Implementing Cognitive Training Research in Older Adults: Randomized Controlled Trial

Year Submitted: 2025
Published Date: 06 November 2025

Tags: Applied/Translational Research, Mental Health, Quality Of Life, Quantitative Research, Care Continuum, Population Health

About this Content

Aims

With the global surge in aging population, there is increasing attention to develop and utilize evidence-based cognitive training programs as potential tools to slow down the age-related cognitive decline. Employing a randomized controlled trial design, we evaluated the efficacy of a pen-paper-based cognitive intervention program on three different cognitive profiles (i.e., cognitively healthy, mild cognitive impairment, and dementia) of older adults in Singapore. This program, namely, Active Brain Learning, was modified from the original cognitive intervention program known as Learning Therapy in Japan. The training components consist of simple arithmetic calculation and reading aloud which were adapted and contextualized to suit the local older adults. Historical influences and sociocultural contexts played significant roles in the development and implementation of the Active Brain Learning program. In this case, we discuss the research and methodological approaches as well as the issues and challenges of evaluating the efficacy of the Active Brain Learning program on cognition and general wellbeing of older adults within the community and in senior daycare facilities. Concerted effort from all stakeholders would be essential toward bridging the gap between research implementation and the ground realities to meet the changing needs of the aging population.

Methods

See Figure 1

Conclusion

It has been a learning experience through trial and error in some way in the efforts to bridge the gap between science and practice to implementation on the ground. In our
conversations with others in the field, we realize that much of the issues and other considerations discussed are more common than uniquely ours. We hope that our sharing could be of benefit to the readers as well as to stimulate more critical thinking and discussions on how we can do better as we learn from each other.

Lessons Learnt

In the case discussion, we have shared a few lessons learned that span across three studies. First, it is important to consider the right sample and the profile of the participants that could have an unintended bearing on the outcomes. For example, the high-functioning sample of participants might translate to limited margin for improvement. In our other study on brain training games in older adults, the right sample to consider might be those who belong to the Fitbit group (i.e., more receptive to technology) or smart phone users. This also shows the multi-pronged intervention approach is essential to cater to the varying needs of older adults across a spectrum of functioning.
Second, it might be necessary to localize and contextualize the training and assessment methods. In the case study, we highlighted the unique profile of the current cohort of local seniors in Singapore with very different educational and cultural background. Taking this into consideration might require modifying the training materials and the careful selection of the appropriate test instruments. Third, we need to consider the most appropriate research design for the studies purpose, and this could mean striving for a judicious balance between ideal versus practical in its implementation, while not compromising the rigor of the research.
Fourth, one of the main goals of cognitive intervention programs is to demonstrate transfer effects as meaningful gains in daily life or delay in cognitive decline. Therefore, careful thought needs to be given to the selection of the right measures to capture the target core cognitive processes and relevant dimensions, while taking into account the contextual factors.
Fifth, the key to implementing a research program on the ground necessarily depends largely on people on the ground. This is one of the greatest challenges, so finding the right
stakeholders to work with and getting the support from the people on the ground is critical.

Keywords

cognitive training program, therapy

Innovators' Details

Connect with this contributor!

Devin Chew Sim Chee - chee_chew_sim@tp.edu.sg

Project Attachment

173_TP_TPCABS_Implementing_Cognitive_Training_Research_in_Older_Adults.pdf