Cognitive retraining and functional treatment (CRAFT) for adults with cancer related cognitive impairment: A randomized controlled trial

Abstract Purpose: To examine the applicability and efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI). Methods: Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12 weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention and 3-month follow up. Results: Significant time X group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F2,34=5.31, p=.01, eta=.238), perceived cognition (F2,34=4.897, p=.014, eta=.224) and cognitive performance on speed of processing test (F=5.678, p=.009, eta=.289). CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (Chi-square= 6.91, p=.032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up (n=32). Conclusions: CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in ‘real world’ health benefits. Implications for Cancer Survivors: A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment. Clinical Trial Registration: ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered.