Association of Racial Status and Training Language with Baseline Performance and Training Gains During Computerized Training of Technology-related Everyday Functional Skills In Older Adults

Abstract

ObjectivesResearch consistently finds that lower baseline performance predicts greater gains with computerized training. Lower baseline performance can originate from many factors, including educational and environmental disadvantages, leading to reduced exposure to functional tasks. Across six computerized technology-related functional skills, baseline performance and training gains were compared across race and training language. DesignRandomized clinical trial. SettingAbout 14 community centers in New York City and Miami. ParticipantsParticipants aged 60–90 with diverse ethnic (52% Latinx) and racial (27% Black) status, trained in in English (60%) or Spanish (40%). InterventionRemotely delivered computerized cognitive and skills training (FUNSATTM) for an hour twice a week for up to 12 weeks. MeasurementsCompletion time across all 6 tests pre and post training. ResultsThe total sample included 42 Black English Speakers, 52 White English speakers, and 61 Spanish speakers. Spanish speakers had the poorest baseline performance on all tasks, underperforming English-speaking Latinx participants. However, Spanish speaking participants had the largest training gains. Lower MOCA scores predicted lower baseline performance and greater training gains across samples. Educational attainment predicted training gains only in the Spanish speakers. Despite education effects in this group, all improvements were statistically significant with large effect sizes. ImplicationsLower baseline performance of functional skills was a positive predictor of training gains and was efficiently reversed through training. Even participants who initially appeared more impaired achieved substantial gains, congruent with the results reported in psychiatric populations. Critically, low baseline competence should not be interpreted as reflecting negatively on potential training gains.