title: Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial.
abstract: BACKGROUND
  We evaluated the effects of cognitive training on self-rated health at 1, 2, 3, and 5 years post-baseline.
  
  
  METHODS
  In the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) randomized controlled trial, 2,802 older adults (>or=65 years) were randomly assigned to memory, reasoning, speed of processing, or no-contact control intervention groups. Complete data were available for 1,804 (64%) of the 2,802 participants at five years. A propensity score model was adjusted for attrition bias. The self-rated health question was coded using the Diehr et al. (2001) transformation (E = 95/VG = 90/G = 80/F = 30/P = 15), and analyzed with change-score regression models.
  
  
  RESULTS
  The speed of processing (vs. no-contact control) group had statistically significant improvements (or protective effects) on changes in self-rated health at the 2, 3 and 5 year follow-ups. The 5-year improvement was 2.8 points (p = 0.03). No significant differences were observed in the memory or reasoning groups at any time.
  
  
  CONCLUSIONS
  The speed of processing intervention significantly protected self-rated health in ACTIVE, with the average benefit equivalent to half the difference between excellent vs. very good health.
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA. fredric-wolinsky@uiowa.edu
authors.forename: Fredric D
authors.initials: FD
authors.lastname: Wolinsky
authors.forename: Henry
authors.initials: H
authors.lastname: Mahncke
authors.forename: Mark W
authors.initials: MW
authors.lastname: Vander Weg
authors.forename: Rene
authors.initials: R
authors.lastname: Martin
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Unverzagt
authors.forename: Karlene K
authors.initials: KK
authors.lastname: Ball
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Tennstedt
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008568:Memory; D009048:Motor Skills; D011788:Quality of Life / Q000523:psychology; D011930:Reaction Time; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome