Does Visual Speed of Processing Training Improve Health-Related Quality of Life in Assisted and Independent Living Communities?: A Randomized Controlled Trial

Abstract

Background and Objectives Visual speed of processing training had clinically and statistically significant beneficial effects on health-related quality of life among 2,802 healthy community-dwelling adults 65-94 years old at two and five years post-training in the Advanced Cognitive Training for Independent and Vital Elderly randomized controlled trial. We examined whether that effect would be found among older adults in assisted and independent living communities. Research Design and Methods We conducted a two-arm, parallel randomized controlled trial stratified by assisted vs. independent settings in 31 senior living communities and enrolled 351 adults aged 55-102 years old. The targeted intervention dose was ten hours at baseline with four-hour boosters at five and eleven months. The intervention group received computerized visual speed of processing training, while the attention control group solved computerized crossword puzzles. The health-related quality of life outcomes were the Short Form 36-Item Health Survey’s mental and physical component T-scores. Linear mixed effect models were used. Results Visual speed of processing, assisted living, and their interaction had no clinically or statistically significant effects on the physical component T-scores. However, visual speed of processing (p = 0.022), assisted living (p= 0.022), and their interaction (p = 0.007) had clinically and statistically significant effects on the mental component T-scores. The estimated marginal means revealed a small effect-sized positive 2.2 point visual speed of processing training effect in the independent living communities, but a clinically important harmful -4.2 point visual speed of processing training effect in the assisted living communities. Discussion and Implications Given the medium-sized harmful effect of visual speed of processing training among those in the assisted living communities, caution is advised when using these two visual speed of processing training modalities in assisted living communities until further research verifies or refutes our findings and the underlying etiological pathways.

Brain training using cognitive apps can improve cognitive performance and processing speed in older adults

“…While cognitive training app games have been shown to improve memory in older people with mild cognitive impairment 63 , further studies are needed to determine if technologies, such as apps, can decrease dementia risk in healthy subjects or slow down the progression of the disease in patients suffering from cognitive impairment and if there is a transfer to the activities of daily living. We can, also, speculate that since psychomotor slowing associated with aging has an important negative effect on multi-tasking activities of daily living, improving the processing speed could have a positive effect on the quality of life of the participants 64 .…”

Long-Term Effects of Cognitive Training on All-Cause Mortality in US Older Adults

“…Nevertheless, as all trained groups suggest an apparent adverse effect of training on mortality, this is curious and remains unexplained. It is possible that low-educated individuals found the training more stress-inducing, leading to negative psychological (e.g., negative self-identity perceptions) and physiological (e.g., elevated cortisol levels) responses associated with increased mortality (e.g., [Wolinsky et al, 2020]). However, since we did not measure these variables, we can only speculate about the etiologic mechanisms underlying the education-training interactions.…”

Feasibility of a Home-Based Task-Switching Training in Middle-Aged Caregivers

“…For example, Wolinsky et al (2013) reported that 28.3% of their middle-and old-aged adults (> 50 years) who trained at home performed less than 1 h (out of 10 h) of training in a visual speed task. In a follow-up study, Wolinsky et al (2020) found also a great variety of adherence to a visual processing speed training a community-based sample of older adults (> 55 years). Chan and colleagues (2016) conducted a field training study targeting older adults (60-90 years) in a community setting which included homework as well as group training for an extensive time (> 150 h).…”