Importance: Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited.

Objective: To examine the efficacy of a high-ecological cognitive intervention.

Design: Quasi-experimental, pretest–posttest design with nonequivalent control.

Setting: Community.

Participants: Older adults with mild cognitive impairment from two senior centers.

Intervention: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group).

Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT–Im] and Delayed Recall [CMT–De] tasks), and the Wechsler Adult Intelligence Scale–Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive–functional performance was measured with the Rivermead Behavioural Memory Test–Third Edition (RBMT–3; Immediate Recall [RBMT–3–Im] and Delayed Recall [RBMT–3–De] tasks) and the Cognitive Failures Questionnaire (CFQ).

Results: Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT–Im, and RBMT–3–Im but not on the CMT–De, RBMT–3–De, and CFQ.

Conclusions and Relevance: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive–functional performance with immediate-memory task demands.

What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive–functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.

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