Abstract
BackgroundAge-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life. We hypothesized that 10 hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed.MethodsWithin two age bands (50–64 and≥65) 681 patients were randomized to (a) three computerized visual speed of processing training arms (10 hours on-site, 14 hours on-site, or 10 hours at-home) or (b) an on-site attention control group using computerized crossword puzzles for 10 hours. The primary outcome was the Useful Field of View (UFOV) test, and the secondary outcomes were the Trail Making (Trails) A and B Tests, Symbol Digit Modalities Test (SDMT), Stroop Color and Word Tests, Controlled Oral Word Association Test (COWAT), and the Digit Vigilance Test (DVT), which were assessed at baseline and at one year. 620 participants (91%) completed the study and were included in the analyses. Linear mixed models were used with Blom rank transformations within age bands.ResultsAll intervention groups had (p<0.05) small to medium standardized effect size improvements on UFOV (Cohen's d = −0.322 to −0.579, depending on intervention arm), Trails A (d = −0.204 to −0.265), Trails B (d = −0.225 to −0.320), SDMT (d = 0.263 to 0.351), and Stroop Word (d = 0.240 to 0.271). Converted to years of protection against age-related cognitive declines, these effects reflect 3.0 to 4.1 years on UFOV, 2.2 to 3.5 years on Trails A, 1.5 to 2.0 years on Trails B, 5.4 to 6.6 years on SDMT, and 2.3 to 2.7 years on Stroop Word.ConclusionVisual speed of processing training delivered on-site or at-home to middle-aged or older adults using standard home computers resulted in stabilization or improvement in several cognitive function tests. Widespread implementation of this intervention is feasible.Trial RegistrationClinicalTrials.gov NCT-01165463
Highlights
Age-related cognitive decline is common and affects memory, orientation, attention, abstract thinking, and perception [1,2,3,4]
Useful Field of View (UFOV) was specified as the sole primary outcome because no data existed from ACTIVE or any other study for the other neuropsychological outcomes, which were re-designated as secondary outcomes
Participants in the booster training group had greater odds of being lost to followup, as did those with lower self-reported health (AOR 1.597 per lower category rating, p = 0.004; the adjustment was for the booster training group status and errors on the Digit Vigilance Test (DVT) test), and those with more errors on the DVT test (AOR = 1.040 per error, p = 0.006; the adjustment was for booster training group status and self-rated health)
Summary
Age-related cognitive decline is common and affects memory, orientation, attention, abstract thinking, and perception [1,2,3,4] These cognitive declines may lead to substantial difficulties and disabilities in everyday life [5,6,7,8]. Because life expectancy is at an all-time high and improving [9], identifying interventions that can be widely and efficiently implemented and that may prevent or even reverse cognitive decline are clinical and public health priorities [10,11,12] This is especially important given evidence that cognitive declines are well-documented as early as age 30 in crosssequential data [13,14,15] and as early as age 45 in longitudinal data [16]. We hypothesized that 10 hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
