Development and preliminary evaluation of a dynamic cognitive training program for healthy older adults

Sutthikampa, Warunya; Lersilp, Suchitporn; Punyakaew, Autchariya; Putthinoi, Supawadee · 2026 · Crossref

DOI: 10.66285/jams.2026.066

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Summary

This study addresses the growing prevalence of age-related cognitive decline in Thailand, a nation rapidly transitioning into a super-aged society. The authors aimed to design, develop, and preliminarily evaluate a multimodal dynamic cognitive training program for healthy older adults. The research was motivated by gaps in existing interventions, which often rely on fixed protocols lacking flexibility for individual performance adjustments and insufficient descriptions of therapist-mediated adaptation. The study sought to create a program grounded in occupational therapy principles, neuroplasticity, and the dynamic interactional model to support active aging and functional independence. The researchers employed a three-phase Research and Development (R&D) framework. Phase 1 involved program design, resulting in a six-week intervention comprising 12 biweekly 60-minute sessions. The program integrated physical movement with cognitive exercises targeting attention, memory, visuospatial skills, and executive function. A key feature was its "dynamic" nature, utilizing a graded mediation framework where therapists adjusted task difficulty in real-time based on participant performance. Phase 2 assessed content validity through a panel of five experts, who evaluated the program using the Index of Item-Objective Congruence (IOC). Phase 3 involved a try-out with five community-dwelling, cognitively healthy older adults (aged 64–73) to assess feasibility, acceptability, and preliminary cognitive outcomes. Eligibility was confirmed using the Montreal Cognitive Assessment (MoCA) and the Thai Geriatric Depression Scale (TGDS-15). Cognitive outcomes were measured pre- and post-intervention using the MoCA, Digit Span Test, and selected subtests of the Dynamic Loewenstein Occupational Therapy Cognitive Assessment-Geriatric Version (DLOTCA-G). The program achieved an overall IOC of 0.98, indicating strong content validity. During the Phase 3 try-out, participants demonstrated high engagement with 100% session attendance. Preliminary cognitive evaluations revealed positive trends: 100% of participants showed improvements in global cognition and visuospatial function. The study utilized descriptive analysis due to the small sample size, focusing on individual-level changes rather than statistical hypothesis testing. The results confirmed the program's feasibility and acceptability, with the dynamic adjustment mechanisms proving practical for maintaining optimal challenge levels. The study concludes that the dynamic cognitive training program is valid and feasible for healthy older adults. The findings provide critical insights for refining the intervention for broader application in community settings. By integrating occupational therapy principles with real-time task adaptation, the program offers a methodological framework for mitigating cognitive decline. The authors suggest that this approach supports clinical reproducibility and addresses the need for personalized, adaptable interventions in geriatric care, paving the way for larger-scale efficacy trials.

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