We combined data from six studies, all using the same speed of processing training program, to examine the mechanisms of training gain and the impact of training on cognitive and everyday abilities of older adults. Results indicated that training produces immediate improvements across all subtests of the Useful Field of View test, particularly for older adults with initial speed of processing deficits. Age and education had little to no impact on training gain. Participants maintained benefits of training for at least 2 years, which translated to improvements in everyday abilities, including efficient performance of instrumental activities of daily living and safer driving performance.
Objective-To test the effects of cognitive training on subsequent motor vehicle collision (MVC) involvement of older drivers.
Design-Randomized controlled multi-site single-blind clinical trial.Setting-Community-dwelling seniors across four U.S. sites: Birmingham, AL; Baltimore, MD; Indianapolis, IN and State College, PA.Participants-908 older drivers (mean age 73.1 years; 18.6% African American) who were randomized to either one of three cognitive interventions or a control condition.Interventions-Up to 10-sessions of cognitive training for memory, reasoning, or speed of processing.Measurements-State-recorded MVC involvement up to 6-years following study enrollment.Results-Speed of processing and reasoning training resulted in reduced at-fault collision involvement over the subsequent approximately 6-year period relative to controls. After adjusting for age, gender, race, education, mental status, health, vision, depressive symptoms and testing site, those randomized to the speed of processing and reasoning interventions had an approximately 50% lower rate (per person mile) of at- (RR=0.50, 95% CI 0.27-0.92 for reasoning). There was no significant reduction observed for the memory group.Conclusion-Relative to controls, cognitive speed of processing and reasoning training transferred to decreased at-fault MVC rate among older drivers. Considering the importance of driving mobility, the costs of crashes, and the benefits of cognitive training, these interventions have great potential to sustain independence and quality of life of older adults. More research is needed to understand the effects of different types and quantities of training.
The Useful Field of View test (UFOV) is increasingly used in clinical and rehabilitation settings. To date there have been no normative data for adjusted performance comparisons across demographically-similar, elderly peers. This study examined demographic and cognitive influences on the UFOV in a sample of 2759 participants (65-94 years of age). Performance was found to differ by age and education. Regression analyses examined the relative contributions of age, education, mental status, vision, and health to UFOV performance. All of these factors were found to significantly contribute to UFOV performance, with age accounting for the most variance and education accounting for the least. Normative tables for the UFOV by age and education are provided. These norms will allow researchers and clinicians to compare UFOV performance with similar peers and may help in identifying elderly persons who would benefit from speed of processing training.
We examined the physical, visual, health, and cognitive abilities of 1,656 older adults as prospective predictors of self-reported driving cessation over a 5-year period. We examined the time to driving cessation across 5 years after we controlled for days driven per week at baseline and any cognitive intervention participation. Older age, congestive heart failure, and poorer physical performance (according to the Turn 360 Test) were statistically significant risk factors for driving cessation. Slower speed of processing (according to the Digit Symbol Substitution and Useful Field of View tests) was a significant risk factor even after we took baseline driving, age, health, vision, and physical performance into consideration. Implications are that assessments of cognitive speed of processing can provide valuable information about the subsequent risk of driving cessation.
Cognitive speed of processing training can not only improve cognitive performance but also protect against mobility declines among older drivers. Scientifically proven cognitive training regimens have the potential to enhance the everyday lives of older adults.
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