Introduction

cognitive decline
Age-related cognitive decline is associated with modifiable risk factors that can be addressed with non-pharmacological approaches [While prior studies reported encouraging effects, some issues remain to be addressed. The first relates to the accessibility and flexibility of face-to-face multidomain interventions. Older adults may have mobility challenges or live in remote areas without access to community resources providing face-to-face interventions. With the increase in technological literacy among older adults, there has been considerable recent interest in developing computerized programs to deliver home-based interventions. These interventions can increase flexibility of use, reduce costs, and thus facilitate the scaling up of interventions. Computerized programs allow for real-time feedback on performance, control of item timing, and gamification, among other advantages. Surprisingly, only a few studies have evaluated at-home physical activity training or multidomain programs [A second important issue to address is interindividual variability in response to computerized multidomain interventions. From a personalized medicine perspective, it is important to know the responders and their characteristics. In the present study, we examined efficacy as a function of frailty status–defined as a state of heightened vulnerability due to impairment of multiple systems [Here, we report on a 26-week double-blind parallel-group randomized controlled trial (RCT), which examined the cognitive effects of the home-based computerized multidomain intervention StayFitLonger (SFL), combining physical exercise and cognitive training, compared to an active control condition. Results are reported for the full sample and then separately for pre-frail and robust older adults. We hypothesized that the SFL group would have a larger pre-post intervention effect than the control group. As the compensation model has been most often supported, we predicted a larger SFL advantage in pre-frail participants compared to robust ones.