Does computerized cognitive training improve diabetes self-management and cognition? A randomized control trial of middle-aged and older veterans with type 2 diabetes. (January 2023)

• Record Type: Journal Article
• Authors: Silverman, Jeremy M.; Zhu, Carolyn W.; Schmeidler, James; Lee, Pearl G.; Alexander, Neil B.; Guerrero-Berroa, Elizabeth; Beeri, Michal S.; West, Rebecca K.; Sano, Mary; Nabozny, Martina; Karran, Martha
• Is Part Of: Diabetes research and clinical practice. Volume 195(2023)
• Publication Date: 2023-01
• Subjects: Cognitive decline -- Computerized cognitive training -- Diabetes self-management -- Intact cognition -- Mild cognitive impairment -- Veterans; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.110149
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Type 2 diabetes (T2D) is a risk factor for cognitive decline. Cognitive decline, in turn, contributes to poor diabetes self-management. Computerized cognitive training (CCT) aims to enhance/maintain cognitive function. While adaptive CCT did not outperform non-adaptive CCT, both improved self-management. Combined CCT groups had many cognitive and T2D-related improvements 6 months later. Abstract: Aims: This randomized control trial compared an adaptive computerized cognitive training intervention with a non-adaptive version. The primary hypothesis predicted better diabetes self-management in type 2 diabetes patients at 6 months post-intervention than baseline in the adaptive arm, with seven secondary outcomes. Methods: Intent-to-treat analysis of veterans without dementia aged 55+ from the Bronx, NY and Ann Arbor, MI (N = 90/per arm) used linear mixed model analyses. Results: Contrary to the hypothesis, only memory showed more improvement in the adaptive arm (p < 0.01). Post-hoc analyses combined the two arms; self-management improved at six-months post-intervention (p < 0.001). Memory, executive functions/attention, prospective memory, diastolic blood pressure, and systolic blood pressure improved (p < 0.05); hemoglobin A1c and medication adherence did not improve significantly. Conclusions: The adaptive computerized cognitive training was not substantially better than non-adaptive, but may improve memory. Post-hoc results for the combined arms suggest computer-related activities may improve diabetes self-management and other outcomes for middle-aged and older patients with type 2 diabetes. Practice effects or awareness of being studied cannot be ruled out.