline, underscoring the need for scalable interventions. While computerized cognitive training offers benefits, many seniors face device-related challenges that limit adherence, and facility-based programs pose logistical barriers. To address these, we evaluated a 12-week home-based Hybrid Analog–Digital Cognitive Training (HCT) program, which paired a sensor-embedded, pressure-sensitive paper workbook with a Bluetooth-linked television, to enhance usability and engagement among cognitively unimpaired (CU) older adults. Methods: In this single-blind, randomized controlled trial, 66 CU adults aged ≥60 years were allocated to HCT or control (each n=33) groups. Participants had literacy and Korean Mini-Mental State Examination scores above −1.5 standard deviation. The HCT group performed 30-minute sessions 5 times weekly for 12 weeks, while controls continued usual activities. Primary outcomes were changes in composite Z-scores for frontal, attention, and memory domains, derived from the Cambridge Neuropsychological Testing Automated Battery. Z-scores were direction-weighted and aggregated by domain. Between-group differences were analyzed using linear mixed-effects models. Results: Baseline characteristics were similar between groups. After 12 weeks, the HCT group showed a significant group × visit interaction in the frontal domain (estimate, 0.29; standard error, 0.13; p=0.03), indicating improved executive function. No significant differences were found in attention or memory domains. Also, the HCT group exhibited improvements in psychological profiles. Conclusions: A home-based HCT program improved frontal executive function in CU older adults. The hybrid analog-digital design may help reduce digital barriers, support usability, and foster sustained participation. Larger trials with active controls, modality-specific comparators, and extended follow-up are warranted to confirm benefits and optimize delivery. Trial Registration: Clinical Research Information Service Identifier: KCT0007922
Abstract
Background and Purpose: Global population aging heightens concern about cognitive decline, underscoring the need for scalable interventions. While computerized cognitive training offers benefits, many seniors face device-related challenges that limit adherence, and facility-based programs pose logistical barriers. To address these, we evaluated a 12-week home-based Hybrid Analog–Digital Cognitive Training (HCT) program, which paired a sensor-embedded, pressure-sensitive paper workbook with a Bluetooth-linked television, to enhance usability and engagement among cognitively unimpaired (CU) older adults. Methods: In this single-blind, randomized controlled trial, 66 CU adults aged ≥60 years were allocated to HCT or control (each n=33) groups. Participants had literacy and Korean Mini-Mental State Examination scores above −1.5 standard deviation. The HCT group performed 30-minute sessions 5 times weekly for 12 weeks, while controls continued usual activities. Primary outcomes were changes in composite Z-scores for frontal, attention, and memory domains, derived from the Cambridge Neuropsychological Testing Automated Battery. Z-scores were direction-weighted and aggregated by domain. Between-group differences were analyzed using linear mixed-effects models. Results: Baseline characteristics were similar between groups. After 12 weeks, the HCT group showed a significant group × visit interaction in the frontal domain (estimate, 0.29; standard error, 0.13; p=0.03), indicating improved executive function. No significant differences were found in attention or memory domains. Also, the HCT group exhibited improvements in psychological profiles. Conclusions: A home-based HCT program improved frontal executive function in CU older adults. The hybrid analog-digital design may help reduce digital barriers, support usability, and foster sustained participation. Larger trials with active controls, modality-specific comparators, and extended follow-up are warranted to confirm benefits and optimize delivery. Trial Registration: Clinical Research Information Service Identifier: KCT0007922