title: Effect of memory impairment on training outcomes in ACTIVE.
abstract: Cognitive training improves mental abilities in older adults, but the trainability of persons with memory impairment is unclear. We conducted a subgroup analysis of subjects in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial to examine this issue. ACTIVE enrolled 2802 non-demented, community-dwelling adults aged 65 years and older and randomly assigned them to one of four groups: Memory training, reasoning training, speed-of-processing training, or no-contact control. For this study, participants were defined as memory-impaired if baseline Rey Auditory Verbal Learning Test (AVLT) sum recall score was 1.5 SD or more below predicted AVLT sum recall score from a regression-derived formula using age, education, ethnicity, and vocabulary from all subjects at baseline. Assessments were taken at baseline (BL), post-test, first annual (A1), and second annual (A2) follow-up. One hundred and ninety-three subjects were defined as memory-impaired and 2580 were memory-normal. Training gain as a function memory status (impaired vs. normal) was compared in a mixed effects model. Results indicated that memory-impaired participants failed to benefit from Memory training but did show normal training gains after reasoning and speed training. Memory function appears to mediate response to structured cognitive interventions in older adults.
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. funverza@iupui.edu
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Unverzagt
authors.forename: Linda
authors.initials: L
authors.lastname: Kasten
authors.forename: Kathy E
authors.initials: KE
authors.lastname: Johnson
authors.forename: George W
authors.initials: GW
authors.lastname: Rebok
authors.forename: Michael
authors.initials: M
authors.lastname: Marsiske
authors.forename: Kathy Mann
authors.initials: KM
authors.lastname: Koepke
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Elias
authors.forename: John N
authors.initials: JN
authors.lastname: Morris
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Willis
authors.forename: Karlene
authors.initials: K
authors.lastname: Ball
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Rexroth
authors.forename: David M
authors.initials: DM
authors.lastname: Smith
authors.forename: Fredric D
authors.initials: FD
authors.lastname: Wolinsky
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Tennstedt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D005853:Geriatrics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D012111:Residence Characteristics; D016037:Single-Blind Method; D013067:Speech Perception; D016896:Treatment Outcome; D014706:Verbal Learning / Q000502:physiology