title: The effect of cognitive training on the subjective perception of well-being in older adults.
abstract: BACKGROUND
  There is a growing number of studies indicating the major consequences of the subjective perception of well-being on mental health and healthcare use. However, most of the cognitive training research focuses more on the preservation of cognitive function than on the implications of the state of well-being. This secondary analysis of data from a randomised controlled trial investigated the effects of individualised television-based cognitive training on self-rated well-being using the WHO-5 index while considering gender and education as influencing factors. The effects of cognitive training were compared with leisure activities that the elderly could be engaged in to pass time.
  
  
  METHODS
  Cognitively healthy participants aged 60 years or above screened using the Mini-Mental State Examination (MMSE) and Major Depression Inventory (MDI) were randomly allocated to a cognitive training group or to an active control group in a single-blind controlled two-group design and underwent 24 training sessions. Data acquired from the WHO-5 questionnaire administered before and after intervention were statistically analysed using a mixed design model for repeated measures. The effect of individualised cognitive training was compared with leisure activities while the impact of gender and education was explored using estimated marginal means.
  
  
  RESULTS
  A total of 81 participants aged 67.9 ± 5.59 [60-84] without cognitive impairments and absent of depression symptoms underwent the study. Participants with leisure time activities declared significantly higher scores compared to participants with cognitive trainingM= 73.48 ± 2.88, 95% CI [67.74-79.22] vsM= 64.13 ± 3.034, 95% CI [58.09-70.17] WHO-5 score. Gender and education were found to moderate the effect of cognitive training on well-being when compared to leisure activities. Females engaged in leisure activities in the control group reported higher byM= 9.77 ± 5.4, 95% CI [-0.99-20.54] WHO-5 scores than females with the cognitive training regimen. Participants with high school education declared leisure activities to increase WHO-5 scores byM= 14.59 ± 5.39, 95% CI [3.85-25.34] compared to individualised cognitive training.
  
  
  CONCLUSIONS
  The findings revealed that individualised cognitive training was not directly associated with improvements in well-being. Changes in the control group indicated that involvement in leisure time activities, in which participants were partly free to choose from, represented more favourable stimulation to a self-perceived sense of well-being than individualised cognitive training. Results also supported the fact that gender and education moderated the effect of cognitive training on well-being. Females and participants with high school education were found to be negatively impacted in well-being when performance connected with cognitive training was expected.
authors.affiliation: Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Bureš
authors.affiliation: Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Čech
authors.affiliation: Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic.
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Mikulecká
authors.affiliation: Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ponce
authors.affiliation: Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic; Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Kuca
keywords: Cognitive training; Elderly; Subjective perception; WHO-5; Well-being