title: Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults.
abstract: OBJECTIVE
  To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years.
  
  
  METHODS
  Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control group.
  
  
  METHODS
  Six U.S. cities.
  
  
  METHODS
  A volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently.
  
  
  METHODS
  Ten training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial training.
  
  
  METHODS
  Objectively measured cognitive abilities and self-reported and performance-based measures of everyday function.
  
  
  RESULTS
  Participants in each intervention group reported less difficulty with instrumental activities of daily living (IADLs) (memory: effect size = 0.48, 99% confidence interval (CI) = 0.12-0.84; reasoning: effect size = 0.38, 99% CI = 0.02-0.74; speed of processing: effect size = 0.36, 99% CI = 0.01-0.72). At a mean age of 82, approximately 60% of trained participants, versus 50% of controls (P < .05), were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size = 0.23, 99% CI = 0.09-0.38; speed of processing: effect size = 0.66, 99% CI = 0.43-0.88). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size = 0.21, 99% CI = 0.01-0.41) and the speed-of-processing intervention for speed-of-processing performance (effect size = 0.62, 99% CI = 0.31-0.93).
  
  
  CONCLUSIONS
  Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.
authors.affiliation: Department of Mental Health, Johns Hopkins University, Baltimore, Maryland; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: George W
authors.initials: GW
authors.lastname: Rebok
authors.forename: Karlene
authors.initials: K
authors.lastname: Ball
authors.forename: Lin T
authors.initials: LT
authors.lastname: Guey
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: King
authors.forename: Michael
authors.initials: M
authors.lastname: Marsiske
authors.forename: John N
authors.initials: JN
authors.lastname: Morris
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Tennstedt
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Unverzagt
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Willis
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living; D008297:Male; D008569:Memory Disorders / Q000517:prevention & control; D008606:Mental Processes; D016037:Single-Blind Method; D014481:United States
keywords: cognitive abilities; cognitive training; elderly; everyday function; training maintenance