Learning ratio performance on a brief visual learning and memory test moderates cognitive training gains in Double Decision task in healthy older adults

Abstract

Cognitive training using a visual speed-of-processing task, called the Useful Field of View (UFOV) task, reduced dementia risk and reduced decline in activities of daily living at a 10-year follow-up in older adults. However, there was variability in the achievement of cognitive gains after cognitive training across studies, suggesting moderating factors. Learning trials of visual and verbal learning tasks recruit similar cognitive abilities and have overlapping neural correlates with speed-of-processing/working memory tasks and therefore could serve as potential moderators of cognitive training gains. This study explored the association between the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) learning with a commercial UFOV task called Double Decision. Through a secondary analysis of a clinical trial, we assessed the moderation of HVLT-R and BVMT-R learning on Double Decision improvement after a 3-month speed-of-processing/attention and working memory cognitive training intervention in a sample of 75 cognitively healthy older adults. Multiple linear regressions showed that better baseline Double Decision performance was significantly associated with better BVMT-R learning (β = - .303). This association was not significant for HVLT-R learning (β = - .142). Moderation analysis showed that those with poorer BVMT-R learning improved the most on the Double Decision task after cognitive training. This suggests that healthy older adults who perform below expectations on cognitive tasks related to the training task may show the greatest training gains. Future cognitive training research studying visual speed-of-processing interventions should account for differing levels of visuospatial learning at baseline, as this could impact the magnitude of training outcomes and efficacy of the intervention.

Keywords: Cognitive training; Healthy aging; Speed of processing; Verbal learning; Visual learning.

Fig. 1

Study timeline

Fig. 2

Still frame of POSIT Double Decision assessment at moderate difficulty. Reproduced/adapted from POSIT Brain HQ, used with permission

Fig. 3

Diagram of moderation model

Fig. 4

Regressions of HVLT-R learning ratio (A) and BVMT-R learning ratio (B) with Double Decision assessment performance with 95% confidence Intervals; r.² reflects variance explained from the partial correlation between predictors and Double Decision assessment performance; β = standardized beta; x-axis = residual predictors controlling for covariates; y-axis = Double Decision performance; *p < .05

Fig. 5

Moderation of education control group HVLT-R (A) and BVMT-R (B) learning ratio and cognitive training group HVLT-R (C) and BVMT-R (D) learning ratio on Double Decision assessment performance from baseline to 3-month follow-up. As Double Decision performance output is in milliseconds, lower scores reflect better performance. “Above Mean” reflects those who performed .5 standard deviations and above the mean, “Below Mean” reflects those who performed − .5 standard deviations and below the mean, and “Mean” reflects all other participants on the respective moderation variable. *p < .01 moderation