Chinese Calligraphy Writing for Augmenting Attentional Control and Working Memory of Older Adults at Risk of Mild Cognitive Impairment: A Randomized Controlled Trial

Background: Nonpharmacological intervention for individuals with mild cognitive impairment (MCI) needs further investigation. Objective: Test efficacy of an eight-week Chinese calligraphy writing training course in improving attentional control and working memory. Methods: Ninety-nine participants with MCI were randomized into the eight-week calligraphy writing (n=48) or control (tablet computer) training (n=51). Outcomes of the interventions were attentional control, working memory, visual scan and processing speed. They were measured at baseline, post-training, and six-month follow-up. Results: Calligraphy writing, when compared with control, significantly improved working memory as reflected from DST-Backward sequence (p=0.009) and span scores (p=0.002), and divided attention as reflected from CTT2 (p < 0.001), and at the post-training. The unique improvement in working memory (span: p < 0.001; sequence: p=0.008) of the intervention group was also found at follow-up when comparing with those at baseline. Changes in the other outcome measures were not statistically significant. Conclusion: The findings provide support that Chinese calligraphy writing training for eight weeks using a cognitive approach would improve working memory and to a lesser extent attentional control functions of patients with early MCI. They also demonstrate the usefulness of using mind-and-body practice for improving specific cognitive functions.