Cognitive Training for Independent and Vital Elderly

¶ … Cognitive Training for Independent and Vital Elderly -- ACTIVE) was a randomized controlled, single-blind trial; the group design was with four groups, which included " ... 3 treatment groups and a control group" (Willis, et al., 2006).

Participant selection: the researchers had recruited 2,832 elder persons (who lived independently, not in nursing homes, for example) that averaged 73.6 years of age; the researchers located the participants from community centers, senior housing, clinics and hospitals in 6 American cities (Birmingham; Detroit; Indianapolis; State College, PA; Boston; and Baltimore). These individuals were originally recruited in April 1998 and there was a follow-up in December 2004; 67% of the original sample participated in 2004.

Assignment to groups: those who were disqualified from the study included: younger than 65; or had serious cognitive decline; had other "substantial impairments"; had Alzheimer disease; were near death or in serious decline; nearly blind, nearly deaf or had trouble communicating adequately; had recent cognitive training; or were simply going to be unavailable for the whole of the study period

Assignment to groups and description of the groups and the treatment: There were four groups in all; three of them were part of the research and one was a "control group"; a computer randomized those who were qualified. The treatment for each of the 3 intervention groups included a "narrowly" targeted a certain cognitive ability (memory, reasoning, or speed of processing); for the memory training they used "mnemonic strategies" (including ability to organize, visualize make associations and remember word lists); for the reasoning intervention teaching strategies were used " ... for finding the pattern in a letter ... and identifying the next word or letter in a series"; and for the speed of processing an image was presented on a computer screen at "increasingly brief exposures" (Willis, 2808).

Outcome measures: Besides the initial sessions described above, there were "booster training" sessions at 11 and 35 months; those lasted 75 minutes and were designed to "maintain the improvement in cognitive ability." Cognitive outcomes measured how effective each intervention was in the various cognitive abilities of the participants; for memory training 3 measures of verbal ability were tested; also 3 reasoning abilities were tested; and 3 outcomes were measured for speed of processing (Willis, 2808).

What were the researchers actually testing -- what did they hope to find out?

This was reportedly the first study of its kind to carefully examine the "long-term outcomes of cognitive interventions" on how older people function when / while living independently. In other words, when given interventions to improve cognitive skills, how well did those interventions succeed in accomplishing improved cognitive skills, and how well did they hold up over five years?

Summarize the results -- what did the researchers find?

Each of the interventions did produce "immediate improvements" for the cognitive skills of the participants over the five years of the survey; also, the booster training did produce "significantly better performance" on the expected outcomes (Willis, 2811). Other findings included: the measurement of daily living (IADL) was dramatic just for the reasoning group; the speed of processing and memory training didn't show significant improvements on daily living (which is what this research focused on) (Willis, 2811).

Are there any alternative explanations -- why or why not?

One explanation in addition to the particulars reviewed could be just a simplification of the findings. In short, people in their 70s who hope to avoid serious dementia or Alzheimer's disease should willingly participate in proven cognitive training in order to avoid becoming dependent on institutions or other healthcare services.