Older adults with pre-existing mild memory impairment benefit as much as those with normal memory function from certain forms of cognitive training that don't rely on memorization, according to a study published this week in the "Journal of the International Neuropsychological Society". These findings could indicate the ability for older adults to maintain skills that allow them to carry out daily tasks and lead a higher quality of life.
In the study supported by the National Institutes of Health (NIH),
older adults who were otherwise healthy and living independently
received training focused on targeted cognitive skills. A small number
of participants in the study were found to have a decline in their
ability to form new memories of experiences or facts, an ability called
declarative memory. These individuals were unable to improve their
memorization skills, but were able to improve their reasoning skills
and become faster at processing visual information. This study was conducted as part of the multi-site Advanced
Cognitive Training for Independent and Vital Elderly (ACTIVE) clinical
trial, which was co-funded by the National Institute of Nursing
Research (NINR) and the National Institute on Aging (NIA) -- both
components of the NIH. The ACTIVE research authors of this paper were
headed by Dr. Frederick Unverzagt of Indiana University-Purdue
University at Indianapolis (IUPUI). "Our previously published studies have found that the ACTIVE
protocols improve the function of older adults in certain target skills
of cognitive training," said Dr. Unverzagt. "These skills -- memory,
reasoning, and speed-of-processing -- were emphasized because they are
thought to be important in allowing elders to maintain independent
living. The current study builds on the previous findings by focusing
on those adults who already have experienced some loss of memory." "Research such as this is critical to discovering ways to help older
individuals stay independent and take charge of their own lives and
health for many years to come," said NINR Director Dr. Patricia A.
Grady, Ph.D., RN. "Persons with mild memory impairment may have
difficulty improving in this one area, but may still benefit from
different types of learning and mental activities to improve their
quality of life and functioning -- a major goal of the NINR mission." "The notion that interventions can be designed and demonstrated to
maintain cognitive skills with age is of enormous interest in the
research community right now," said NIA Director Richard J. Hodes, M.D.
"This study tests that hypothesis and shows the potential promise of
continued research in this area." The ACTIVE study followed more than 2,800 healthy,
community-dwelling older adults from six cities -- Baltimore;
Birmingham, Ala.; Boston; Detroit; State College, Pa.; and
Indianapolis. The participants averaged 74 years of age and 14 years of
education, 76 percent were female, 74 percent were white, and 26
percent were African-American. At the outset of the study, those
potential participants with cognitive impairment were excluded. But
over time, roughly 200 were found to have declined in their cognitive
function, and they were the primary subjects of the current report. The participants were divided into treatment groups to receive
cognitive training in one of the three target skills. The memory
training focused on methods to learn and remember new information such
as word lists and short narratives; the reasoning training emphasized
pattern detection and inductive skills to solve problems; and the
speed-of-processing training addressed the speed of responses to visual
and manual prompts on a computer screen. Only the memory training
component relied on the participant's declarative memory ability.
Training was conducted in 10 sessions of 60-75 minutes over a period of
5-6 weeks. Compared to a control group that received no training, participants
who received the memory training and had normal memory ability at the
start of the study showed significant improvement in memorization
skills. However, among the participants with declines in memory
function, those in the memory training group showed no benefit, while
those who received the reasoning or the speed-of-processing training
showed improvement in these areas comparable to normal-memory
participants. In the article, Dr. Unverzagt stated that a further step for this
research would be to "examine the effect of other cognitive subgroups
(low reasoning, low speed-of-processing) on trainability."
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Sources: National Insititute of Mental Health, See also blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Aging
Dr. Jeffrey Speller
Dr. Tanya Korkosz
Psychopharmacology Associates of New England
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