Assessing and Improving the Durability of Compensatory Cognitive Training for Older Veterans

Summary

Veterans have numerous risk factors (e.g., Post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), cerebrovascular problems) for later-life cognitive and functional decline. Evidence supports the effectiveness of strategy-based cognitive rehabilitation therapies, including compensatory cognitive training (CCT), for such decline. However, questions remain about the length of time that CCT-driven improvements in cognitive and everyday function last, and whether additional 'booster' training sessions could provide additional benefit to aging Veterans who previously underwent treatment. This study examines the long-term durability of CCT in Veterans aged 55+ and provides an opportunity to develop and pilot test a series of CCT booster sessions that can be personalized toward individual everyday functional goals.

Interventions

• Motivationally-Enhanced Compensatory Cognitive Training (ME-CCT) Booster Modules · BEHAVIORAL

  ME-CCT is a traditionally a manualized group-based behavioral intervention (8 weeks, 2 hours per week) designed to improve cognitive and everyday functioning in patients with Mild Cognitive Impairment (MCI). Our booster modules will be shortened and distilled from ME-CCT using the IM Adapt protocol (and thus will not be new information but rather 'reminder' content) for a personalized four-session sequence of booster training targeted toward specific everyday functional needs of individual participants.

• Treatment As Usual · OTHER

  Treatment for MCI is generally managed by Primary Care or Neurology. Participants will continue to receive their usual care with their current providers. With no effective pharmacological treatment known for persons with MCI, providers tend to focus on encouraging a healthy lifestyle, prevention and management of modifiable risk factors for cognitive impairment, and treatment of behavioral and psychiatric symptoms.

Published eligibility criteria

Verbatim from the registry. Only the site can decide how these apply to a specific patient.

Inclusion Criteria:

* Veterans aged 55 and older who are able to provide informed consent
* Previous completion of the "Cognitive Rehabilitation for Older Veterans with Mild Cognitive Impairment" \[PI: Twamley, VA CSRD: I01CX001592\] study and received the ME-CCT intervention
* Independently living
* English-speaking: this is necessary to complete cognitive and functional testing and participate in booster development and other study procedures

Exclusion Criteria:

* Participation in sub-study 2 of this CDA, in which study participants assist with the design of booster intervention modules
* DSM-5 criteria for current substance use disorder and has been substance abstinent for less than 30 days
* History of schizophrenia, schizoaffective disorder, or other primary psychotic disorder
* History of significant brain injury with loss of consciousness \>30 minutes
* Auditory or visual impairments that would prevent ability to participate in booster sessions or ability to benefit from compensatory strategies

Sites (1)

• VA San Diego Healthcare System, San Diego, CA, San Diego, California