# COGNITIVE TRAINING AND NEUROPLASTICITY IN MILD COGNITIVE IMPAIRMENT

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2024 · $1,813,346

## Abstract

Effective, clinically meaningful treatments are lacking for patients with mild cognitive impairment (MCI),
which is associated with increased risk of transition to dementia. Cognitive training represents an important
therapeutic strategy. In our recently completed two-site, blinded, COG-IT trial (R01AG052440, PI Devanand),
107 participants with MCI were randomized to web-based cognitive videogames (computerized cognitive
training, n=51) or computerized crossword puzzles (n=56) for 12 weeks of intensive training followed by
booster sessions for a total of 78 weeks. Crossword puzzles were superior to computerized cognitive training
on the primary cognitive outcome (ADAS-Cog11; effect size 0.43 at 12 weeks and 0.34 at 78 weeks) and
function (Functional Activities Questionnaire) with decreased brain atrophy on MRI over 78 weeks. Building on
these findings, for this competitive renewal we propose a 78-week clinical trial, WORDFIT, involving 4 U.S.
academic sites that compares high dose crosswords (4 puzzles per week) to low dose crosswords (1 puzzle
per week) and a health education control group in the initial acute phase of 12 weeks. Subsequent booster
sessions will occur up to 78 weeks. Blinded assessments will occur at baseline and weeks 12, 32, 52, and 78.
Sample size will be 240 with 80 participants per group. Sites led by Dr. Devanand (PI) at Columbia and Dr.
Doraiswamy at Duke, who were the investigators in the COG-IT trial, will be joined by sites at University of
Miami (PI Dr. Philip Harvey) and University of Washington (PI Dr. Angela Hanson). On measures of cognition
(primary outcome ADAS-Cog14) and informant report of function (secondary outcome Functional Activities
Questionnaire), we hypothesize that the high dose crosswords will show superior efficacy to the control group
and that there will be an increasing trend in treatment effects across the three ordered groups (control < low
dose crosswords < high dose crosswords). We will evaluate changes in MRI hippocampal volume and cortical
thickness in relation to changes in cognition and function and explore whether reduction in plasma
neurofilament light (marker of neurodegeneration) and plasma ptau181 (marker of Alzheimer's Disease) will be
associated with efficacy for high dose crosswords compared to control. In summary, in our completed COG-IT
trial in MCI, home-based computerized crossword puzzles training showed superior efficacy to computerized
cognitive training on cognition and function with decreased brain atrophy over 78 weeks, but there was no
control group. If these findings are confirmed and expanded with two crossword conditions and a control group
in WORDFIT, crosswords training could become a low-cost, home-based, scalable, cognitive enhancement
tool for people with MCI, which is a common condition and major public health problem worldwide.

## Key facts

- **NIH application ID:** 10799179
- **Project number:** 2R01AG052440-06A1
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** DAVANGERE P DEVANAND
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,813,346
- **Award type:** 2
- **Project period:** 2017-07-15 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10799179

## Citation

> US National Institutes of Health, RePORTER application 10799179, COGNITIVE TRAINING AND NEUROPLASTICITY IN MILD COGNITIVE IMPAIRMENT (2R01AG052440-06A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10799179. Licensed CC0.

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