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

Objectives: To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years.

Design: Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control group.

Setting: Six U.S. cities.

Participants: A volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently.

Intervention: Ten training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial 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 (IADLs) (memory: effect size = 0.48, 99% confidence interval (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 a mean age of 82, approximately 60% of trained participants, versus 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 Memory training effects were no longer maintained for memory performance.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).

Conclusion: Each Advanced Cognitive Training for Independent and Vital Elderly 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.

Keywords: cognitive abilities; cognitive training; elderly; everyday function; training maintenance.

© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Figures

Figure 1

Profile of the ACTIVE trial

Figure 1

Profile of the ACTIVE trial

Figure 2. Cognitive Outcomes by Time and Training Group

The figures displays mean scores for the three cognitive outcomes - memory (panel A), reasoning (panel B), speed-of-processing (panel C) - for each training group at each time point. Higher scores indicate better performance. The sample sizes show the number of participants with complete data for each cognitive outcome at each time point.

Figure 3

Training effects on self-reported Instrumental Activities of Daily Living (IADL) difficulty scores. The figure displays mean IADL difficulty scores for each training group at each time point. Higher scores indicate better functioning. The sample sizes show the number of participants with complete data for the IADL difficulty score at each time point.