Abstract
<p>Objectives: Cognitive and functional skills training improves skills and cognitive test performance, but the true test of efficacy is real -world transfer. We trained participants with mild cognitive impairment (MCI) or normal cognition (NC) for up to 12 weeks on six technology -related skills using remote computerized functional skills assessment and training (FUNSAT) software. Using ecological momentary assessment (EMA), we measured real -world performance of the technology -related skills over 6 months and related EMA-identified changes in performance to training gains. Design: Randomized clinical trial with post -training follow-up. Setting: A total of 14 Community centers in New York City and Miami. Participants: Older adults with normal cognition (n = 72) or well-defined MCI (n = 92), ranging in age from 60 to 90, primarily female, and racially and ethnically diverse. Intervention: Computerized cognitive and skills training. Measurements: EMA surveys measuring trained and untrained functional skills 3 or more days per week for 6 months and training gains from baseline to end of training. Results: Training gains in completion times across all 6 tasks were significant (p < 0.001) for both samples, with effect sizes more than 1.0 SD for all tasks. EMA surveys detected increases in performance for both trained (p < 0.03) and untrained (p < 0.001) technology -related skills for both samples. Training gains in completion times predicted increases in performance of both trained and untrained technology -related skills (all p < 0.001). Conclusions: Computerized training produces increases in real -world performance of important technology -related skills. These gains continued after the end of training, with greater gains in MCI participants. (Am J Geriatr Psychiatry 2024;</p>