A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study.
OBJECTIVE
To investigate the efficacy of a novel brain plasticity-based computerized cognitive training program in older adults and to evaluate the effect on untrained measures of memory and attention and participant-reported outcomes.


METHODS
Multisite randomized controlled double-blind trial with two treatment groups.


METHODS
Communities in northern and southern California and Minnesota.


METHODS
Community-dwelling adults aged 65 and older (N=487) without a diagnosis of clinically significant cognitive impairment.


METHODS
Participants were randomized to receive a broadly-available brain plasticity-based computerized cognitive training program (intervention) or a novelty- and intensity-matched general cognitive stimulation program modeling treatment as usual (active control). Duration of training was 1 hour per day, 5 days per week, for 8 weeks, for a total of 40 hours.


METHODS
The primary outcome was a composite score calculated from six subtests of the Repeatable Battery for the Assessment of Neuropsychological Status that use the auditory modality (RBANS Auditory Memory/Attention). Secondary measures were derived from performance on the experimental program, standardized neuropsychological assessments of memory and attention, and participant-reported outcomes.


RESULTS
RBANS Auditory Memory/Attention improvement was significantly greater (P=.02) in the experimental group (3.9 points, 95% confidence interval (CI)=2.7-5.1) than in the control group (1.8 points, 95% CI=0.6-3.0). Multiple secondary measures of memory and attention showed significantly greater improvements in the experimental group (word list total score, word list delayed recall, digits backwards, letter-number sequencing; P<.05), as did the participant-reported outcome measure (P=.001). No advantage for the experimental group was seen in narrative memory.


CONCLUSIONS
The experimental program improved generalized measures of memory and attention more than an active control program.
Smith
Glenn E
GE
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota 55905, USA. smitg@mayo.edu
Housen
Patricia
P
Yaffe
Kristine
K
Ruff
Ronald
R
Kennison
Robert F
RF
Mahncke
Henry W
HW
Zelinski
Elizabeth M
EM
D000368:Aged; D002140:California; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology* / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008910:Minnesota; D009473:Neuronal Plasticity / Q000502:physiology*; D009483:Neuropsychological Tests; D016896:Treatment Outcome