Page 106 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP1.3 Patient Empowerment 10:45 Room 221

Monday, 18 May Evaluating the Sustainability of Computer-based Cognitive Training Programme for Older Adults with Cognitive
Decline Managed in Hong Kong Primary Care Setting
Leung WT 1,Hui KY 1, Ma HY 1, Ho CM 1, Lee KY 1, Ma WL1, Leung KF 1, Chan SL 2, Chan KHK 2
1Department of Occupational Therapy, 2Department of Family Medicine and General Outpatient Clinic,

Queen Elizabeth Hospital, Hong Kong

Introduction

Primary care settings were viewed as the place providing early detection and intervention for people with cognitive
complaints and impairment. Occupational therapy service was introduced in Kowloon Central Cluster (KCC) Enhancement
of Public Primary Care Service (EPPS) since 2012. Cognitive assessment and training accounted for one third of the total
referrals of the service. A modified computer-based cognitive training programme was found to be effective to improve older
adults’ cognitive function in study conducted in 2014 by our centre, the result was consistent with other recent published
studies.

Objectives
To evaluate the sustainability of the cognitive function after joining a computer-based cognitive training for six months.

Methodology

A retrospective study was conducted to clients who were referred for cognitive assessment and training from March 2013
to April 2014. Modified computer-based cognitive training programme (eight sessions per week) was developed by our
centre. The programme contained multiple cognitive domains, e.g. attention, memory, logical reasoning. Clients were aged
65 or above, with self-reported memory problem in daily living, and had Chinese Mini Mental State Examination (CMMSE)
score from 13 to 29 (13 to 22: suspected dementia; 23 to 29: suspected mild cognitive impairment). The intervention group
completed a computer-based cognitive training programme, then followed-up with a six-month cognitive reassessment. The
control group declined computer-based cognitive training, only completed a six-month cognitive reassessment. Chinese Mini
Mental State Examination (CMMSE) and Everyday Memory Questionnaire (EMQ) were the outcome measures.

Results

A total of 44 clients completed the six-month cognitive reassessment were analysed. 72.7% were female. 50% of them
were suffered from two or more comorbid chronic illnesses, e.g. hypertension, diabetics. 18 of them were in the intervention
group. Regarding the EMQ scores, the baseline was 6.32 which indicated moderate influence on clients’ daily living.
Comparisons of CMMSE and EMQ at baseline and six-month follow-up within the intervention group and control group were
conducted respectively. There was no significant difference found within the intervention group (baseline CMMSE score:
22.94; six-month CMMSE score: 23.94; t= -2.068, p=0.053), this indicated that clients’ cognitive function could be sustained
at six-month interval. In contrast, significant difference was noted within control group (baseline CMMSE score: 19.73;
6-month CMMSE score: 18.42; t=3.485, p=0.002), their cognitive function deteriorated after six months. However, there was
no significant difference found in EMQ within both groups respectively. Our modified computer-based cognitive training
programme shows promising effects in sustaining cognitive function for six months in older adults.

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