Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Lee T(1), Tsui PY (1), Lau FC, Andy (1), Leung KH (1)
Affiliation :
(1) Occupational Therapy Department, Pok Oi Hospital
Introduction :
Introduction: Woods et al. (2023) have indicated that cognitive training is an effective non-pharmacological treatment for patients with mild cognitive impairment (MCI) and dementia. Bodner et al. (2020) highlighted the effectiveness of computerized cognitive training in improving global cognition of such patients. In recent years, the Hong Kong Hospital Authority has actively developed TeleHealth service, e.g. establishing mobile app HA Go. The mobile app also incorporated elements of rehabilitation, such as prescription of cognitive training by Occupational Therapist to suitable patients through HA Go as one of the home-based programs. There are two types of cognitive training: N-Back, which is specifically for working memory training, and the other is Task Switching, which focuses on attention and executive function training. Given the effectiveness and practicality, the Occupational Therapy Department at Pok Oi Hospital (POH) has prescribed Cognitive training to patients with MCI, mild dementia or moderate dementia via HA Go in accordance with the patient's needs.
Objectives :
Objective: This retrospective study aims to evaluate the effectiveness of regular cognitive training via HA Go on enhancing cognitive function in patients with MCI or mild to moderate dementia.
Methodology :
Methodology: The Montreal Assessment Hong Kong version (HK-MoCA) was used to assess cognitive function; Functional Assessment Staging Tool(FAST) was used to monitor the progression of dementia. During the period of 2022, a total of 27 patients fulfilled the following criteria: 1.Referred for cognitive assessment and training in Occupational Therapy out-patient department; 2. Assessed as having features of MCI or mild to moderate dementia by using FAST; 3. Attended at least 2 sessions of Occupational therapy treatment sessions; 4. Suitable and willing to undergo cognitive training via HA Go. To define regular cognitive training, patients should complete HA Go cognitive training at least once per week, which means a minimum compliance rate should be 20%.
Result & Outcome :
Result: Among all 27 patients, there were 10 male (37%) and 17 female (63%). Their ages ranged from 59 to 94 years old, with an average of 7.29 years of education. 51.8% (N=14) of patients were at FAST stage 3 indicating MCI, 33.3% (N=9) were at FAST stage 4 indicating mild dementia and 14.8% (N=4) at FAST stage 5 indicating moderate dementia. A paired t-test was used to evaluate the outcome measure. For group A (Cognitive training Compliance greater than or equal to 20%, N=16), it showed significant improvement in cognitive function (p=0.028) with cognitive training via HA Go. The mean score of HK-MoCA increased from 20.6875 to 21.8125. For Group B (Cognitive training compliance less than 20%, N=11), there was no significant improvement in cognitive function (p=0.082). However, the mean score of HK-MoCA decreased from 16.1818 to 14.3636. There was no deterioration in the FAST stage for all patients. Conclusion: The result suggested that cognitive training via HA Go, prescribed by Occupational Therapist at POH with a compliance greater than or equal to 20%, showed a positive effect on improving cognitive function in patients with MCI to moderate dementia. The limitation of this study is relatively small sample size. Therefore, a further prospective study with a larger sample size is suggested to explore which FAST stage patient could derive the greatest benefits by receiving cognitive training via HA Go.
