Web-enabled Conversational Interactions as a Method to Improve Cognitive Functions: Results of a 6-week Randomized Controlled Trial

Introduction Increasing social interaction could be a promising intervention for improving cognitive function. We examined the feasibility of a randomized controlled trial to assess whether conversation-based cognitive stimulation through personal computers, webcams, and a user-friendly interactive Internet interface had high adherence and a positive effect on cognitive function among older adults without dementia. Methods Daily 30-minute face-to-face communications were conducted during a 6-week trial period in the intervention group. The control group received only a weekly telephone interview. The cognitive status of normal subjects and those with mild cognitive impairment was operationally defined as a global clinical dementia rating of 0 and 0.5, respectively. Age, sex, education, mini mental state examination score, and clinical dementia rating score were balancing factors in randomization. The subjects were recruited using mass-mailing invitations. The pre- to postintervention differences in the cognitive test scores and loneliness scores were compared between the control and intervention groups using linear regression models. Results Eighty-three subjects participated (41 in the intervention group and 42 in the control group). Their mean ± standard deviation age was 80.5 ± 6.8 years. Adherence to the protocol was high. There was no dropout and mean percentage of days completed of the targeted trial days among the intervention group was 89% (range 77%-100%). Among the cognitively intact participants, the intervention group improved more than did the control group on a semantic fluency test (P =.003) at the post-trial assessment and a phonemic fluency test (P =.004) at the 18-week assessments. Among those with mild cognitive impairment, a trend (P =.04) toward improved psychomotor speed was observed in the intervention group. Conclusion Daily conversations by way of user-friendly Internet communication programs demonstrated high adherence. Among the cognitively intact, the intervention group showed greater improvement in tests of language-based executive functions. Increasing daily social contacts through communication technologies could offer cost-effective home-based prevention methods. Additional studies with a longer follow-up duration are required to examine whether the intervention slows cognitive declines and delays the onset of dementia.