Enhanced Cognitive Training in a Driving Simulator Improves Cognition in Older Adults

Abstract

<h3>Research Objectives</h3> A few cognitive training studies have purported that maximal gains are achieved with intense, challenging, and multitask training. Yet, proof-of-concept is currently lacking. Our aim was to evaluate the effects of an enhanced cognitive training program to improve cognitive functions in older adults. <h3>Design</h3> Within-group pre- to post-training quasi-experimental design. <h3>Setting</h3> Academic institution. <h3>Participants</h3> Eighteen older adults (age 76±6); 18% women; MMSE scores 28±2) enrolled in the study. Fourteen (78%) completed pre-training and post-training assessments. <h3>Interventions</h3> Participants trained on the driving simulator for four weeks, three days per week for a total of 12 hours. Training involved following a lead car. The difficulty level of the training sessions was altered by changing the speed of the lead car, the following distance of the driver, visibility and weather conditions, and ambient traffic. <h3>Main Outcome Measures</h3> Participants completed a comprehensive battery of cognitive tests evaluating memory, visuospatial skills, word finding, and cognitive flexibility pre- and post-intervention. <h3>Results</h3> Pre- to post-training changes were examined using Wilcoxon Signed Rank test. Participants improved on the California Verbal Learning Test short delay free recall (2.31±1.75; p=0.001) and delayed recall (1.69±1.89; p=0.009); Rey-Osterrieth Complex Figure immediate recall (5.73±6.10; p=0.002) and delayed recall (2.54±4.61; p=0.05); Logical Memory immediate (3.61±4.89; p=0.02) and delayed (4.38±4.77; p=0.009) total scores; and Boston Naming Test total score (3.58±8.67; p=0.002). No changes were observed in performance on Delis-Kaplan Executive Function System and Wechsler Adult Intelligence Scale tests. <h3>Conclusions</h3> The enhanced cognitive training in a driving simulator improved several memory domains. This pilot study warrants an adequately powered randomized controlled trial to better determine the short- and long-term effects of enhanced cognitive training on cognition and daily-life activities in older adults. <h3>Author(s) Disclosures</h3> The authors report a financial conflict of interest. The training scenarios were played on the Portable Driving Simulator. H.D. and A.E.A. stand to profit from the sales of the Portable Driving Simulator. H.D. and A.E.A. were not involved in the training sessions or assessments.