Feasibility And Effectiveness Of Remote Cognitive Training On Cognitive Function And Work Performance

Cognitive training (CT) involves structured activities designed to improve specific cognitive functions like attention, memory, and problem-solving.

Studying its remote application is crucial in today’s digital age, especially given the rise of remote work and the need for accessible mental health interventions.

Remote CT could potentially offer a scalable solution for enhancing cognitive function and work performance across diverse populations, without the constraints of traditional in-person interventions.

Understanding its effectiveness in remote settings is vital for developing practical, widely-implementable cognitive enhancement strategies in various contexts, including workplace environments.

Shibaoka, M., Masuda, M., Iwasawa, S., Ikezawa, S., Eguchi, H., & Nakagome, K. (2024). The feasibility and effectiveness of remote cognitive training on cognitive function and work performance in workers. Frontiers in Psychology, 15, 1404518. https://doi.org/10.3389/fpsyg.2024.1404518

Key Points

• Remote cognitive training (CT) showed limited feasibility, with only 22.7% of participants adhering to the recommended 720 minutes of training over 12 weeks.
• Longer training time was associated with greater improvement in attention and executive function, as measured by the Spotter test.
• Intrinsic motivation for CT was positively associated with training time, changes in cognitive function, and improvements in work performance.
• There was no significant improvement in overall work performance after CT compared to baseline.
• Factors like intrinsic motivation, training time, and changes in specific cognitive functions affected outcomes, but the relationship between cognitive improvement and work performance was complex.
• This research had limitations such as potential sample bias, lack of face-to-face briefings due to COVID-19, and use of a single visual analog scale to measure work performance.
• The study highlights the importance of cognitive function and motivation in workplace performance and mental health, with potential implications for occupational health practices.

Rationale

Cognitive impairment has emerged as a significant public health issue affecting occupational functioning, daily life, and quality of life across various health areas (Wilson et al., 2013; Green et al., 2000; Barkley, 1997; Romero-Ayuso et al., 2021; Rao et al., 1991; Janelsins et al., 2014).

Previous research has shown that cognitive training (CT) can be effective in improving cognitive function in patients with neuropsychiatric disorders (Cicerone et al., 2011; Wykes et al., 2011).

However, the impact of CT on cognitive function and work performance in the general workforce remains understudied.

The COVID-19 pandemic has led to an increase in remote interventions, including CT, which offers advantages for those with distance and time constraints.

However, remote interventions may lack the prompting and motivation provided by in-person therapist interactions (Engan et al., 2023). Additionally, the optimal duration and intensity of CT for the general workforce are not well established.

This study aimed to investigate the feasibility and effectiveness of remote CT on cognitive function and its relationship with work performance in Japanese workers.

By exploring this novel approach to mental health care in the workplace, the research sought to contribute to the growing body of knowledge on occupational health practices and the potential benefits of cognitive interventions for the general workforce.

Method

The study employed an intervention time series design, with participants completing cognitive function tests and self-administered questionnaires at three timepoints: baseline, after 12 weeks of CT (post-treatment), and 12 weeks after the cessation of CT (follow-up).

Procedure

Participants were recruited from 10 companies in a metropolitan area of Japan. They were provided with BrainHQ accounts for CT and were recommended to complete three 20-minute sessions per week.

Reminders were sent three times a week. Cognitive function tests were administered using the THINC-Integrated Tool (THINC-it®) on a tablet computer.

Sample

The study included 119 Japanese workers aged 18-65 years. Most participants were full-time male workers.

Measures

• THINC-Integrated Tool (THINC-it®): A brief computerized battery assessing multiple cognitive domains.
• Work performance: Assessed using a single visual analog scale question.
• Intrinsic Motivation Inventory (IMI): Used to measure participants’ intrinsic motivation for CT.
• Kessler Psychological Distress Scale (K6): Used to assess depression tendencies.

