title: The PACE study: a randomized clinical trial of cognitive activity strategy training for older people with mild cognitive impairment.
abstract: OBJECTIVE
  The role of cognition-focused interventions in reducing cognitive decline in older people remains uncertain. This study aimed to clarify whether a group cognitive activity (CA) strategy-training program would decrease the 2-year rate of cognitive decline of people with mild cognitive impairment (MCI).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  One study site.
  
  
  METHODS
  160 older adults with MCI ≥65 years of age (mean: 75, SD: 5.8).
  
  
  METHODS
  Five-week CA strategy training or a control nonspecific educational program. The primary outcome measure was change from baseline in the total score on the Cambridge Cognitive Examination-Revised (CAMCOG-R). Secondary outcomes of interest included changes in memory, attention, executive functions, mood, and quality of life. Endpoints were collected 10, 52, and 104 weeks post baseline.
  
  
  RESULTS
  Intention to treat analysis identified no significant difference in CAMCOG-R scores over time between the two groups (mean difference: -0.36, 95% CI: -1.02,0.29) or across secondary outcome measures. The exceptions were better performance of the CA group on immediate attention (Digit Span Forwards, adjusted mean difference: 0.15, 95% CI: 0.01,0.30) and better quality of life (adjusted mean difference: 0.57, 95% CI: 0.10,1.04) compared with controls.
  
  
  CONCLUSIONS
  The devised program of CA did not improve general cognitive performance of older adults with MCI over a period of 2 years. Although favorable, the beneficial effects of the intervention on attention and quality of life were small, and of uncertain significance.
authors.affiliation: Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia. Electronic address: mandy.vidovich@uwa.edu.au.
authors.forename: Mandy R
authors.initials: MR
authors.lastname: Vidovich
authors.affiliation: Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia; Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Australia.
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Lautenschlager
authors.affiliation: Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.affiliation: Research in Ageing and Cognitive Health, School of Psychology, Bangor University, Wales, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Clare
authors.affiliation: Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia.
authors.forename: Kieran
authors.initials: K
authors.lastname: McCaul
authors.affiliation: Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia.
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
mesh_terms: D000339:Affect; D000368:Aged; D001288:Attention; D015928:Cognitive Behavioral Therapy; D060825:Cognitive Dysfunction / Q000523:psychology* / Q000628:therapy*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Neuropsychology; cognition; dementia; intervention; prevention