Computer-based cognitive training for older adults: Determinants of adherence

PLoS One. 2019 Jul 10;14(7):e0219541. doi: 10.1371/journal.pone.0219541. eCollection 2019.


The possibilities of computer-based cognitive training (CCT) in postponing the onset of dementia are currently unclear, but promising. Our aim is to investigate older adults´ adherence to a long-term CCT program, and which participant characteristics are associated with adherence to the CCT. This study was part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Participants were 60-77-year-old individuals with increased dementia risk, recruited from previous population-based studies. The participants included in this study (n = 631) had been randomized to receive a multi-domain lifestyle intervention, including CCT. The measure of adherence was the number of completed CCT sessions (max = 144) as continuous measure. Due to a substantial proportion of participants with 0 sessions, the zero inflated negative binomial regression analyses were used to enable assessment of both predictors of starting the training and predictors of completing a higher number of training sessions. Several cognitive, demographic, lifestyle, and health-related variables were examined as potential predictors of adherence to CCT. Altogether, 63% of the participants participated in the CCT at least once, 20% completed at least half of the training, and 12% completed all sessions. Previous experience with computers, being married or cohabiting, better memory performance, and positive expectations toward the study predicted greater odds for starting CCT. Previous computer use was the only factor associated with a greater number of training sessions completed. Our study shows that there is a large variation in adherence to a long-lasting CCT among older adults with an increased risk of dementia. The results indicate that encouraging computer use, and taking into account the level of cognitive functioning, may help boost adherence to CCT.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / statistics & numerical data*
  • Dementia / prevention & control*
  • Female
  • Finland
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Patient Compliance / statistics & numerical data*
  • Therapy, Computer-Assisted / methods
  • Therapy, Computer-Assisted / statistics & numerical data*
  • Treatment Outcome

Grant support

This work was funded by the Academy of Finland´s Responding to Public Health Challenges Research Programme (SALVE) grants; Academy of Finland 259615, 278457, projects; Academy of Finland for Joint Program of Neurodegenerative Disorders –prevention (MIND-AD); the Finnish Medical Foundation, La Carita Foundation, Alzheimer Association grant (HAT-10-173121); Juho Vainio Foundation; Novo Nordisk Foundation; Finnish Social Insurance Foundation; Ministry of Education and Culture Research Grant; EVO/VTR grants of University Hospitals of Kuopio, Oulu and Turku, Seinäjoki Central Hospital and Oulu City Hospital for FINGER project; Swedish Research Council; Alzheimer´s Research & Prevention Foundation USA; AXA Research Found; the Sheika Salama Bint Hamdan Alahyan Foundation; the Swedish Research Council, the Swedish Research Council for Health, Working Life, and Welfare, Knut and Alice Wallenberg Foundation Sweden; Center for Innovative Medicine (CIMED) at Karolinska Institutet Sweden; Stiftelsen Stockholms sjukhem Sweden, Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse Sweden; an Alexander von Humboldt Research award, and a donation from the af Jochnick Foundation as well as personal grants from Finnish Cultural Foundation Central Found 00161052, Finnish Cultural Foundation Satakunta Regional Fund 75142262, and Juho Vainio Foundation 201410050, 201610032 to MT. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.