Long-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults

Bibliographic Data

ID23329926
AuthorsSherry L Willis (0000-0002-1404-179X, Pennsylvania State University), Sharon L Tennstedt (New England Research Institutes), Michael Marsiske (0000-0001-5973-2116, University of Florida), Karlene Ball (0000-0003-1811-9870, University of Alabama at Birmingham), Jeffrey W Elias (National Institutes of Health), Jeffrey Elias, Kathy Mann Koepke (National Institutes of Health), John N Morris (0000-0001-5867-0697, Hebrew College), George W Rebok (0000-0002-5371-8767, Johns Hopkins University), Frederick W Unverzagt (0000-0001-9297-1186, University School), Anne M Stoddard (New England Research Institutes), Elizabeth Wright (0000-0003-0712-9475), ELIZABETH C WRIGHT (0000-0002-9841-3879, New England Research Institutes)
Year2006
Volume296
Issue23
Pages2805
Publication date2006-12-20
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJAMA (JOURNAL)
Journal identifiersISSN: 0098-7484 • E-ISSN: 1538-3598
PublisherAmerican Medical Association (AMA) (PUBLISHER)
DOI10.1001/jama.296.23.2805
PMID17179457
PMCIDPMC2910591
OpenAlexW2131162932
LanguageEN
Citations received107
References cited9

CONTEXT: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. OBJECTIVE: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. INTERVENTIONS: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. MAIN OUTCOME MEASURES: Self-reported and performance-based measures of daily function and cognitive abilities. RESULTS: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). CONCLUSIONS: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00298558.

Activities of daily living · Audiology · Cognition · Cognitive skill · Cognitive Training · Confidence interval · Effects of sleep deprivation on cognitive performance · Episodic memory · Physical therapy · Psychiatry · Randomized controlled trial · Cognitive Abilities and Testing · Dementia and Cognitive Impairment Research · Medicine · Technology Use by Older Adults · Gerontology

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