Ten‐Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults

Abstract

Objective To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. Design, Setting, and Participants Ten-year follow-up of a randomized, controlled single-blind trial with 3 intervention groups and a no-contact control group. A volunteer sample of 2832 persons (mean baseline age, 73.6 years; 26% African American) living independently in 6 US cities. Interventions Ten-session training for memory, reasoning, or speed-of-processing.; 4-session booster training at 11 and at 35 months after training. Measurements Objectively measured cognitive abilities and self-reported and performance-based measures of everyday function. Results Participants in each intervention group reported less difficulty with instrumental activities of daily living (IADL) (memory: effect size, 0.48 [99% CI, 0.12-0.84]; reasoning: effect size, 0.38 [99% CI, 0.02-0.74]; speed-of-processing: effect size, 0.36 [99% CI, 0.01-0.72]). At mean age of 82 years, about 60% of trained participants compared to 50% of controls (p<.05) were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size, 0.23 [99% CI, 0.09-0.38]; speed-of-processing: effect size, 0.66 [99% CI, 0.43-0.88]). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size, 0.21 [99% CI, 0.01-0.41]) and the speed-of-processing intervention for speed-of-processing performance (effect size, 0.62 [99% CI, 0.31-0.93]). Conclusions Each ACTIVE cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.

Systematic Literature Review and Meta-Analysis of Commercially Available Computerized Cognitive Training Among Older Adults

“…Of note, three of these studies used a version of InSight and found significant transfer to IADL performance. One of the largest studies of CT to date indicated that far transfer may not be immediately evident, but can emerge over time (Rebok et al 2014). Thus, the lack of significant effects on everyday functional performance in these analyses could be to be examining only immediate posttraining effects.…”

“…Ample evidence demonstrates that CT programs enhance the cognitive abilities targeted by training Edwards et al 2005b;Jaeggi et al 2008;Smith et al 2009). However, there have been mixed findings regarding whether CT generalizes or transfers to untrained tasks Brehmer et al 2012;Rebok et al 2014;Schmiedek et al 2010;Willis et al 2006). Trained tasks refer to the tasks that were employed or directly targeted during the training sessions and are also referred to as primary, proximal, or criterion outcomes (Zelinski 2009).…”

“…The efficacy of these programs should be examined to allow older adults to make informed decisions when choosing a commercially available CT program. Based on the results from previous studies in the literature Rebok et al 2014;Smith et al 2009;Willis et al 2006), it was hypothesized that (a) there would be evidence for the efficacy of commercialized computerized CT programs and (b) there would be far transfer of training to improved everyday function. This systematic literature review and meta-analysis was prospectively registered with PROSPERO (CRD42015027628).…”

The Role and Sources of Individual Differences in Critical-Analytic Thinking: a Capsule Overview

“…Another found that preschoolers can improve their reasoning skills through practicing computerized tasks involving pattern recognition (Bergman Nutley et al 2011). Older adults who participated in reasoning training maintain their improved reasoning skills for at least 10 years, and scored better on overall health and quality of life measures than a control group (Rebok et al 2014). Fluid reasoning training, in the form of preparing for a reasoning-intensive standardized test, has been linked to increased functional connectivity between the RLPFC and the rest of the fronto-parietal network (Mackey et al 2013), as well as changes in structural connectivity (Mackey et al 2012).…”

The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study (Preprint)

“…The cognitive training program (provided by MindAgilis; London, England) focused on processing speed, executive function, working memory, episodic memory, and mental speed, which are tasks shown to be associated with improved cognitive ability and less difficulty with instrumental activities of daily living. 28,29 All program coaches were certified as personal trainers with mastery of exercise physiology safety and nutritional health practices. Coaches were available via telephone, email, and text messaging.…”