SmithHousenYaffeEtAl09
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A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory withPlasticity-based Adaptive Cognitive Training (IMPACT) Study
Smith, Housen, Yaffe & et al (2009) A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) Study, Journal of the American Geriatrics Society , 2009, 1-10
SmithHousenYaffeEtAl09.pdf
Abstract
OBJECTIVES: To investigate the efficacy of a novel brain plasticity–based computerized cognitive training program in older adults and to evaluate the effect on untrained mea- sures of memory and attention and participant-reported outcomes. DESIGN: Multisite randomized controlled double-blind trial with two treatment groups. SETTING: Communities in northern and southern Cali- fornia and Minnesota. PARTICIPANTS: Community-dwelling adults aged 65 and older (N 5 487) without a diagnosis of clinically sig- nificant cognitive impairment. INTERVENTION: Participants were randomized to receive a broadly-available brain plasticity–based computerized cog- nitive training program (intervention) or a novelty- and in- tensity-matched general cognitive stimulation program modeling treatment as usual (active control). Duration of training was 1 hour per day, 5 days per week, for 8 weeks, for a total of 40 hours. MEASUREMENTS: The primary outcome was a compos- ite score calculated from six subtests of the Repeatable Battery for the Assessment of Neuropsychological Statusthat use the auditory modality (RBANS Auditory Memory/ Attention). Secondary measures were derived from perfor- mance on the experimental program, standardized neuro- psychological assessments of memory and attention, and participant-reported outcomes. RESULTS: RBANS Auditory Memory/Attention improve- ment was significantly greater (P 5.02) in the experimental group (3.9 points, 95% confidence interval (CI) 5 2.7–5.1) than in the control group (1.8 points, 95% CI 5 0.6–3.0). Multiple secondary measures of memory and attention showed significantly greater improvements in the experi- mental group (word list total score, word list delayed recall, digits backwards, letter–number sequencing; Po.05), as did the participant-reported outcome measure (P 5.001). No advantage for the experimental group was seen in nar- rative memory. CONCLUSION: The experimental program improved generalized measures of memory and attention more than an active control program.
Keywords
clinical trial, cognitive decline, computerized cognitive training, participant-reported outcomes, brain plasticity
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