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A study on the effects of CCRT on cognitive function and blood biomarkers in community-dwelling older adults with MCI
Zhenkun Tan1, Junjiao Ping1, Haibo Zhang1
1Third People's Hospital of Zhongshan City, Zhongshan, China.
Objective:
To investigate the effects of Computerized Cognitive Remediation Therapy (CCRT) on cognitive function and blood biomarker levels in community-dwelling older adults with Mild Cognitive Impairment (MCI), and to provide objective evidence for evaluating the effectiveness of CCRT.
Methods:
This randomized controlled trial included 68 participants who completed the intervention and were included in the final analysis (37 in the intervention group and 31 in the control group). The control group received health education, while the intervention group received both health education and a 12-week CCRT intervention. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the intervention. Plasma levels of glial fibrillary acidic protein (GFAP) and phosphorylated Tau181 (P-tau181) were also measured at baseline and post-intervention. Linear mixed-effects models and receiver operating characteristic (ROC) curve analyses were used to examine the effects of CCRT on cognitive function and biomarker levels, as well as the predictive value of biomarkers for cognitive improvement.
Results:
After the 12-week intervention, the intervention group showed significantly greater improvements in MMSE and MoCA total scores compared to the control group (MMSE: P = 0.007; MoCA: P = 0.001). Significant improvements were also observed in memory (MMSE: P = 0.027), language (MMSE: P = 0.018; MoCA: P < 0.001), and attention (MoCA: P < 0.001). Plasma GFAP levels significantly decreased in the intervention group compared to the control group (P < 0.001), while no significant difference was found in P-tau181 levels (P = 0.501). ROC curve analysis showed that a reduction in GFAP levels significantly predicted cognitive improvement in MCI patients (AUC = 0.805, P < 0.001).
Conclusion:
This study demonstrates that a 12-week CCRT intervention can significantly improve cognitive function and reduce GFAP levels in community-dwelling older adults with MCI. The change in GFAP is associated with cognitive improvement, suggesting its potential as an objective biomarker for evaluating intervention effectiveness.
Trial Registration:
Chinese Clinical Trial Registry，Trial Registration Number: ChiCTR2500107961，Registration Date: August 21, 2025.
