Jeanine M. Parisi

Computerized Cognitive Training with Older Adults: A Systematic Review

A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer’s disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.

The effects of an engaged lifestyle on cognitive vitality: a field experiment.

Experimental studies on cognitive training have suggested that the effects of experience are narrow in augmenting or maintaining cognitive abilities, while correlational studies report a wide range of benefits of an engaged lifestyle, including increased longevity, resistance to dementia, and enhanced cognitive flexibility. The latter class of evidence is ambiguous because it is possible that it is simply the case that those with relatively better cognitive vitality seek out and maintain a wider range of activities. The authors report data from a field experiment in which older adults were randomly assigned to participate in a program intended to operationalize an engaged lifestyle, built on a team-based competition in ill-defined problem solving. Relative to controls, experimental participants showed positive change in a composite measure of fluid ability from pretest to posttest. This study, thus, provides experimental evidence for the proposition that engagement, in the absence of specific ability training, can mitigate age-related cognitive declines in fluid ability.

Memory training interventions for older adults: A meta-analysis

A systematic review and meta-analysis of memory training research was conducted to characterize the effect of memory strategies on memory performance among cognitively intact, community-dwelling older adults, and to identify characteristics of individuals and of programs associated with improved memory. The review identified 402 publications, of which 35 studies met criteria for inclusion. The overall effect size estimate, representing the mean standardized difference in pre-post change between memory-trained and control groups, was 0.31 standard deviations (SD; 95% confidence interval (CI): 0.22, 0.39). The pre-post training effect for memory-trained interventions was 0.43 SD (95% CI: 0.29, 0.57) and the practice effect for control groups was 0.06 SD (95% CI: −0.05, 0.16). Among 10 distinct memory strategies identified in studies, meta-analytic methods revealed that training multiple strategies was associated with larger training gains (p = 0.04), although this association did not reach statistical significance after adjusting for multiple comparisons. Treatment gains among memory-trained individuals were not better after training in any particular strategy, or by the average age of participants, session length, or type of control condition. These findings can inform the design of future memory training programs for older adults.

An Engagement Model of Cognitive Optimization Through Adulthood

The engagement hypothesis suggests that social and intellectual engagement may buffer age-related declines in intellectual functioning. At the same time, some have argued that social structures that afford opportunities for intellectual engagement throughout the life span have lagged behind the demographic shift toward an expanding older population. Against this backdrop, we developed the Senior Odyssey, an existing team-based program of creative problem solving. We tested the engagement hypothesis in a field experiment. Relative to controls, Senior Odyssey participants showed improved speed of processing, marginally improved divergent thinking, and higher levels of mindfulness and need for cognition after the program. This pilot translational project suggests that the Senior Odyssey program may serve as one effective model of engagement with good scaling-up potential.

Lifestyle activities and memory: variety may be the spice of life. The women's health and aging study II.

This study examined whether participation in a variety of lifestyle activities was comparable to frequent participation in cognitively challenging activities in mitigating impairments in cognitive abilities susceptible to aging in healthy, community-dwelling older women. Frequencies of participation in various lifestyle activities on the Lifestyle Activities Questionnaire (LAQ) were divided according to high (e.g., reading), moderate (e.g., discussing politics), and low (e.g., watching television) cognitive demand. We also considered the utility of participation in a variety of lifestyle activities regardless of cognitive challenge. Immediate and delayed verbal recall, psychomotor speed, and executive function were each measured at baseline and at five successive exams, spanning a 9.5-year interval. Greater variety of participation in activities, regardless of cognitive challenge, was associated with an 8 to 11% reduction in the risk of impairment in verbal memory and global cognitive outcomes. Participation in a variety of lifestyle activities was more predictive than frequency or level of cognitive challenge for significant reductions in risk of incident impairment on measures sensitive to cognitive aging and risk for dementia. Our findings offer new perspectives in promoting a diverse repertoire of activities to mitigate age-related cognitive declines.

Predispositional Engagement, Activity Engagement, and Cognition among Older Adults

ABSTRACT We investigated interrelationships between the predisposition toward approaching experiences in a mindful and creative way, participation in specific activities, and cognition among older adults. Participants were administered a battery measuring cognition (i.e., working memory, processing speed, divergent thinking, inductive reasoning, visuo-spatial processing), activity level, and the predisposition towards mental engagement (Need for Cognition, Mindfulness, and Openness to Experience). Results indicated that predispositional engagement and activity engagement are distinct constructs that independently contribute to different aspects of fluid ability, highlighting the importance of considering both the predisposition toward mental engagement as well as the habitual tendency to participate in activities when exploring principles of cognitive optimization.

Training versus engagement as paths to cognitive enrichment with aging.

While a training model of cognitive intervention targets the improvement of particular skills through instruction and practice, an engagement model is based on the idea that being embedded in an intellectually and socially complex environment can impact cognition, perhaps even broadly, without explicit instruction. We contrasted these 2 models of cognitive enrichment by randomly assigning healthy older adults to a home-based inductive reasoning training program, a team-based competitive program in creative problem solving, or a wait-list control. As predicted, those in the training condition showed selective improvement in inductive reasoning. Those in the engagement condition, on the other hand, showed selective improvement in divergent thinking, a key ability exercised in creative problem solving. On average, then, both groups appeared to show ability-specific effects. However, moderators of change differed somewhat for those in the engagement and training interventions. Generally, those who started either intervention with a more positive cognitive profile showed more cognitive growth, suggesting that cognitive resources enabled individuals to take advantage of environmental enrichment. Only in the engagement condition did initial levels of openness and social network size moderate intervention effects on cognition, suggesting that comfort with novelty and an ability to manage social resources may be additional factors contributing to the capacity to take advantage of the environmental complexity associated with engagement. Collectively, these findings suggest that training and engagement models may offer alternative routes to cognitive resilience in late life.

Modeling Change in Memory Performance and Memory Perceptions: Findings from the ACTIVE Study

Within the context of the ACTIVE study, the current investigation explored the relationships between objective memory and two components of subjective memory (frequency of forgetting and use of external aids) over a five-year period. Relationships were assessed using parallel process latent growth curve models. Results indicated that changes in objective memory were associated with changes in perceived frequency of forgetting, but not with use of external aids (calendars, reminder notes) over time. Findings suggest that memory complaints may accurately reflect decline in objective memory performance, but that these memory changes are not necessarily related to compensatory behaviors.

Impact of the Baltimore Experience Corps Trial on cortical and hippocampal volumes.

There is a substantial interest in identifying interventions that can protect and buffer older adults from atrophy in the cortex and particularly, the hippocampus, a region important to memory. We report the 2‐year effects of a randomized controlled trial of an intergenerational social health promotion program on older mens and womens brain volumes.

The Relationship Between Cognitive Function and Life Space: The Potential Role of Personal Control Beliefs

We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a persons environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p < .001 for each), and reasoning ability appeared most predictive (B = .117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t = -2.07; p = .039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space.