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Randomized Controlled Trial
. 2014 Jan;62(1):16-24.
doi: 10.1111/jgs.12607. Epub 2014 Jan 13.

Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults

George W Rebok  1 , Karlene Ball, Lin T Guey, Richard N Jones, Hae-Young Kim, Jonathan W King, Michael Marsiske, John N Morris, Sharon L Tennstedt, Frederick W Unverzagt, Sherry L Willis; ACTIVE Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults

George W Rebok et al. J Am Geriatr Soc. 2014 Jan.

Abstract

Objectives: To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years.

Design: Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control group.

Setting: Six U.S. cities.

Participants: A volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently.

Intervention: Ten training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial training.

Measurements: Objectively measured cognitive abilities and self-reported and performance-based measures of everyday function.

Results: Participants in each intervention group reported less difficulty with instrumental activities of daily living (IADLs) (memory: effect size = 0.48, 99% confidence interval (CI) = 0.12-0.84; reasoning: effect size = 0.38, 99% CI = 0.02-0.74; speed of processing: effect size = 0.36, 99% CI = 0.01-0.72). At a mean age of 82, approximately 60% of trained participants, versus 50% of controls (P < .05), were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size = 0.23, 99% CI = 0.09-0.38; speed of processing: effect size = 0.66, 99% CI = 0.43-0.88). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size = 0.21, 99% CI = 0.01-0.41) and the speed-of-processing intervention for speed-of-processing performance (effect size = 0.62, 99% CI = 0.31-0.93).

Conclusion: Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.

Keywords: cognitive abilities; cognitive training; elderly; everyday function; training maintenance.

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Figures

Figure 1
Figure 1
Profile of the ACTIVE trial
Figure 1
Figure 1
Profile of the ACTIVE trial
Figure 2
Figure 2. Cognitive Outcomes by Time and Training Group
The figures displays mean scores for the three cognitive outcomes - memory (panel A), reasoning (panel B), speed-of-processing (panel C) - for each training group at each time point. Higher scores indicate better performance. The sample sizes show the number of participants with complete data for each cognitive outcome at each time point.
Figure 3
Figure 3
Training effects on self-reported Instrumental Activities of Daily Living (IADL) difficulty scores. The figure displays mean IADL difficulty scores for each training group at each time point. Higher scores indicate better functioning. The sample sizes show the number of participants with complete data for the IADL difficulty score at each time point.
See this image and copyright information in PMC

References

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    1. Rebok G. State-of-Science Review: SR:E22 UK. Government Foresight Mental Capital and Mental Wellbeing Project. Government Office for Science; 2008. Cognitive training: influence on neuropsychological and brain function in later life.
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    1. Ball K, Berch DB, Helmers KF, et al. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002;288(18):2271–2281. - PMC - PubMed
    1. Willis SL, Tennstedt SL, Marsiske M, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006;296(23):2805–2814. - PMC - PubMed

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