The effect of speed-of-processing training on depressive symptoms in ACTIVE.
OBJECTIVE
We evaluated the effects of three cognitive training interventions on depressive symptoms at 1 and 5 years.


METHODS
Advanced Cognitive Training for Independent and Vital Elderly is a multisite randomized controlled trial (age >or= 65 years), with four groups (memory, reasoning, speed-of-processing, and no-contact control). Complete data were available for 2,014 (72%) and 1,516 (54%) of 2,802 participants at 1 and 5 years. Separate propensity score models adjusted for potential attrition bias. Clinically important increases in depressive symptoms were defined as: (a) Center for Epidemiological Studies-Depression scale (CES-D)-12 score increases >or=0.5 SD and (b) CES-D-12 score increases >or=1.0 SD. Multivariable logistic regression was used.


RESULTS
The speed-of-processing group (vs the no-contact control group) was 30% less likely to experience clinically important increases in depressive symptoms at 1-year (adjusted odds ratio [AOR] = 0.700, p = .012) and 5-year (AOR = 0.698, p = .023) posttraining for the >or=0.5 SD threshold. Similar results (AOR = .669 with p = .039 at 1 year; AOR = 0.651 with p = .059 at 5 years) were obtained for the >or=1.0 SD threshold. No differences were observed among the control, memory, or reasoning groups at either time period or at either threshold.


CONCLUSIONS
The speed-of-processing intervention reduced the risk of clinically important increases in depressive symptoms at 1- and 5-years postbaseline.
Wolinsky
Fredric D
FD
Department of Health Management and Policy, College of Public Health, University of Iowa, 200 Hawkins Drive, E205 General Hospital, Iowa City, IA 52242, USA. fredric-wolinsky@uiowa.edu
Vander Weg
Mark W
MW
Martin
Rene
R
Unverzagt
Frederick W
FW
Ball
Karlene K
KK
Jones
Richard N
RN
Tennstedt
Sharon L
SL
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008568:Memory; D008606:Mental Processes / Q000502:physiology*; D015999:Multivariate Analysis; D011340:Problem Solving; D011930:Reaction Time; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome