Effects of cognitive training interventions with older adults: a randomized controlled trial.
2002
ContextCognitive function in older adults is related to independent living
and need for care. However, few studies have addressed whether improving cognitive
functions might have short- or long-term effects on activities related to
living independently.ObjectiveTo evaluate whether 3 cognitive training interventions improve mental
abilities and daily functioning in older, independent-living adults.DesignRandomized, controlled, single-blind trial with recruitment conducted
from March 1998 to October 1999 and 2-year follow-up through December 2001.Setting and ParticipantsVolunteer sample of 2832 persons aged 65 to 94 years recruited from
senior housing, community centers, and hospital/clinics in 6 metropolitan
areas in the United States.InterventionsParticipants were randomly assigned to 1 of 4 groups: 10-session group
training for memory (verbal episodic memory; n = 711), or reasoning (ability
to solve problems that follow a serial pattern; n = 705), or speed of processing
(visual search and identification; n = 712); or a no-contact control group
(n = 704). For the 3 treatment groups, 4-session booster training was offered
to a 60% random sample 11 months later.Main Outcome MeasuresCognitive function and cognitively demanding everyday functioning.ResultsThirty participants were incorrectly randomized and were excluded from
the analysis. Each intervention improved the targeted cognitive ability compared
with baseline, durable to 2 years (P<.001 for
all). Eighty-seven percent of speed-, 74% of reasoning-, and 26% of memory-trained
participants demonstrated reliable cognitive improvement immediately after
the intervention period. Booster training enhanced training gains in speed
(P<.001) and reasoning (P<.001)
interventions (speed booster, 92%; no booster, 68%; reasoning booster, 72%;
no booster, 49%), which were maintained at 2-year follow-up (P<.001 for both). No training effects on everyday functioning were
detected at 2 years.ConclusionsResults support the effectiveness and durability of the cognitive training
interventions in improving targeted cognitive abilities. Training effects
were of a magnitude equivalent to the amount of decline expected in elderly
persons without dementia over 7- to 14-year intervals. Because of minimal
functional decline across all groups, longer follow-up is likely required
to observe training effects on everyday function.
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