Background: Cognitive training is increasingly being considered and proposed as a solution for several pathologies, particularly those associated with aging. However, trainees need to be willing to invest enough mental effort to succeed and make progress. Objective: In this study, we explore how gamification in a narrative context (i.e. the addition of visual game-like elements [GLE] embedded in real-world contexts) could contribute increase perceived playfulness (PP) and voluntary mental effort allocated to a cognitive task. In such context, narrative elements and GLE can be designed to align with a commonly relatable scenario (like simulating fishing or gardening activity) to ground the task in familiar, real-world contexts. We also consider if the supposed effect of GLE on PP and voluntary mental effort, could endure while manipulating an intrinsic variable of the task (i.e., by increasing cognitive solicitation).  Methods: Twenty participants (average age 33.6 years, SD = 8.6 years) took part in 3 cognitive tasks proposed in a numerical format: a classic version of the Corsi test (Classic Corsi, a spatial memory task), a Playful version of the Classic Corsi test (Playful Corsi), with added visual GLE in a narrative context, and a playful version of the Classic Corsi test with added cognitive solicitation, i.e., mental motor inhibition (Playful Corsi Multi). We assessed the impact of visual GLE and cognitive solicitation on PP (one question) and Mental Workload (MWL) using NASA-TLX and Workload Profile (WP) questionnaires. Results: Results showed that PP was not influenced by interface’s playful characteristics (Classic Corsi [Mean 62.4; SD 8.8] vs Playful Corsi [Mean 66 ; SD 8.8]; W=77; P=0.3 ) but decreased the time necessary to complete the task (Classic Corsi [Mean 10.7s; SD 2.1s] vs Playful Corsi [Mean 6.8s; SD 1.6s]; W=209; P

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Background: Compensatory cognitive training (CCT) is an evidence-based treatment for improving cognitive function in patients with schizophrenia. However, the need for patients to commute to treatment sites hinders its widespread use. Using a remote device to conduct CCT could improve its accessibility, making it easier for participants to adjust their schedules and reducing their burden. Objective: The purpose of this study was threefold: to investigate the creation and participant acceptability of CCT using a remote device (r-CCT); to determine the #feasibility of implementing the developed intervention; and to collect preliminary data for future studies of the effectiveness of r-CCT in Japan. Methods: To reduce participant movement during training, CCT was conducted remotely in real time, using borrowed iPads. The training was conducted in a group format via video conferencing once a week for 2 h, for a total of 12 sessions. Four patients with schizophrenia who underwent r-CCT were recruited to determine participation or dropout rates across 12 training sessions. In addition, their diagnostic assessment,(the Scale of Positive Symptoms and the Scale of Negative Symptoms), cognitive function (e.g., the Japanese version of the Trail Making Test Part A (TMT-A) and Part B (TMT-B), digit span, digit symbol), social functioning (Social Functioning Scale Japanese version; SFS-J), and quality of life (Japanese Schizophrenia Quality of Life Scale; JSQLS) were assessed before, immediately after, and three months after implementation. Results: The average participation rate of the three participants (a male in his thirties was excluded) was high at 92%. Immediately after the r-CCT, positive trends were observed in cognitive function―excluding prospective memory. For example, the TMT-A scores improved for all three participants: Mr. A (58s→56s), Mr. B (52s→49s), and Ms. C (65s→49s). The Japanese Verbal Learning Test (JVLT) immediate scores also increased: Mr. A (16→19), Mr. B (13→14), Ms. C (14→21). Functional outcomes, assessed using the SFS-J, showed limited improvement immediately postintervention but tended to return to or fell below preintervention levels at the three-month follow-up. Quality of Life (QOL) scores, measured using the JSQLS, remained relatively stable or improved immediately following the r-CCT and at the three-month follow-up. Conclusions: Despite this study’s small number of participants and lack of randomization, it suggests that the accessibility and implementation potential of r-CCT may be high. The ability to participate in training from any location could be expected to increase participation rates or reduce dropout rates. In the future, the authors will develop the implementation method further and increase the sample size to demonstrate the training’s effectiveness.

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Background: Cognitive training for older adults is crucial before cognitive impairment emerges. During periods of social distancing like the #covid19 pandemic, cognitive stimuli are lacking. Online dual-task training is proposed as a solution to address these needs. Objective: We aimed to explore the feasibility, acceptance, and potential effects of online group-based dual-task training as an intervention for enhancing cognitive function among community-dwelling older adults. Methods: A randomized controlled feasibility study was conducted with 76 participants in Hong Kong, randomly assigned to the intervention and attention control groups in a ratio of 2:1 (n=50, 66% and n=26, 34%, respectively). The intervention group underwent 60-minute online dual-task training sessions twice a week for 12 weeks, incorporating cognitive components (upper limb and finger movement, arithmetic operation, and verbal fluency) and physical components (chair-based exercises) developed through a co-design approach. The attention control group received online health talks. Outcomes related to feasibility and acceptance included class attendance and self-reported satisfaction. Main outcomes related to potential effects included the Memory Inventory in Chinese and the Montreal Cognitive Assessment 5 Minutes (Hong Kong Version) at baseline, 6 weeks (midintervention), 12 weeks (postintervention) and 18 weeks (follow-up). Descriptive statistics and linear mixed effects models were used. Effect size was described with Cohen d. Qualitative feedback was collected from 12 informants and analyzed by thematic analysis. Results: About 72% (36/50) of the participants in the intervention group and 62% (16/26) in the control group attended over 75% of the classes. In total, 44 (88%) participants from the intervention group provided acceptance feedback; 82% (36/44) were satisfied and 84% (37/44) would recommend the training to others. Improvement in the Memory Inventory in Chinese score in the intervention group was observed at midintervention, postintervention, and follow-up, with a medium-to-large effect size (d=0.65, 0.43 and 0.85, respectively). Adjusting for baseline values, the between-group differences in the Montreal Cognitive Assessment 5 Minutes (Hong Kong Version) score attained a small-to-medium effect size at midintervention (d=0.34) and postintervention (d=0.23). Qualitative feedback highlighted the timesaving and convenient aspects of online dual-task training, with participants finding the sessions challenging and enjoyable, and reporting benefits across cognitive, physical, and psychosocial domains. However, a preference for traditional in-person training was noted among the older adults despite the advantages of online training. Conclusions: Online dual-task training is a feasible intervention accepted by the older adults, with potential benefits in cognitive abilities. Online training may complement in-person sessions. Further investigation in a full-scale randomized controlled trial is warranted to comprehensively explore its effects and address areas for improvement. Trial Registration: ClinicalTrials.gov NCT05573646; https://clinicaltrials.gov/study/NCT05573646