Working memory training in MCI patients: A pilot study

Feasibility

Feasibility will be evaluated on the basis of (a) age, (b) patient*s

abilities/capacity (daily investment, duration and difficulty level of the

tasks and questionnaires), and (c) weakly (or daily) telephonic conservations

between the researchers and the patient or his/her partner/caregiver. In

addition, the (possible) lack of computer skills and the necessity of an

involved partner/caregiver are also important factors to consider in regard to

the feasibility



Accomplishment of the WMT, excluded subjects and dropouts

The number of participants that accomplish the whole WMT (25 days), the number

of excluded subjects (e.g. by the researchers) and the number of dropouts will

be recorded.

The researchers will try to contact withdrawn subjects, in order to clarify,

whether his or her reasons were related to experimental set up. Subjects are

not obligated to give the reason why he or she has stopped with the experiment.

These outcome measurements can give us crucial information about the applied

intervention and the investigated population

WM capacity

WM capacity will be measured with using the same tasks that will be used during

the WMT. However, the assessment versions of the three tasks will end when

participants are unable to reproduce a sequence of two consecutive trials. The

outcome measure for each task will be the length of the longest sequences that

participants correctly reproduce on two consecutive trials. See section 3 for

detailed information about the WM tasks.



WM (equal, but not trained task)

The Backward letter span will be used to function as a control WM task. This

means that this task is equal to the other WM tasks, but that it not will be

trained. During this backward letter spa task, a sequence of letters will be

presented on the computer screen. Participants have to reproduce this sequence

in reversed order, using either the computer mouse or the letter keys on the

keyboard. This task is added to the present study to see whether the

participants show an improved WM performance on only the trained WM tasks or on

all WM tasks (including the not trained task). By this way, we can chart the

(generalization) effect of WMT.



Consequences of WM deficits in everyday life.

The Working Memory Questionnaire (WMQ) is a self-administered scale, addressing

three dimensions of WM: short-term storage, attention, and executive control.

The WMQ assess the consequences of WM deficits in everyday life (Vallat-Azouvi,

Pradat-Diehl & Azvouvi, 2012). The WMQ consist of 30 items and each question

will be rated on a five-point Likert-type scale, ranging from 0 (*no problem at

all*) to 4 (*very severe problem in everyday life*). Examples of items are:

**Do you find it difficult to remember the name of a person who has just been

introduced to you?** and Do you feel that fatigue excessively reduces your

concentration?**. This questionnaire is added in the present study to monitor

the everyday WM problems of our participants.



Executive functioning (non-equal task)

A computerized version of the Stroop task (Stroop, 1935) will be used to

measure information processing speed and susceptibility to interfere.

Participants have to respond in the first block as fast as possible to four

coloured (blue, red, green and yellow) words (**Blue**, **Red**, **Green** and

**Yellow**) by using the number keys on the keyboard. During the second block,

participants have to respond to the colour (blue, red, green and yellow) of the

words (distracters) by using the number keys on the keyboard. This task is

included in the present study to chart the executive functioning performance of

the participants at pre-test, post-test and follow-up and primarily to see

whether executive functioning will improve after WMT.



Cognitive failures

The Cognitive Failure Questionnaire (CFQ; Broadbent et al., 1982; Ponds et al.,

2006) is a self-report questionnaire which consists of 25 items measuring the

frequency of everyday cognitive failures. Each item is rated for frequency in

the past 6 months on a four point scale, ranging from *0* (never) to *4* (very

often). The maximum score is 100. Examples of items are: ** Forgetting

appointments** and ** Forgetting people*s names**. This questionnaire is

included in the present study to monitor the cognitive failures of our

participants at pre-test, post-test and follow-up.



Sense of control

Mastery, or *the feeling as the extent to which a person perceives himself or

herself to be in control of events and ongoing situations* is considered as a

psychosocial resource when coping with stressful life events. A high sense of

mastery is expected to reduce psychological distress and increase well being.

The Mastery-questionnaire (Pearlin, 1978) is used to measure this level of

control that people experience. The Mastery scale consist of seven items scored

on a 5-point scale from **totally agree** (1) to **totally disagree** (5).

Examples of items are: ** Some of my problems I can't seem to solve at all**

and ** Sometimes I feel like a play ball of life**. This questionnaire is

included to the present study to see whether WM effects are independent of

control. One interesting question is for example whether participants with the

lowest improvement in WM performance also have a low level of control.



Self-efficacy

Self-efficacy is defined as the belief that one is capable of performing in a

certain manner to attain certain goals. The Dutch General Self-efficacy Scale

(GSE) consists of 10 statements on a 4-point scale from **totally

incorrect** (1) to **totally correct**. The GSE is designed to assess

optimistic self-beliefs to cope with a variety of difficult demands in life

(Teeuw, Schwarzer & Jerusalem, 1994). An example of an item is: **Whatever

happens, I will manage**. This questionnaire is included in the present study

to monitor the self-beliefs and goals of our participants at pre-test,

post-test and follow-up



Psychological states

The Symptom Check List 90 (SCL-90) will be used as a screening measure of

general psychiatric symptomatology (Buckelew et al. 1988). Patients are asked

to rate the severity of their experiences with each symptom over the past week

on a 5-point scale ranging from 0 (not at all) to 4 (extremely). Examples of

items (or symptoms) are: **Headache** and **Thinking about death or dying**.

This questionnaire is included in the present study to monitor the psychiatric

symptomatology of our participants at pre-test, post-test and follow-up. In

addition, it will also be used to measure the progress and outcome of our

(neuro) psychological intervention.