Memory training and strategy use in older adults: results from the ACTIVE study

Abstract

Little is known about the long-term effects of memory training in later life on strategy use. Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 1,401) were used to describe strategy use in a community-dwelling sample of older adults. Strategy clustering scores on verbal list learning tasks of episodic memory were used to test the impact of memory training on strategy use and study longitudinal associations between strategy clustering, memory performance, and everyday functioning. Results suggested that younger, female, white, healthier, and more educated participants show higher strategy clustering scores initially but no characteristics were consistently associated with different trajectories in strategy clustering across all strategy clustering measures together. Memory training had significant immediate effects on all measures of strategy use that were maintained through five years of follow-up. With respect to longitudinal mediation, pre-post training changes in most strategy clustering scores mediate changes in objective memory performance and everyday functioning, implying that strategies can be modified and are closely related to both memory ability and the ability to function independently. This study provides evidence that older adults can be trained to use cognitive strategies, the effects are durable, and strategies are associated with memory and everyday functioning.

Figures

Figure 1. Parallel Process Latent Growth Curve Model of Strategy Clustering Scores

Group-specific parallel process latent growth model of strategy clustering growth processes (HVLT semantic, subjective, and serial clustering; AVLT subjective and serial clustering) across six measurement occasions in the ACTIVE study. The model is described notationally in equations in the Methods section. Latent variable intercepts and slopes for each strategy clustering score were regressed on covariates, which included age, sex, ethnicity, self-rated health, and education. Residual error variances are shown by smaller arrows going towards the observed (boxed) and latent (circled) dependent variables. Numbers on arrows going from latent growth parameters to observed time points indicate factor loadings. T: Assessment wave (1=Baseline; 2=Immediate Post-test; 3=Year1; 4=Year2; 5=Year3; 6=year5).

Figure 2. Mean Trajectories of Strategy Clustering Scores: Results from ACTIVE (N=1,401)

Mean trajectories of strategy clustering scores for the ACTIVE memory training and control groups are shown by solid lines and dotted lines, respectively. 95% confidence bands are shown for each group.