title: Cognitive remediation for adults with schizophrenia: Does age matter?
abstract: Cognitive remediation (CR), a novel behavioral intervention designed to improve cognitive deficits through repeated task practice and/or strategy acquisition has gained increasing empirical support in people with schizophrenia, but substantial individual differences in treatment response remain (Wykes et al., 2011). The role of age on response to CR in schizophrenia remains understudied. We evaluated the role of three age ranges in treatment response to CR relative to a closely-matched computer skills control intervention in a blinded, randomized control trial (RCT) with 112 adults with schizophrenia divided into three groups: an early-stage group (ES; 25 years or younger, mean=3.4 years of illness; n=45), an early-chronic group (EC; 26-39, mean=7.6 years of illness; n=31) and a late-chronic group (LC; 40 and over, mean=18.2 years of illness; n=36). With respect to cognitive outcomes, early-stage and early-chronic individuals with schizophrenia showed greater improvement in response to CR on a working memory measure at a trend level, relative to late-chronic clients. These findings were confirmed in analyses of a subsample of clients who received an adequate dose of treatment. These findings emphasize the need for adaptations of currently-existing CR programs to more effectively address the needs of older client populations.
authors.affiliation: Schizophrenia Rehabilitation Program, Institute of Living, Hartford, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Central Connecticut State University, New Britain, CT, USA.
authors.forename: Silvia
authors.initials: S
authors.lastname: Corbera
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wexler
authors.affiliation: Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA; University of Saint Joseph,West Hartford, CT, USA.
authors.forename: Ania
authors.initials: A
authors.lastname: Poltorak
authors.affiliation: Schizophrenia Rehabilitation Program, Institute of Living, Hartford, CT, USA.
authors.forename: Warren R
authors.initials: WR
authors.lastname: Thime
authors.affiliation: Schizophrenia Rehabilitation Program, Institute of Living, Hartford, CT, USA; Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Middletown, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. Electronic address: mkurtz@wesleyan.edu.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Kurtz
mesh_terms: D000328:Adult; D000367:Age Factors; D003072:Cognition Disorders / Q000523:psychology / Q000628:therapy*; D000072466:Cognitive Remediation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D012559:Schizophrenia / Q000150:complications / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Age; Cognitive remediation; Early psychosis; Schizophrenia; Working memory