Trial Outcomes & Findings for Online Grammatical Reasoning Training for Older Adults (NCT NCT03661190)

NCT ID: NCT03661190

Last Updated: 2026-05-04

Results Overview

Measured by the validated task-switching test of Trailmaking B. This is a well established computerised test of executive function. On a computer screen participants are presented with 24 circles with either numbers (0-13) or letters (A-L). They must select the circles in the correct numerical and alphabetic order, alternating numbers and letters each time (e.g. 1, A, 2, B, 3, C etc). The test is completed when all the circles have been correctly selected. The test outputs a total score. A higher score indicates a better performance. A negative mean score indicates a decline in performance. The range of scoring for this test is 0 - 300,000. Data reported here are for mean change per group form baseline to six weeks

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

6544 participants

Primary outcome timeframe

Baseline to Six weeks

Results posted on

2026-05-04

Participant Flow

Participant milestones

Participant milestones
Measure
Grammatical Reasoning
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Overall Study
STARTED
3279
3265
Overall Study
COMPLETED
1739
1736
Overall Study
NOT COMPLETED
1540
1529

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Grammatical Reasoning
n=3279 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=3265 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Total
n=6544 Participants
Total of all reporting groups
Age, Continuous
62.4 years
STANDARD_DEVIATION 7.23 • n=3279 Participants
62.5 years
STANDARD_DEVIATION 7.08 • n=3265 Participants
62.5 years
STANDARD_DEVIATION 7.15 • n=6544 Participants
Sex: Female, Male
Female
2617 Participants
n=3279 Participants
2601 Participants
n=3265 Participants
5218 Participants
n=6544 Participants
Sex: Female, Male
Male
662 Participants
n=3279 Participants
664 Participants
n=3265 Participants
1326 Participants
n=6544 Participants
Educational Attainment
3.28 units on a scale
STANDARD_DEVIATION 1.40 • n=3279 Participants
3.23 units on a scale
STANDARD_DEVIATION 1.36 • n=3265 Participants
3.25 units on a scale
STANDARD_DEVIATION 1.38 • n=6544 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: Baseline to Six weeks

Measured by the validated task-switching test of Trailmaking B. This is a well established computerised test of executive function. On a computer screen participants are presented with 24 circles with either numbers (0-13) or letters (A-L). They must select the circles in the correct numerical and alphabetic order, alternating numbers and letters each time (e.g. 1, A, 2, B, 3, C etc). The test is completed when all the circles have been correctly selected. The test outputs a total score. A higher score indicates a better performance. A negative mean score indicates a decline in performance. The range of scoring for this test is 0 - 300,000. Data reported here are for mean change per group form baseline to six weeks

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1739 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1736 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Executive Function From Baseline
5435.9 score on a scale
95% Confidence Interval 331.80 • Interval 4905.71 to 5966.09
9671.19 score on a scale
95% Confidence Interval 330.46 • Interval 9138.87 to 10203.51

SECONDARY outcome

Timeframe: Baseline to six weeks

Digit Span test for numerical working memory. Partifcipants complete a computerised task. They must remember increasingly long strings of digits and repeat them back. Scores are based on correct responses. Higher score means better performance. Score range is 0 - 20

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1737 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1729 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Numerical Working Memory From Six Weeks
0.55 score on a scale
Interval 0.41 to 0.69
0.29 score on a scale
Interval 0.14 to 0.42

SECONDARY outcome

Timeframe: Baseline to six weeks

Measured through a computerised version of the Paired Associate Learning task in which participants must remember the location of a symbol behind a series of boxes on a screen, and accurately identify the correct location when prompted. Scores are based on accuracy. Higher score indicates better performance. Data reported here shows mean change from baseline. Range of scores is 0 - 16

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1737 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1729 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Working Memory From Baseline
1.90 score on a scale
Interval 1.68 to 2.1
1.09 score on a scale
Interval 0.87 to 1.31

SECONDARY outcome

Timeframe: Baseline to six weeks

Measured through a Simple Reaction time test as part of the Wesnes Cognition Ltd CogTrackTM system. Participants are shown a target symbol on the screen and must react by pressing the keyboard / touching the screen (depending on the device being used) when the target appears. Output is measured in milliseconds as a reaction time variable. Lower scores are better; higher scores are worse. Range of scores is 100 - 30,000

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1737 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1728 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Reaction Time From Baseline
10.04 time (milliseconds)
Interval 6.13 to 13.95
3.66 time (milliseconds)
Interval -0.26 to 7.58

SECONDARY outcome

Timeframe: Baseline to six weeks

Measured with the Delayed Picture Recognition task in which participants recall a series of images shown earlier in the cognitive test battery. The test outputs percentage of correct answers as the measure. A higher score shows a better outcome. Range output is 0 - 100

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1737 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1729 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Episodic Memory From Baseline
57.9 score on a scale
Interval 54.77 to 61.03
45.4 score on a scale
Interval 42.27 to 48.53

SECONDARY outcome

Timeframe: Baseline to six weeks

This is a composite measure of overall cognition that is created by normalising the outputs from all other cognitive tests to give a total score out of 100. The data shown here is the change in total score from baseline to six weeks. Range is 0 - 100. A higher score indicates a better outcome

Outcome measures

Outcome measures
Measure
Grammatical Reasoning
n=1737 Participants
This group will complete a short-term Intensive Grammatical Reasoning cognitive task delivered online by Wesnes Cognition Ltd (START). Participants will be encouraged to complete the START training once a day for six-weeks. Grammatical Reasoning: START measures the ability to determine the relationships among different shape combinations which are assigned to grammatical statements about them which can be either correct or incorrect. It is a measure of attention, working memory and executive control.
Control - Card Pairs
n=1729 Participants
The control group will complete a basic picture-matching task that will provide the same level of engagement, but without the learning effects. Card Pairs: A basic picture-matching task.
Change in Overall Composite Measure of Global Cognition
0.22 score on a scale
Interval 0.18 to 0.28
0.08 score on a scale
Interval 0.04 to 0.12

Adverse Events

Control - Card Pairs

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Grammatical Reasoning

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Professor Anne Corbett

University of Exeter

Phone: 01392 661000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place