Computerised cognitive training combined with nutritional counseling in mild cognitive impairment - results of a 2 × 2 factorial randomized controlled trial (BrainFit-nutrition study).

Authors

Julia-Sophia Scheuermann, Elmar Graessel, Etienne Hanslian, Julia Schiele, Melanie Dell'oro, Martin Schmitt, Michael Jeitler, Christian S Kessler

Published in

Alzheimer's research & therapy. Volume 18. Issue 1. Nov 09, 2026. Epub Nov 09, 2026.

Abstract

Computerized cognitive training (CCT) and nutritional interventions may improve cognitive functioning in individuals with mild cognitive impairment (MCI). This study investigated whether a combination of CCT and online nutritional counseling can improve global cognition in individuals with MCI. We also evaluated differences between MCI-specified and active control versions of the interventions.
In this 2 × 2 factorial randomized controlled trial (BrainFit-Nutrition study), conducted fully remotely, participants in Germany with a psychometric diagnosis of MCI (age 60+) were randomized into four groups (Intention to treat, n = 270). For each intervention, one MCI specified and one active control version were developed (cognition: individualized CCT (iCCT) vs. basic CCT (bCCT); nutrition: whole-food plant-based nutrition (WFPB) vs. German Nutrition Society (DGE)). At baseline and after six months, cognitive functioning was assessed with the Montreal Cognitive Assessment (MoCA; primary outcome: change after six months). A mixed-model ANCOVA (t0-t6, complete case strategy (CC), n = 228) was applied for the main analysis.
All four groups achieved a significant improvement of approximately 2 points on the MoCA after six months. Estimated marginal means varied from M = 2.44 (iCCTxDGE) to M = 1.77 (iCCTxWFPB), notably without significant group differences. The 2 × 2 mixed ANCOVA revealed a significant main effect of time (F = 3.96, p = 0.048, partial η² = 0.018). The specific content of the respective modalities being compared (iCCT vs. bCCT; WFPB vs. DGE-oriented counseling) did not appear to make a relevant group difference with regard to the primary outcome. After 6 months, 55% of all participants reached non-MCI values on the MoCA.
The results of this study suggest, that in people with MCI, notable improvement in global cognition can be achieved in a six-months intervention period. When CCT is combined with digital nutritional counseling, the form of intervention - whether elaborate or basic - apparently did not modify the outcome; rather, this data set suggests that it is worthwhile to proactively undertake something in both domains. Future clinical studies in mixed-methods-designs, including usual-care comparators, basic science study modules, qualitative aspects and health economic variables are warranted to gain a better understanding of mechanisms, sustainability of effects, clinical relevance, and cost-effectiveness.
ISRCTN10560738; registered 11/23/2021.

PMID:
43015907
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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