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 Older adults who underwent a brief course of brain
exercises saw improvements in reasoning skills and processing speed
that could be detected as long as 10 years after the course ended,
according to results from the largest study ever on cognitive
training.
The findings, published on Monday in the Journal of the American
Geriatrics Society, offer welcome news in the search for ways to
keep the mind sharp as 76 million baby boomers in the United States
advance into old age.
The federally sponsored trial of almost 3,000 older adults, called
the Advanced Cognitive Training for Independent and Vital Elderly
study, or ACTIVE, looked at how three brain training programs — focusing on processing speed, memory and reasoning ability — affected cognitively normal adults as they aged.
People in the study had an average age of 74 when they started the
training, which involved 10 to 12 sessions lasting 60 to 75 minutes
each. After five years, researchers found, those with the training
performed better than their untrained counterparts in all three
measures.
Although gains in memory seen at the study's five-year mark appeared
to drop off over the next five years, gains in reasoning ability and
processing speed persisted 10 years after the training.
"What we found was pretty astounding. Ten years after the training,
there was evidence the effects were durable for the reasoning and
the speed training," said George Rebok, an expert on aging and a
professor at Johns Hopkins University in Baltimore, who led the
study.
Participants in all three training groups also reported that they
had an easier time with daily activities such as managing their
medications, cooking meals or handling their finances than did
participants who did not get the training. But standard tests of
these activities showed no differences between the groups.
"The speed-of-processing results are very encouraging," said study
co-author Jonathan King, program director for cognitive aging in the
Division of Behavioral and Social Research at the National Institute
on Aging (NIA), part of the National Institutes of Health, which
helped fund the research.
King said the self-reported improvements in daily function were
interesting, but added, "We do not yet know whether they would truly
allow older people to live independently longer."
However, researchers said even a small gain would be likely to ease
the burden on caregivers and healthcare providers.
"If we delay the onset of difficulties in daily activities even by a
small amount, that can have major public health implications in
terms of helping to curb healthcare costs, delaying entry into
institutions and hospitals," Rebok said.
PREVENT SLIPS
The training course was designed to bolster specific cognitive
abilities that begin to slip as people age. It does not aim to
prevent dementia caused by underlying disease such as Alzheimer's.
At the start of the study, all 2,832 participants were cognitively
normal. The study included four groups: three training groups plus a
control group of volunteers who came in for regular testing to see
how they were faring with age.
People were trained in small groups over a period of several weeks
and then were tested immediately after the training and again one,
two, three, five and 10 years later.
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About 60 percent of the volunteers who underwent training also got
booster training sessions, which enhanced the initial benefits.
At the end of the trial, all groups showed declines compared with
their initial baseline tests in memory, reasoning and processing
speed, but those who got training in reasoning and processing speed
experienced less decline.
Among those given training in reasoning strategies, 73.6 percent
were still performing above their pre-trial baseline level, compared
with 61.7 percent of those who received no training and were only
benefiting from practice on the test.
The effect was even greater in processing speed. Among the training
group, 70.7 percent of participants were performing at or above
their baseline level, compared with 48.8 percent of those in the
control group. There was no difference in memory performance between
the memory group and the control group after 10 years.
Two of the three training programs — the memory and the reasoning
strategies — were done with paper and pencil, while the processing
speed training was done on a computer.
The programs, developed by the researchers, were focused largely on
teaching strategies to improve cognitive performance. For example,
the memory training taught people how to remember word lists,
sequences and main ideas, while the reasoning training focused on
things like recognizing number patterns.
In the processing speed training, people were asked to focus on the
main object in a computer screen while also trying to quickly
recognize and identify objects on the periphery of the screen. Such
training can help older drivers with things like recognizing road
signs while driving.
A version of the speed training program developed for this trial is
now commercially available through the brain fitness company Posit
Science, but the researchers are working on making other types of
training available as well.
Rebok's team just got a grant from the National Institute on Aging
to make a computerized version of the memory test, with the hope
that repeated training can improve the results.
The study was not designed to explain why cognitive training can
have such a lasting effect. Rebok said it may be that people take
the strategies they learn and practice them over time. As they age,
trained individuals can rely on these strategies to compensate for
their declines.
Whether this training actually strengthened the brain in the way
that exercising builds muscle is not clear, but the government
intends to study this, too. Last week, NIA put out a request for
proposals that would study whether cognitive training causes
physical changes in the brain.
(Reporting by Julie Steenhuysen; editing
by Michele Gershberg and Douglas Royalty)
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