Long-term effects of cognitive training on everyday functional outcomes in older adults

Sherry L. Willis, Sharon L. Tennstedt, Michael Marsiske, Karlene Ball, Jeffrey Elias, Kathy Mann Koepke, John N. Morris, George W. Rebok, Frederick Unverzagt, Anne M. Stoddard, Elizabeth Wright

Research output: Contribution to journalArticle

893 Citations (Scopus)

Abstract

Context: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. Objective: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. Design, Setting, and Participants: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. Interventions: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. Main Outcome Measures: Self-reported and performance-based measures of daily function and cognitive abilities. Results: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). Conclusions: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention.

Original languageEnglish
Pages (from-to)2805-2814
Number of pages10
JournalJournal of the American Medical Association
Volume296
Issue number23
DOIs
StatePublished - Dec 20 2006

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Aptitude
Confidence Intervals
Activities of Daily Living
Learning
Control Groups
Episodic Memory
Community Hospital
Cognition
Volunteers
Outcome Assessment (Health Care)

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  • Medicine(all)

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Willis, S. L., Tennstedt, S. L., Marsiske, M., Ball, K., Elias, J., Koepke, K. M., ... Wright, E. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. Journal of the American Medical Association, 296(23), 2805-2814. https://doi.org/10.1001/jama.296.23.2805

Long-term effects of cognitive training on everyday functional outcomes in older adults. / Willis, Sherry L.; Tennstedt, Sharon L.; Marsiske, Michael; Ball, Karlene; Elias, Jeffrey; Koepke, Kathy Mann; Morris, John N.; Rebok, George W.; Unverzagt, Frederick; Stoddard, Anne M.; Wright, Elizabeth.

In: Journal of the American Medical Association, Vol. 296, No. 23, 20.12.2006, p. 2805-2814.

Research output: Contribution to journalArticle

Willis, SL, Tennstedt, SL, Marsiske, M, Ball, K, Elias, J, Koepke, KM, Morris, JN, Rebok, GW, Unverzagt, F, Stoddard, AM & Wright, E 2006, 'Long-term effects of cognitive training on everyday functional outcomes in older adults', Journal of the American Medical Association, vol. 296, no. 23, pp. 2805-2814. https://doi.org/10.1001/jama.296.23.2805
Willis, Sherry L. ; Tennstedt, Sharon L. ; Marsiske, Michael ; Ball, Karlene ; Elias, Jeffrey ; Koepke, Kathy Mann ; Morris, John N. ; Rebok, George W. ; Unverzagt, Frederick ; Stoddard, Anne M. ; Wright, Elizabeth. / Long-term effects of cognitive training on everyday functional outcomes in older adults. In: Journal of the American Medical Association. 2006 ; Vol. 296, No. 23. pp. 2805-2814.
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abstract = "Context: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. Objective: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. Design, Setting, and Participants: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26{\%} black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67{\%} of the sample. Interventions: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. Main Outcome Measures: Self-reported and performance-based measures of daily function and cognitive abilities. Results: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99{\%} confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99{\%} CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99{\%} CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99{\%} CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99{\%} CI, 0.11-0.35]; reasoning: effect size, 0.26 [99{\%} CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99{\%} CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99{\%} CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99{\%} CI, 0.61-1.09). Conclusions: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention.",
author = "Willis, {Sherry L.} and Tennstedt, {Sharon L.} and Michael Marsiske and Karlene Ball and Jeffrey Elias and Koepke, {Kathy Mann} and Morris, {John N.} and Rebok, {George W.} and Frederick Unverzagt and Stoddard, {Anne M.} and Elizabeth Wright",
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AU - Willis, Sherry L.

AU - Tennstedt, Sharon L.

AU - Marsiske, Michael

AU - Ball, Karlene

AU - Elias, Jeffrey

AU - Koepke, Kathy Mann

AU - Morris, John N.

AU - Rebok, George W.

AU - Unverzagt, Frederick

AU - Stoddard, Anne M.

AU - Wright, Elizabeth

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N2 - Context: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. Objective: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. Design, Setting, and Participants: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. Interventions: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. Main Outcome Measures: Self-reported and performance-based measures of daily function and cognitive abilities. Results: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). Conclusions: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention.

AB - Context: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. Objective: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. Design, Setting, and Participants: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. Interventions: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. Main Outcome Measures: Self-reported and performance-based measures of daily function and cognitive abilities. Results: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). Conclusions: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention.

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