Authors (including presenting author) :
Chan WK, Cheung H, Chan Y, Lau KH, Wong MY, Wong MS
Affiliation :
Department of Family Medicine & Primary Health Care Services
Introduction :
Deficits in attention and working memory are the most common symptoms in older adults with neurocognitive impairment. Early assessment and intervention are important to maintain/enhance their cognitive abilities as far as possible. With the support of HKEC Family Medicine department, Cognitive Assessment and Management program (CAMP) started to commence in 2018 as part of the Occupational Therapy Enhanced Public and Primary Care Service. With the advent of technology and support from senior management, HKEC GOPC was the pioneer to utilize Neurofeedback (NF) training in 4Q2019.
Objectives :
(1) To empower patients’ and caregivers’ knowledge on self-management strategies to maintain/enhance cognitive abilities in the domains of attention and working memory; (2) To enhance patients’ and caregivers’ commitment to engage in prescribed home program by utilizing mobile apps that allows progress tracking for training.
Methodology :
From October 2019 to November 2020, 28 patients were recruited. The training includes 3 sessions each comprises of: education of memory strategies, physical maintenance, and prescription of cognitive-stimulating activities with NF tools. For the last component, each participant wore a non-invasive EEG headband that reflects the user’s real-time mental state while engaging in a Brain-computer interface (BCI) game, “Psychic Cyclist”, where the participant directed the motions/speed of the cyclist through the use of brainwave sensors with no physical movement. Such dynamics encouraged participant to focus and set the stage for subsequent cognitive games. At the last session, account license of the app and a list of suggested games in the domains of attention and working memory were prescribed, as well as the HA Go Cognitive Training. Participants were recommended to make routine engagement to maintain/enhance their cognitive abilities by tracking their progress reports and to progress to higher challenge accordingly.
Result & Outcome :
Default rate of the program was 7%, mainly due to COVID-19. Positive feedback included patient's and caregivers' enjoyment in class dynamics, and appreciation of the service establishment and the application of innovative device were received. 5 patients have completed the post 1-year re-assessment: 4 maintained HK-MoCA >16th percentile while 1 improved from 7th percentile to >16th percentile. ADL impairment mean value in ADLQ-CV decreased from 10.8% to 7.2%. Patients/Caretakers reported good home program compliance. Ongoing evaluations of the other 21 patients in progress for further evaluation of program effectiveness.
Conclusion: BCI-based NF training provides exciting new method in conducting cognitive training in elderly.
