Plasticity-based Adaptive Cognitive Remediation for Alzheimer Disease

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DESCRIPTION (provided by applicant): The primary objective of the current project is to develop and evaluate the efficacy of on-line brain plasticity-based computerized assessment tool and training program for the prevention and delay of the onset of Alzheimer's disease (AD). This novel therapeutic strategy is designed to re-connect and reinvigorate Default Network (DN) brain areas by 1) increasing feed-forward power in brain systems in ways that are designed to reactivate them, and by 2) directly exercising highest-level neurological (DN) processes. Computerized assessments will be embedded in the exercise suite to further document the status of 1) DN levels of operation in the brain, 2) the complex systems that support them, and 3) important near- and far-transfer targets for training. Also, brief self-report of lifestyle stats and change provided via weekly self-rated evaluations related to health status, physical exercise, social activities, diet, sleep, mood, and self-efficacy shall provide data useful both fo evaluating real-world outcomes and product model acceptability. In the first specific aim, we will organize a series of small focus groups composed of normally aged adults to discuss and play various computer games and cognitive training programs. Based on questionnaires from and discussions with these focus groups, we will define a set of enhancements to make the user experience and the game play sufficient to motivate the forty hours of program. We will then employ established methods of software design and development and iteratively refine the implemented design to complete the development of the enhanced program for a feasibility trial conducted locally, in collaboration with the research team at the University of Iowa. Given the ease of access of online-based assessment and training, this project should result in the development of a new, powerful tool to assess and prevent the risk of onset of AD, and to provide effective adjunctive therapy those results in far greater resilience against cognitive impairment in a substantially greater pre-AD population.