title: Which older adults maintain benefit from cognitive training? Use of signal detection methods to identify long-term treatment gains.
abstract: BACKGROUND
  Cognitive training has been shown to improve memory in older adults; however, little is known about which individuals benefit from or respond best to training in the long term. Identification of responders' characteristics would help providers match cognitive interventions to individuals to improve their effectiveness. Signal detection methods may prove more informative than more commonly used analytic methods. The goal of the current study is to identify baseline characteristics of long-term treatment responders and of those able to maintain their initial benefit from cognitive training.
  
  
  METHODS
  Participants were 120 non-demented, community-dwelling older adults who had participated in a cognitive training intervention. Tested predictors included both demographic and neurocognitive variables. Primary outcome variables were performance on measures of memory at one-year follow-up.
  
  
  RESULTS
  Results of the signal detection analysis indicated that different neurocognitive performances predicted long-term effects of memory training and maintenance of initial treatment response according to different types of to-be-remembered material. Higher baseline scores on tests of associative memory, delayed verbal memory, attention, episodic memory, and younger age were found predictive of long-term response one year later. Higher associative memory scores and lower initial gains at the end of treatment (week 14) predicted successful maintenance of training gains at week 52.
  
  
  CONCLUSIONS
  To derive long-term benefit from particular cognitive training programs, it appears necessary for older adults to have specific neurocognitive profiles. Further, inclusion of booster sessions to cognitive training programs may assist in maintenance of initial treatment gains.
authors.affiliation: Department of Veterans Affairs and Sierra-Pacific MIRECC, Palo Alto, California 94304, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Fairchild
authors.forename: L
authors.initials: L
authors.lastname: Friedman
authors.forename: A C
authors.initials: AC
authors.lastname: Rosen
authors.forename: J A
authors.initials: JA
authors.lastname: Yesavage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D008568:Memory; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve; D017603:Signal Detection, Psychological; D016896:Treatment Outcome