Abstract:
Objective To investigate the effects of different scenario-based simulation intervention modes combined with computer-assisted cognitive training (CACT) on cognitive function, risk perception, and medical-seeking intention in older adults with hypertension and mild cognitive impairment (MCI), and to identify the optimal intervention mode.
Methods A randomized controlled trial was adopted. From December 2023 to August 2025, a total of 149 elderly patients with hypertension and MCI [Montreal cognitive assessment (MoCA) score 18 - 26] were prospectively recruited from the Department of Neurology, Peking University International Hospital. After baseline assessment, in a 1∶1∶1∶1 ratio, the participants were randomly divided into an interactive scenario-based simulation group (group A, n=37), a non-interactive scenario-based simulation group (group B, n=37), a non-relevant scenario-based simulation group (group C, n=37), and a health education control group (group D, n=38). Two interventions were implemented in parallel: (1) scenario-based simulation intervention, consisting of a single 5 – 7-minute animated video administered immediately after baseline (T0) assessment, with follow-up until 3 weeks post-intervention (T3); and (2) CACT administered concurrently for 6 weeks (≥30 minutes per day, ≥7 sessions per week, total duration ≥20 hours). Cognitive function was assessed using the MoCA at T0 and after 6 weeks of CACT (T4). Risk perception was assessed using the Tripartite Risk Perception Scale (TRIRISK) at T0, immediately after the scenario intervention (T1), 1 week post-intervention (T2), and 3 weeks post-intervention (T3). Health behavior intention and medical-seeking intention were also evaluated at the same time points. Paired t-tests and one-way analysis of variance were used to compare differences in cognitive function. Repeated-measures analysis of variance (LSD method) was used to compare changes in risk perception and intention. Binary Logistic regression analysis was performed to identify predictors of medical-seeking intention.
Results During the intervention period, a total of 5 cases were lost to follow-up, with a total loss-to-follow-up rate of 3.36%. Group A, Group B, and Group C each lost 1 case, while Group D lost 2 cases. Eventually, 36 cases were included in each group for statistical analysis. At T4, the total MoCA scores of patients in all four groups significantly increased compared to T0. The scores of patients in Group A increased from 22.51±2.01 to 25.78±1.71, those in Group B increased from 22.10±2.20 to 25.59±1.82, those in Group C increased from 22.41±2.14 to 25.47±1.91, and those in Group D increased from 22.23±2.34 to 25.68±1.64. The differences were statistically significant (t=7.435, 7.334, 6.401, 7.244, all P<0.001). However, there was no statistically significant difference in the total MoCA scores among the four groups at T4 (F=0.199, P=0.897). In terms of risk perception, since T1, the total risk perception score of patients in Group A remained consistently higher than those in the other groups. The total score of Group A patients at T3 was 7.42±1.56, which increased by 131.15% compared to the baseline (t=36.617, P<0.001), and was significantly higher than the total scores of patients in Group B, Group C, and Group D at T3 (6.35±1.48, 4.22±1.65, 4.17±1.59), and the differences were statistically significant (t=2.986, 8.456, 8.754; P=0.004, <0.001, <0.001). At T3, the compliance rate of health behavior intentions in Group A was 91.67%, and the medical-seeking intention score was 4.68±0.52, which were significantly higher than those of the other three groups. Binary Logistic regression analysis showed that experiential risk perception (OR=1.186, 95%CI: 1.012 - 1.389, P=0.043) and health behavior intentions (OR=1.207, 95%CI: 1.082 - 1.346, P=0.001) were positive predictors of medical-seeking intention.
Conclusion CACT can significantly improve cognitive function in older patients with hypertension and MCI. Among the concurrently implemented scenario-based simulation interventions, the interactive (individual-participatory) mode is the most effective in enhancing risk perception and health-related intentions.
Key words:
Mild cognitive impairment,
Hypertension,
Computer-assisted cognitive training,
Scenario simulation,
Risk perception,
Medical-seeking willingness
Jing Shi, Sifan Wang, Hongwei Wang, Yudi Tang, Dan Li, Yan Xing. Influence of scenario simulation combined with computer-assisted cognitive training on elderly hypertensive patients with mild cognitive impairment[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2026, 20(02): 139-147.