Case Study: Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE)
| At a Glance |
Research Question
Can cognitive training maintain both cognitive function and daily function in older adults?
NERI's Role
As the data coordinating center for a six-site RCT, NERI provided expertise in CRF design, data collection methods, site training and certification, data management and analysis.
Results
Cognitive training resulted in improved cognitive abilities that lasted for 5 years after training. The transfer of these training effects to daily function was modest but promising and might not be observed until there is more functional decline in the control group.
Funding Institution
This project was funded by the National Institute on Aging and the National Institute of Nursing Research.
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As the population ages, it is increasingly important to understand how cognitive functioning can be preserved or enhanced in older adults. NERI researchers played a major role in a landmark study showing that mental training improves cognitive function in healthy older adults and that these benefits persisted for up to five years. The study also provided the first evidence that these effects may also help with tasks of daily living.
NERI's Role
NERI was the data coordinating center for the Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE). The study recruited 2,832 adults in six U.S. cities who lived independently and had normal cognitive and functional status at the start of the study. Participants were randomly assigned to one of three intervention groups or a control group. The interventions over five to six weeks comprised 10 training sessions (60 to 75 minutes each) for memory, executive reasoning, or speed of processing. This was followed by four-sessions of booster training at 11 and 35 months in a random sample of those who completed training. The memory group learned ways to remember word lists and sequences of items ideas. The reasoning group practiced pattern recognition, while the speed of processing group learned ways to identify an object on a computer screen at increasingly brief exposures.
Results
The mental exercise activities conducted as part of the study slowed the expected decline in the thinking ability of participants five years after the intervention. The improvements in cognitive abilities roughly counteracted the decline in cognitive performance that would be expected over a seven-to-14 year period in individuals without dementia.
Older adults who participated in the cognitive training reported less difficulty with everyday tasks than did those who were not trained. Of the three types of training conducted, only the training aimed at improving reasoning ability showed an effect that rose to the level of statistical significance. The investigators recently completed 10-year assessments of study participants to investigate the durability of these training programs on cognitive function and the hypothesized delay in training effects on daily function. This study proved the value of systematic cognitive training and has provided a model for the development of similar programs at senior centers and residential facilities, rehabilitation centers, and other types of facilities around the world.