Abstract
We present an evaluation of a self-administered, biofeedback-aided, alertness training programme called the Alertness: Training for Focused Living (ATFL) Programme, which was developed as part of the Technology Research for Independent Living (TRIL) collaboration. We conducted two studies in order to evaluate the programme. A randomized controlled trial was, first of all, conducted with 40 older adults aged between 60 and 83. A series of five single case studies was then conducted to examine the suitability of the programme for use with people with more severe memory difficulties. In the randomized controlled trial, participants were assigned to the ATFL Programme or to a placebo programme. Aspects of participants' memory, attention and executive functioning were assessed via telephone prior to and following completion of the training programmes and at 1, 3, and 6-month follow-up sessions. Significant improvements in sustained attention and verbal fluency were noted in the ATFL group. The series of single case studies illustrated the importance of tailoring a programme to the needs and abilities of the clients in question. The potential benefits of the ATFL programme in terms of periodically boosting alertness and aiding executive functioning are discussed.
Highlights
Normal aging is associated with decline in cognitive processes such as memory and executive functioning (West, 1996; Park, 2000; Park et al, 2001)
Essential to the maintenance of goal-directed behavior (Robertson, 2003; Robertson and Garavan, 2004), the ability to sustain attention under conditions of routine and low external demand has been found to be related to absentmindedness or everyday slips of memory and attention (Robertson et al, 1997; Smilek et al, 2010) and this capacity is measurable by a test, the Sustained Attention to Response Test (SART) (Robertson et al, 1997), which has been shown to be closely associated with the brain’s noradrenaline system (Bellgrove et al, 2006; Greene et al, 2009)
The training programme evaluated here—Alertness: Training for Focused Living (ATFL)—was developed as part of the Technology Research for Independent Living (TRIL) programme
Summary
Normal aging is associated with decline in cognitive processes such as memory and executive functioning (West, 1996; Park, 2000; Park et al, 2001). The current paper presents an evaluation of a training programme designed to provide older adults with a strategy to increase their alertness levels at will, in order to help them sustain attention to goal-directed activity. The training programme evaluated here—Alertness: Training for Focused Living (ATFL)—was developed as part of the Technology Research for Independent Living (TRIL) programme (www.trilcentre.org) It aimed to teach older people how to recognize when their alertness levels were low in everyday life, and how to implement a specific strategy for temporarily increasing alertness in order to achieve key everyday life goals which they had identified. We report the results of two studies, a randomized controlled trial designed to examine the efficacy of the ATFL programme in improving aspects of memory, attention, and executive functioning in a group of older adults and a series of single case studies designed to explore the suitability of the programme in addressing the needs of adults with subjective memory complaints and Mild Cognitive Impairment (MCI)
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