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January 13, 2014

Cognitive Training Program Shows 10-Year Benefit in Areas of Speed and Reasoning in Older Individuals

The benefits of training older individuals in two important cognitive areas – reasoning and speed of processing – lasted to some degree ten years after the training program was completed, according to the results of clinical trials published in the January 2014 issue of Journal of the American Geriatrics Society. The study was supported by the National Institute on Aging and the National Institute of Nursing Research, both components of the National Institutes of Health. George Rebok, PhD, professor in the Department of Mental Health and the Center on Aging and Health at the Johns Hopkins Bloomberg School of Public Health, was one of the study’s six investigators.

The report, from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, assessed 2,832 volunteer participants in six U.S. cities who were divided into three training groups – reasoning, speed of processing and memory – and a control group. The training groups participated in ten 60- to 70-minute sessions over five to six weeks, with some randomly selected for later “booster” sessions. The study measured effects for each specific cognitive ability trained immediately following the sessions and at 1, 2, 3, 5, and 10 years after the training.

While all groups showed declines in the three cognitive categories -- memory, reasoning, and speed of processing -- following the end of the trial, the participants who had training in reasoning and speed of mental processing experienced less decline than those who had not been trained. Results of the cognitive tests after 10 years show that 73.6 percent of reasoning-trained participants were still performing reasoning tasks above their baseline level before the trial compared to 61.7 percent of control participants, who received no training and were only benefiting from practice on the test. This same pattern was seen in speed training: 70.7 percent of speed-trained participants were performing at or above their baseline level compared to 48.8 percent of controls. The results for memory-trained participants were not significant.

The investigators also assessed whether the training had an effect on the participants’ abilities to undertake complex tasks of daily living, using composite measures and asking the participants themselves about their ability to handle things such as meal preparation, housework, finances, health care, using the telephone, shopping, travel, and needing assistance in dressing, personal hygiene, and bathing.  Ten years after initial training, all three training groups reported less difficulty in performing these daily tasks than the control group.  A significant percent of participants in all trained groups (at least 60 percent) continued to report less difficulty performing daily living activities compared to non-trained participants (49 percent). After 10 years, 60-70 percent of participants said they were as well or better off than when they started.

“Showing that training gains are maintained for up to ten years is a remarkable result because it suggests that a fairly modest intervention in practicing mental skills can have long-term effects on older adults’ cognition and daily function beyond what we might reasonably expect,” said Rebok.

The participants averaged 74 years of age at the beginning of the study and 14 years of education, 76 percent were female, 74 percent were white, and 26 percent were African-American. The 10-year follow-up was conducted with 44 percent of the original sample between April 1998 and October 2010.

In addition to Professor Rebok, the ACTIVE study was conducted by Karlene Ball, PhD, University of Alabama at Birmingham; Richard N. Jones, Sc.D., Social and Health Policy Research, Hebrew SeniorLife, Boston, Mass.; Michael Marsiske, PhD, University of Florida, Gainesville; John N. Morris, PhD, Hebrew Senior Life, Boston, Mass.; Sharon Tennstedt, PhD, New England Research Institutes, Watertown, Mass.; Frederick Unverzagt, Ph.D., Indiana University, Indianapolis; and Sherry L. Willis, Ph.D., University of Washington, Seattle

Johns Hopkins Bloomberg School of Public Health media contact: Tim Parsons at 410-955-7619 or tmparson@jhsph.edu.