Does age matter? Effects of cognitive rehabilitation across the age span.
BACKGROUND
Cognitive remediation (CR) therapy in its various disguises can be helpful for people with schizophrenia but it is not clear if patient characteristics are likely to interfere with its effectiveness.


METHODS
This paper describes the assessment of one putative moderating variable, age, on the outcome of CRT in a rigorous randomised control trial with memory, cognitive flexibility and planning as primary outcomes and social behaviour, symptoms and self-esteem as secondary outcomes. Calendar age was divided into younger (< 40; N55) and older (40 or more years; N30). There were no differences between the groups at baseline in their cognitive, social or demographic data except on predicted variables.


RESULTS
Younger people benefited more from cognitive remediation in two of the three cognitive domains tested. In the memory domain both groups benefited. Only negative symptoms showed a moderating effect of age on CRT, where again the younger group showed improvements in the context of CRT but the older group did not. When older people did show a cognitive advantage in memory following therapy this cognitive improvement benefited social behaviour.


CONCLUSIONS
CRT needs some modification to increase the benefits to older participants. However, any cognitive improvements do still seem to have a beneficial effect.
Wykes
Til
T
King's College, Institute of Psychiatry London, UK. til.wykes@kcl.ac.uk
Reeder
Clare
C
Landau
Sabine
S
Matthiasson
Pall
P
Haworth
Elke
E
Hutchinson
Chloe
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology*; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006608:Hierarchy, Social; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology; D011597:Psychomotor Performance; D012559:Schizophrenia / Q000150:complications* / Q000534:rehabilitation; D012649:Self Concept; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult