title: A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study.
abstract: 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.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota 55905, USA. smitg@mayo.edu
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Smith
authors.forename: Patricia
authors.initials: P
authors.lastname: Housen
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Ronald
authors.initials: R
authors.lastname: Ruff
authors.forename: Robert F
authors.initials: RF
authors.lastname: Kennison
authors.forename: Henry W
authors.initials: HW
authors.lastname: Mahncke
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Zelinski
mesh_terms: 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