Statistical measures

• Paired t-tests to compare changes in cognitive function between timepoints.
• Student’s t-tests to compare changes between long- and short-training groups.
• Multiple regression analysis to explore factors related to changes in work performance.
• Spearman’s rank correlation analysis to test associations between changes in cognitive function and IMI scores.

Results

Hypothesis 1: Remote CT would be feasible for Japanese workers.

Result: Not supported. Only 22.7% of participants achieved the recommended 720 minutes of training over 12 weeks.

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Hypothesis 2: Longer training time would lead to greater improvements in cognitive function.

Result: Partially supported. The long-training group showed significantly greater improvement in the Spotter test (attention and executive function) compared to the short-training group.

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Hypothesis 3: Improvements in cognitive function would lead to improvements in work performance.

Result: Not supported. There was no significant improvement in overall work performance after CT compared to baseline.

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Hypothesis 4: Intrinsic motivation would be associated with training time and improvements in cognitive function and work performance.

Result: Supported. Higher IMI scores were associated with longer training time, greater improvements in cognitive function, and improvements in work performance.

Insight

This study provides valuable insights into the feasibility and effectiveness of remote CT for the general workforce.

The low adherence rate (22.7%) suggests that remote CT may not be feasible enough in its current form for widespread implementation in workplace settings.

However, the study does indicate that longer training times can lead to improvements in specific cognitive functions, particularly attention and executive function.

The finding that intrinsic motivation plays a crucial role in both adherence to CT and improvements in cognitive function and work performance extends previous research on the importance of motivation in cognitive interventions.

This suggests that future interventions should focus on enhancing participants’ intrinsic motivation to improve outcomes.

The lack of significant improvement in overall work performance despite some cognitive gains highlights the complex relationship between cognitive function and workplace productivity.

This complexity may be due to the relatively preserved cognitive function in the general workforce compared to clinical populations, where cognitive improvements have shown clearer links to functional outcomes.

Further research could explore ways to improve adherence to remote CT in workplace settings, possibly through gamification or personalized interventions.

Additionally, more comprehensive measures of work performance and longer follow-up periods could help elucidate the long-term effects of CT on workplace productivity.

Strengths

The study had several methodological strengths, including:

• Use of a standardized, validated cognitive assessment tool (THINC-it®)
• Inclusion of multiple timepoints (baseline, post-treatment, and follow-up)
• Assessment of intrinsic motivation as a potential mediating factor
• Inclusion of participants from multiple companies, increasing generalizability

Limitations

This study also had several methodological limitations, including:

• Potential sample bias due to recruitment from a previous cognitive assessment study
• Lack of face-to-face briefings due to COVID-19 restrictions
• Use of a single visual analog scale to measure work performance
• Missing data for one item on the IMI Interest/Enjoyment subscale
• Lack of a true control group, limiting causal inferences
• Relatively short training period compared to some previous CT studies

These limitations may affect the generalizability of the results and the ability to draw strong causal conclusions about the effectiveness of remote CT in improving work performance.

Implications

The results of this study have several implications for occupational health practices and mental health care in the workplace:

1. Feasibility challenges: The low adherence rate suggests that implementing remote CT in workplace settings may require additional strategies to improve engagement and motivation.
2. Importance of intrinsic motivation: The strong association between intrinsic motivation and outcomes highlights the need to focus on enhancing participants’ internal drive to engage in CT.
3. Cognitive improvements: The findings suggest that longer CT can lead to improvements in specific cognitive functions, which may have potential benefits for workplace performance in tasks requiring attention and executive function.
4. Complex relationship with work performance: The lack of direct improvement in overall work performance indicates that the relationship between cognitive function and workplace productivity is complex and may require more nuanced interventions and measurements.
5. Personalized approaches: Given the variability in adherence and outcomes, future interventions may need to be tailored to individual needs and motivations to maximize effectiveness.
6. Integration with occupational health: The study provides a foundation for incorporating cognitive interventions into broader occupational health practices, potentially as part of a comprehensive approach to mental health in the workplace.
7. Remote interventions: While challenges exist, the study demonstrates the potential for remote cognitive interventions in workplace settings, which could be particularly valuable in situations where in-person interventions are not feasible.

