Preventing cognitive decline via digital literacy and virtual game management: a randomized controlled intervention study in community-dwelling elderly

Objective: To evaluate the impact of cognitive stimulation via digital inclusion and game management on cognition in the elderly in primary health care. Method: This is a randomized controlled intervention study nested within a population-based cohort study. Based on the application of the Clinical Dementia Rating (CDR), individuals with scores of 0 and 0.5, and aged 60 years or older were included and randomly allocated to the Intervention Group (IG) and Control Group (CG). Initially, 160 participants met the selection criteria and underwent neuropsychological evaluation via Montreal Cognitive Assessment (MoCA), used before and after the intervention. The IG (n=62) participated in the computer-based intervention once a week for 1.5 hours for a total of 4 months. The CG (n=47) participated in Mindfulness workshops held with the same durability over the same time period. Results: The screening of cell phone and computer use in the initial sample (n=160) showed that 93% of the elderly have a cell phone, 82.5% of the devices is of the smatphone model with Internet access, 80% have a computer at home and, the majority (56.5%) fit with the basic level regarding use. Sixty-two elders in GI (50 women; 12 men), with a mean age of 74.8±6.3 years and 56.5% had high schooling, and 47 in CG (41 women; 6 men), with a mean age of 74±5.7 years and 46.8% with medium schooling, joined the study. 34% of the IG seniors had an income greater than or equal to 5 minimum wages, as well as 44.5% of the CG seniors. The IG who went through the Remembrance Workshops had on average 2.6 points more in MoCA after 4 months than the control group (p<0.001; 95%CI [1.90; 3.31]). The change in final MoCA decreased by 0.46 points (p<0.001; 95% CI [-0.57; -0.34]) for each additional unit in baseline MoCA. Individuals with average education had a 0.93 point (p=0.011; 95% CI [0.21; 1.64]) increase in MoCA change compared to individuals with low or high education. Conclusion: Digital inclusion combined with the practice of video games has the potential to improve cognition in the elderly. This prevention program can be structured to be applied in primary health care.Objetivo: Avaliar o impacto da estimulação cognitiva via inclusão digital e o manejo de games na cognição de idosos atendidos na atenção primária a saúde. Método: Trata-se de um estudo de intervenção controlado e randomizado, aninhado num estudo de coorte populacional. Com base na aplicação do Clinical Dementia Rating (CDR), indivíduos com escore 0 e 0,5, e idade igual ou maior que 60 anos, foram incluídos e alocados aleatoriamente no Grupo Intervenção (GI) e Grupo Controle (GC). Inicialmente, 160 participantes atenderam aos critérios de seleção e passaram por avaliação neuropsicológica via Montreal Cognitive Assessment (MoCA), utilizado antes e após a intervenção. O GI (n=62) participou da intervenção via computador 1 vez por semana durante 1 hora e meia, totalizando 4 meses. O GC (n=47) participou de oficinas de Mindfulness realizadas com a mesma durabilidade no mesmo período de tempo. Resultados: O rastreio do uso de celulares e computadores na amostra inicial (n=160) demonstrou que 93% dos idosos possuem celular, 82,5% dos aparelhos é do modelo smatphone com acesso à Internet, 80% possui computador em casa e, a maioria (56,5%) se enquadrou com o nível básico quanto ao uso. Aderiram ao estudo 62 idosos no GI (50 mulheres; 12 homens), com média de idade de 74.8±6.3 anos e 56.5% possuíam alta escolaridade, 47 no GC (41 mulheres; 6 homens) com média de idade de 74±5.7 anos e 46.8% com escolaridade média. 34% dos idosos do GI possuíam renda maior ou igual a 5 Salários Mínimos bem como 44,5% dos idosos do GC. O GI que passou pelas Oficinas da Lembrança teve em média 2,6 pontos a mais no MoCA após 4 meses do que o grupo controle (p<0,001; IC95% [1,90; 3,31]). A mudança no MoCA final diminuiu de 0,46 pontos (p