The study, known as Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE, is the first to link such cognitive training to benefits in activities in everyday living and not just to mental skills related to the exercises, said Frederick W. Unverzagt, Ph.D., professor in the Department of Psychiatry at the Indiana University School of Medicine and one of the ACTIVE study investigators.
“Previous data from this clinical trial demonstrated that the effects of the training lasted for five years,” said Richard J. Hodes, M.D., director of the National Institute on Aging. “Now, these longer term results indicate that particular types of cognitive training can provide a lasting benefit a decade later. They suggest that we should continue to pursue cognitive training as an intervention that might help maintain the mental abilities of older people so that they may remain independent and in the community.”
The study involved 2,832 people living independently in Detroit, Baltimore and western Maryland, Birmingham, Ala., Indianapolis, Boston and central Pennsylvania. The participants averaged 74 years old at the beginning of the study. About one-quarter of the participants were African-Americans, and about three-quarters were women.
The participants were divided randomly into groups receiving either memory training, reasoning training or speed training. A fourth — control — group received no training. Meeting in small groups, the participants had 10 training sessions of 60 to 75 minutes each over a period of five to six weeks. Some participants received “booster” training one and three years after the initial sessions.
Memory training involved improving abilities to recall texts and lists. Reasoning training included solving problems that involved patterns. Speed training, conducted on touch screen computers, was designed to increase speed in identifying information in different screen locations. The types of training were selected because they appeared in previous testing to be applicable to such daily activities as using the phone, tracking medication use and taking care of finances.
After 10 years, participants in each of the training groups reported less difficulty in conducting activities of daily living than those in the control groups. Participants in all three treatment groups saw immediate improvements in the cognitive ability that was trained compared to participants in the control group who received no training. This cognitive improvement was maintained through 5 years for all three treatments and through 10 years for the participants who received reasoning and speed training.
“The durability of this effect was remarkable,” Dr. Unverzagt said.
Dr. Unverzagt noted that overall, the training sessions produced clear but modest benefits, suggesting it would be worthwhile to study the potential benefits of combining cognitive training with other lifestyle and health interventions as exercise and improved diet.
Other researchers involved in the study were Karlene Ball, Ph.D., Department of Psychology, University of Alabama at Birmingham; Richard N. Jones, Sc.D., Social and Health Policy Research, Hebrew SeniorLife; Jonathan W. King, Ph.D., Division of Social and Behavioral Research, National Institute on Aging; Michael Marsiske, Ph.D., Institute on Aging and Department of Clinical and Health Psychology, University of Florida; John N. Morris, Ph.D., Social and Health Policy Research, Hebrew SeniorLife; George W. Rebok, Ph.D., Department of Mental Health and Center on Aging and Health, Johns Hopkins University; Sharon L. Tennstedt, Ph.D., New England Research Institutes and Sherry L. Willis, Ph.D., Department of Psychiatry and Behavioral Sciences, University of Washington; the ACTIVE Study Group.
The study was supported by grant numbers U01NR04507, U01NR04508, U01AG14260, U01AG14282, U01AG14263, U01AG14289, and U01AG14276 from the National Institute on Aging and the National Institute for Nursing Research of the National Institutes of Health.