Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT) Trial: Rationale, design, and baseline characteristics

Abstract

Age-related perceptual and cognitive declines are associated with difficulties performing everyday tasks required to remain independent. Encouraging improvements in cognitive abilities have been shown for various short-term interventions but there is little evidence for direct impact on independence. This project compares the effect of broad and directed (narrow) technology-based training on basic perceptual and cognitive abilities in older adults and on the performance of simulated tasks of daily living including driving and fraud avoidance. Participants (N = 230, Mean age = 72) were randomly assigned to one of four training conditions: broad training using either (1) a web-based brain game suite, Brain HQ, or (2) a strategy video game, Rise of Nations, or to directed training for (3) Instrumental Activities of Daily Living (IADL) training using web-based programs for both driving and fraud avoidance training, or (4) to an active control condition of puzzle solving. Training took approximately 15-20 hours for each intervention condition across four weeks. Before training began, participants received baseline ability tests of perception, attention, memory, cognition, and IADL, including a driving simulator test for hazard perception, and a financial fraud recognition test. They were tested again on these measures following training completion (post-test). A one-year follow-up from training completion is also scheduled. The baseline results support that randomization was successful across the intervention conditions. We discuss challenges and potential solutions for using technology-based interventions with older adults. We also discuss how the current trial addressed methodological limitations of previous intervention studies.

Relative effectiveness of general versus specific cognitive training for aging adults.

“…Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT) was a single-site randomized and controlled clinical trial with four-group design including three intervention groups (brain training, video game training, or a directed IADL training) and an active control group with puzzle training (see Yoon et al, 2019, for details). This trial was conducted from October, 2017—through August 2019 with older adults aged ≥65 years living in the Leon Country area (Florida, USA).…”

“…Participants were ineligible if they: (a) reported terminal illness with life expectancy <12 months; (b) reported or exhibited a disabling visual condition assessed as the inability to read printed material; (c) reported or exhibited a disabling speech hearing and comprehension condition assessed by inability to hear and comprehend the screener’s instructions; (d) reported or exhibited a disabling speech production condition assessed as the inability to respond with comprehensible English speech to the screener’s queries; (e) reported or exhibited a disabling psychomotor condition assessed as the inability to use a keyboard and pointing device. Participants were also ineligible if they had previously experienced any of the intervention tasks used in the present trial (for more detail about ineligibility criteria, see Yoon et al, 2019). From 595 individuals contacted for prescreening, 230 were randomized and the sample was more likely to be female (58%), with age ranging from 64 1 to 92 years ( M = 71.35, SD = 5.33).…”

“…For general training, we chose two cognitive training tasks that have shown efficacy in improving cognitive abilities: BrainHQ, a web-based commercial program based on speed of processing training developed in ACTIVE (Smith et al, 2009), and Rise of Nations, a strategy videogame shown to improve executive functioning (Basak et al, 2008). For specific training, we used a combination of a newly designed tutorial on finances and fraud (described in Yoon et al, 2019) and the American Association of Retired Persons (AARP) web-based training program for older adults aimed at improving knowledge and strategies for driving. That condition was called the IADL training condition.…”

“…We conducted assessments at baseline, at an immediate posttest, and at a 1-year follow-up. Details of the study design and baseline results are given in Yoon et al (2019). To guard against capitalization on chance for the many possible comparisons across training groups and outcome measures, we registered our analysis plan.…”

A New Tool for Assessing Older Adults’ Wireless Network Proficiency: The Wireless Network Proficiency Questionnaire

“…Participants were presented an honorarium for each study visit in the study. For further discussion of consent, recruitment, and other baseline characteristics, see Yoon et al (2019).…”