Psychiatr News January 19, 2007
Volume 42, Number 2, page 16
© 2007 American Psychiatric Association
Mental Exercises Boost Functioning in Older Adults
Eve Bender
Older adults in a multisite study who received a brief period of
cognitive training had an easier time performing activities, such as taking
medication and responding to road signs, that might help them live more
independently.
A limited number of mental exercises helped older adults perform better on
cognitive tests and experience less difficulty in performing daily activities
than those who did not receive the training.
Moreover, the benefits for those who received the training were immediate
and lasted for as long as five years, or the duration of the study, according
to a report in the December 2006 Journal of the American Medical
Association.
Moreover, those who received booster training sessions performed three
times faster than those who received only the initial training sessions on
tasks such as preparing meals, balancing a checkbook, and finding numbers in a
phone book.
Not only does the study suggest that elderly people are capable of
improving their cognitive skills as they continue to age, but that the
cognitive gains may translate into improved functioning in everyday life, said
study author and researcher Michael Marsiske, Ph.D., an associate professor in
the Department of Clinical and Health Psychology at the University of
Florida.
"We found that boosting people's cognitive functions had real-world
implications for their everyday functioning," Marsiske told
Psychiatric News.
As part of the Advanced Cognitive Training for Independent and Vital
Elderly (ACTI VE) study, Marsiske and his colleagues recruited a sample of
2,832 adults aged 65 or older and in good functional and cognitive status from
senior housing, community centers, hospitals, and health clinics in
Birmingham, Ala.; Detroit; Boston; Baltimore; Indianapolis; and State College,
Pa., between March 1998 and October 1999. The study lasted until December
2004.
Four Groups Evaluated
The sample was then randomly divided into four groups: participants in
three of the groups received 10 one-hour sessions of memory training,
reasoning training, or speed of processing training. Each group received only
one type of training. The fourth group served as a control group and received
no cognitive training.
Those who received memory training were instructed on basic strategies to
help them remember lists of words. The strategies included compiling groups of
words into larger categories to more easily remember them, visualizing the
words, and associating the words with a meaningful experience to make them
easier to remember.
Volunteers who received reasoning training were taught to look for patterns
among lists of sequences of letters, for instance. In speed-of-processing
training, participants were asked to identify an object that appeared on a
computer screen among visual distractions at increasing rates of speed.
Researchers assessed participants immediately after the intervention and
annually at one, two, three, and five years using cognitive tests relating to
memory, reasoning, and speed of training. They asked participants to rate
themselves on completing tasks such as preparing meals, completing household
chores, finances, telephone use, and shopping using the six-point Minimum Data
Set–Home Care scale to measure their difficulty in instrumental
activities of daily living.
In addition, the researchers used performance-based measures to test the
effects of training in the three areas that required reasoning and
comprehension skills such as identifying information on medication labels,
using the yellow pages, making change, and reacting to road signs.
"These activities we consider crucial for living independently,"
Marsiske noted.
Researchers conducted four booster training sessions among a random sample
of participants for each type of the cognitive training at 11 and 35 months
after the initial training. The content of the booster sessions was similar to
that of the initial training sessions.
Booster Training Helped Cognition
They found that for certain groups, the initial training and later booster
sessions not only improved cognitive abilities, but also everyday
functioning.
Marsiske found that each type of cognitive training produced immediate
improvement on cognitive ability, which lasted five years after the initial
training sessions. Participants who received reasoning training reported
significantly less difficulty in the activities of daily living than did the
control group. Neither memory training nor speed of processing training had a
significant effect on these activities, according to the report.
However, booster training for people who received speed of processing
training had a significant effect (.30 effect size) on the performance-based
measure of speed of processing training (looking up phone numbers in the
yellow pages or reacting quickly to road signs, for instance) compared with
those who received no booster training.
Further research should examine how older people might substitute
do-it-yourself activities for the training activities assessed in the study.
For instance, CDROMs, books, or Web sites offering cognitive exercises might
help them to slow cognitive decline as they continue to age, Marsiske
noted.
"Given the durability and strength of these cognitive effects,"
he added, "we may be able to build some kind of cognitive reserve using
these approaches."
The findings may also bode well for middle-aged adults looking to sharpen
cognitive skills and improve later-life functioning, he noted. "When
age-related decline begins, these people would have the benefit of declining
from a higher baseline" in cognitive and functional abilities.
An abstract of "Long-Term Effects of Cognitive Training on
Everyday Functional Outcomes in Older Adults" is posted at
<jama.ama-assn.org/cgi/content/abstract/296/23/2805>.
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