Evaluation of the effectiveness of a preventive program focused on cognitive stimulation and physical exercise in virtual reality in people with mild cognitive impairment or subjective cognitive decline

TARGETS: An association exists between vascular and lifestyle modifiable risk factors and incident dementia. Many clinical trials have been started to provide evidence of the effectiveness of interventions aimed at these risk factors in preventing or postponing dementia onset, and multidomain approaches seem to be more effective than single-factor strategies. Virtual Reality (VR) is an innovative approach in neuroscience, that could be feasible and effective for intervention. GR-2013-02356043 is a RCT with 2X2 factorial design, to evaluate the separate and combined effect of cognitive stimulation (CS) and physical exercise (PE) in VR in delaying dementia onset or reduce cognitive and functional progression in 320 people with MCI OR SCD. METHODS: Here we present the results of analyses that compared the sub-samples subjected to training in VR and the outpatient control group (80 participants aged â?¥ 60 yrs). Each subject was twice randomized to receive CS/NO CS and PE/NO PE. The training provided twice-weekly sessions of CS and/or PE for 12 weeks. A complete neuropsychological and functional evaluation was performed at baseline (t0), post-training (t1) and 4 months after (t2). Mixed factor ANOVA (4 groups, 3 times) on ITT-LOCF data were conducted, corrected for demographics and baseline MMSE scores. RESULTS: 59 (73.8%) and 44 (55,0%) participants underwent t1 and t2 evaluations. Analyses showed significant group differences in Immediate and delayed recall of a short story (IR and DR: F3,74 = 2.94; p = 0.04 and F 3,74 = 3.11; p = 0.03) scores. Planned contrasts revealed significant differences at t2 between controls and CS+PE groups in IR (T(38) = 2,76; p < 0,01) and DR scores (t(38) = 2.00; p = 00.45) and between controls and CS groups in DR (T(38) = 2.15; p = 0.03). CONCLUSIONS: CS and CS+PE seem to exert mild effects ON memory performances that appear after a time from treatment. Caution in the interpretation is required due to high drop-out rates; however, the conservativeness of statistical analyses it presumably implies an underestimation of these effects, compared to their real extent.