Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: a preliminary efficacy study

Purpose: To examine the preliminary 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 × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F_2,34 = 5.31, p =.01, eta =.238), perceived cognition (F_2,34 = 4.897, p =.014, eta =.224), and cognitive performance on speed of processing test (F = 5.678, p =.009, eta =.289). The 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.