Background and Objectives Performance of everyday activities is often challenging for older adults. We evaluated a novel computer-based functional skills assessment and training (CFSAT) program, which includes simulations of everyday tasks (e.g., money and medication management). Research Design and Methods The sample included noncognitively impaired (NC) older adults (n = 51) and cognitively impaired (CI) older adults (n = 43), who ranged in age from 60 to 86 years (M = 73.12; SD = 6.06), were primarily female (90%), and ethnically diverse (23% Hispanic, 51% African American). Participants (stratified by cognitive status) were randomized to 1 of the 2 conditions training alone (CFSAT) or CFSAT with computerized cognitive training and trained up to 24 training sessions. Task performance, using measures of completion time and efficiency (accuracy/completion time), was evaluated at baseline, the final training session, and immediately posttraining with an alternate form of the CFSAT assessment. Results Both NC and CI participants demonstrated significant performance improvements across all tasks following training (all ps < .001). The CI participants demonstrated reduced training gains compared to the NC participants (all ps < .001). Training gains did not vary as a function of training conditions. Discussion and Implications The findings suggest that CFSAT is an efficacious program for assessing and training everyday task performance. CFSAT can ultimately be used as an intervention strategy to enhance functional independence for aging adults with and without cognitive impairments.

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program. Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation. 51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p<0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t<1.66, all p>0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t<1.64, all p>0.11). Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training. Video Link The video component of this article can be found at https://www.jove.com/video/60330/ Currently, training in the performance of technology-relevant everyday functional is not systematically delivered. New technology, such as iPhones, tablets, and computers, are commonly delivered without any instructions for their use. Instructions for using websites are not commonly

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Older adults, especially those with cognitive impairments often experience difficulty performing everyday tasks such as medication management, which threatens independence. Thus, there is an interest in developing treatment approaches for those who are experiencing or at risk for cognitive problems. Cognitive remediation training (CRT) programs have shown to be effective in improving cognitive abilities, but there is limited evidence to suggest that CRT results in everyday task performance gains. This presentation will discuss findings from a trial evaluating an innovative computer -based functional skills assessment and skills training program (CFSAT), which includes ecologically valid simulations of everyday tasks (e.g., shopping, money and medication management). The sample includes non-cognitively impaired (NC) older adults (n=50) and those with mild cognitive impairment (MCI) (n = 40), ranging in age from 60 -86 years (M= 73.10; SD = 6.06), is primarily female (90%), and ethnically diverse (69% minority). Participants were randomized into the CFSAT condition or a CFSAT + CRT condition. Performance data includes real time measures of accuracy, response time and efficiency. The findings indicate that the assessment component of the CFSAT program differentiated between the NC and MCI groups at the baseline assessment. Both NC and MCI participants demonstrated improvements in performance following training across all tasks; though the MCI participants required more training. Participants who received CFSAT + CRT training demonstrated increased efficiency in skill acquisition. The results indicate that the CFSAT program is an efficacious tool for assessing and training functional performance in both non-cognitively and cognitively impaired older adults.