These implications suggest that while remote CT shows promise as a workplace intervention, further refinement and research are needed to optimize its effectiveness and integration into occupational health practices.

References

Primary reference

Shibaoka, M., Masuda, M., Iwasawa, S., Ikezawa, S., Eguchi, H., & Nakagome, K. (2024). The feasibility and effectiveness of remote cognitive training on cognitive function and work performance in workers. Frontiers in Psychology, 15, 1404518. https://doi.org/10.3389/fpsyg.2024.1404518

Other references

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological bulletin, 121(1), 65.

Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., … & Ashman, T. (2011). Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of physical medicine and rehabilitation, 92(4), 519-530. https://doi.org/10.1016/j.apmr.2010.11.015

Engan, H., Skanke, F., Dahl, V., Eimhjellen Ryen, E. A., Lindgren, K., Aasvik, J., & Sandmæl, J. A. (2023). The Feasibility of Web-Based Working Memory Training in Patients With Cancer Attending Inpatient Rehabilitation. Integrative Cancer Therapies, 22, 15347354231164401. https://doi.org/10.1177/15347354231164401

Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”?. Schizophrenia bulletin, 26(1), 119-136. https://doi.org/10.1093/oxfordjournals.schbul.a033430

Janelsins, M. C., Kesler, S. R., Ahles, T. A., & Morrow, G. R. (2014). Prevalence, mechanisms, and management of cancer-related cognitive impairment. International review of psychiatry, 26(1), 102-113. https://doi.org/10.3109/09540261.2013.864260

Rao, S. M., Leo, G. J., Ellington, L., Nauertz, T., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology, 41(5), 692-696. https://doi.org/10.1212/WNL.41.5.692

Romero-Ayuso, D., Toledano-González, A., Rodríguez-Martínez, M. D. C., Arroyo-Castillo, P., Triviño-Juárez, J. M., González, P., … & Segura-Fragoso, A. (2021). Effectiveness of virtual reality-based interventions for children and adolescents with ADHD: A systematic review and meta-analysis. Children, 8(2), 70. https://doi.org/10.3390/children8020070

Wilson, R. S., Boyle, P. A., Segawa, E., Yu, L., Begeny, C. T., Anagnos, S. E., & Bennett, D. A. (2013). The influence of cognitive decline on well-being in old age. Psychology and aging, 28(2), 304.

Wykes, T., Huddy, V., Cellard, C., McGurk, S. R., & Czobor, P. (2011). A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. American Journal of Psychiatry, 168(5), 472-485. https://doi.org/10.1176/appi.ajp.2010.10060855

Keep Learning

Socratic questions for a college class discussion:

• How might the effectiveness of remote cognitive training differ between clinical populations and the general workforce? What factors could account for these differences?
• What strategies could be implemented to improve adherence to remote cognitive training in workplace settings?
• How does intrinsic motivation impact the success of cognitive interventions, and what approaches could be used to enhance motivation in workplace settings?
• In what ways might the relationship between cognitive function and work performance be more complex than initially assumed? How could future research address this complexity?
• How might cultural factors specific to Japanese work culture have influenced the results of this study? How might the findings differ in other cultural contexts?
• What ethical considerations should be taken into account when implementing cognitive training programs in workplace settings?
• How could the measurement of work performance be improved in future studies to capture a more comprehensive picture of workplace productivity?
• In what ways might the COVID-19 pandemic have influenced the results of this study, and how might these findings inform future remote interventions in post-pandemic workplaces?
• How might the findings of this study inform the development of personalized cognitive interventions for different types of workers or job roles?
• What potential long-term implications could widespread implementation of cognitive training have on workplace culture and expectations of employee performance?