Speed of Processing Training for Stress Adaptation in Caregivers of a Family Member With Dementia: A Randomized Controlled Trial.

Background and objectives: The chronic stress of caregiving for a family member with Alzheimer's disease and related dementias (ADRD) is associated with a host of health risks, including accelerated cognitive aging and poor emotional well-being. Despite known links between cognitive and emotion regulatory pathways, cognitive training has not been tested in ADRD caregivers as a means to strengthen cognitive capacity and concomitant emotion regulation, domains undergirding stress adaptation. This study aimed to identify effects of computerized cognitive training on cognitive and emotion indicators of caregivers' capacity for stress adaptation, a key mechanism for healthy aging.

Research design and methods: ADRD family caregivers (N = 195; ages 55-85 years) enrolled in a 2-arm randomized controlled trial were assigned (1:1) to engage in a vision-based speed of processing and attention (VSOP/A) training or video education (VE). Processing speed and attention, working memory under stress, and emotion reactivity to laboratory and caregiving stressors were measured at baseline, following an 8-week intervention, and 6 months and 12 months postintervention. Intent-to-treat analyses using mixed models for repeated measures tested effects of VSOP/A training on these outcomes.

Results: The VSOP/A group had significantly improved processing speed and attention performance compared to the VE group, and these differences persisted through 6 months postintervention. At 6 months postintervention only, working memory performance under stress was significantly better among the VSOP/A compared to VE group. At 12 months, caregivers in the VSOP/A group reported less negative emotion in response to ADRD-related behavioral symptoms of their care recipient. There were no group differences in acute emotion reactivity to the laboratory stressor at any time point.

Discussion and implications: Findings from this study suggest that targeted cognitive training should be further developed as an efficacious strategy to strengthen ADRD family caregivers' stress adaptation capacity and healthy aging. Clinical Trials Registration Number: NCT03036423.