January 13, 2014

Cognitive training shows some lasting effects in healthy older adults

UW Health Sciences/UW Medicine

Results from a national, decade-long study suggest that particular types of cognitive training can have lasting benefits for older adults.  The study showed the training can help maintain certain thinking and reasoning skills, but at 10-year followup the memory training and control group had no differences in memory performance.

elderly man teaches chess

Jacob Wackerhauser/iStock

An elderly man teaches his grandson how to play chess. A recent study shows cognitive training helps preserve reasoning and thinking skills in older adults.

The latest findings from the Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE study, are reported in the January 2014 issue of the Journal of the American Geriatrics Study.

The researchers had published previous papers on the results of the training at earlier points in the study.

This is the first large-scale, randomized control trial of cognitive training in healthy older adults.  Most previous clinical trials of this nature were with adults with mild cognitive impairments, dementia, a functional limitation, or another disorder.  ACTIVE was a scientific evaluation of the effects of three theory-based training programs.

This project followed healthy, independent-living older adults from six cities – Baltimore, Birmingham, Ala., Boston, Detroit, State College, Pa., and Indianapolis.  The 2,832 original volunteers averaged 74 years of age at the start of the study and 14 years of formal education. Of the group, 75 percent were women, 74 percent were white, and 26 percent were African-American.

The tenth-year follow-ups, part of an annual evaluation of participants throughout the study period, took place with 44 percent of the original sample from April 1998 to October 2010. The average age of the remaining participants a the end of the study was  82.

Sherry L. Willis, University of Washington professor of psychiatry and behavioral sciences, was one of seven investigators on the trial. The National Institute on Aging and the National Institute of Nursing, both part of the National Institutes of Health, funded the project.

Willis, and her colleagues George Rebok of Johns Hopkins University, and Karlene Ball, of the University of Alabama at Birmingham, put together the training programs used in the study. They plan to continue to work on these programs and to make them more widely available.  They also hope to measure the effects of ACTIVE cognitive training with elderly people who have risk factors for cognitive decline.

The researchers noted that the search for intervention and prevention strategies to postpone mental decline later in life is growing.  Many researchers are interested in pursuing cognitive training as a possible way to help older people live at home for as long as possible.

The ACTIVE study volunteers were divided into three training groups – memory, reasoning, and speed-of processing, or performing a mental task quickly. There was also a control group who did not receive training. Over 5 to 6 weeks, the training groups participated in ten training sessions, each lasting about 60 to 70 minutes. Later, some of the participants were then randomly assigned to booster sessions.  The effects of the training were measured immediately at the end of the sessions, and 1, 2, 3, 5 and 10 years afterward.

The researchers checked to see whether the training had an effect on the participants’ ability to carry out some of the routine and complex tasks of daily living. They used standard measures to assess time and efficiency in performing everyday tasks, and also asked the volunteers to describe their ability to prepare meals, use the telephone, manage their finances, shop and travel, and whether they needed assistance in dressing and other personal care.

By the end of the study, all of the groups, now 10 years older, showed decline in their reasoning, memory, and speed of processing, compared to their tests at earlier points in the study.  Nevertheless, those who had received training in reasoning and speed of processing showed less decline than the memory-training or control group.

Cognitive testing at the 10 year mark showed that 73.6 percent of the participants who had received reasoning training were still performing reasoning tasks better than before they started the training, compared to 67.3 percent of the control group, who had no training but who did have experience taking the test.  Among the speed trained volunteer, 70.7 percent performed above their pre-study baseline level, compared to 48.8 percent of the controls.

The researchers noted that the findings suggest that even relatively brief training can be effective in producing durable improvements in the mental performance of people age 65 and older Without singling any program beyond the training approaches studied, the results also suggest that people who seek to keep their mental functioning strong might consider engaging in mental exercise.  At the same time, the researchers caution that consumers should insist that any cognitive training program offer scientific evidence of its effectiveness. Many products currently available have not undergone rigorous evaluation.

Read the Journal of the American Geriatrics Society paper “Ten Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Function”  by  G. W. Rebok et al.

A version of the speed-of-processing program is available from Posit Science. Manuals for the reason and memory training have also been developed.

The research was  funded by grants U01 AG14263, U01NR04507, U01NR04508, U01AG 14260, U0AG14282, U01AG14263, U01AG14289, and U01AG14276 from the  National Institute on Aging and National Institute for Nursing Research of the National Institutes of Health.

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