Cognitive Interventions In Aging
Video Introduction: Benefits of Cognitive Training in Older Adults are Long-lasting
Ten-Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults
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 rea- soning 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 Memory training effects were no longer maintained for memory performance.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.
[Rebok, G. W., et al, (2014), Journal of the American Geriatric Society, (62), 16-24]
Computerized Cognitive Training with Older Adults: A Systematic Review
A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer’s disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.
[Kueider, A. M. et al, (2012). PLoS One 7 (7)]
Prospective memory training in older adults and its relevance for successful aging [Hering, A. et al, (2014). PsychologicalResearch DOI 10.1007/s00426-014-0566-4]
A review of physical and cognitive interventions in aging
[Bamidis, P. D. et al, (2014). Neuroscience and Biobehavioral Reviews. Epub ahead of print]
Lifestyle change and the prevention of cognitive decline and dementia: what is the evidence?
[Lövdén, M., Xu, W., and Wang, H.X., (2013). Current Opinion Psychiatry 26 (3): 239-243]