Summary: Age-related neurocognitive decline is often an irreversible health issue from onset. The concomitant costs could be exponential if left unchecked. There is a need to be able to delay the onset of age-related neurocognitive decline or possibly avoid it altogether. Previous studies have shown that there is a strong positive relationship between the fitness of neurocognitive function and cognitive training. Our laboratory conducted two pilot trials (Lee et al., 2013 & 2015) and one larger scale randomised controlled trial (RCT) (Yeo et al., 2018) investigating the usability and efficacy of a brain-computer interface (BCI) based attention and memory cognitive training system on older adults between ages 60 to 80. The participants across all three trials found the different iterations of our attention-memory training system to be usable and acceptable, with adherence rates surpassing 90%.

Interestingly, a growing number of studies suggest combined cognitive training and physical activity may result in a better neurocognitive outcome as compared to only cognitive training. Combining the insights from those studies and our previous trials, we developed a novel personalized multimodal BCI-based cognitive and physical training system, NeeuroCycle, for neurocognitive protection and enhancement in older adults. NeeuroCycle comprises of a stationary recumbent bicycle and a gamified cognitive training system paired with real-time frontal electroencephalogram (EEG) neurofeedback. The cognitive training program consists of six different tasks that target attention, immediate/working and delayed memory, decision- making, and visuospatial abilities. Certain parts of the gameplay are directly impacted by the partcipant’s own real-time EEG signals. NeeuroCycle has also been designed to include locally relevant stimuli and designs for our Singaporean older adult participants. Evaluation of NeeuroCycle’s efficacy is ongoing. The current study employs a three-arm RCT approach (physical- and-cognitive training [mBCI], cognitive training only [nBCI], and active control [AC] groups). We hypothesise that mBCI par1cipants will perform significantly better on cognitive assessments compared to nBCI and AC participants. Findings of the study will be presented at the IPA Congress. If tested to be effective, we expect NeeuroCycle to be an accessible, safe, and cost-effective way for older adults to maintain or improve cognitive health, which is beneficial for ageing societies.