Goal-Oriented Attention Self-Regulation (GOALS) training in older adults

Abstract

Objectives: A common cognitive complaint of older adulthood is distractibility, or decline in ability to concentrate and maintain focus, yet few evidence-based interventions exist to address these deficits. We implemented s pilot trial of an evidence-based executive function training program, to investigate whether training in applied goal-directed attention regulation and problem solving would enhance executive control abilities in a sample of cognitively normal older adults with self-reported complaints of concentration problems.Method: Consecutively recruited participants were placed into small groups and randomized to either Goal-Oriented Attentional Self-Regulation training (GOALS; N = 15) or a closely matched Brain Health Education program (BHE; N = 15).Results: GOALS participants significantly improved on: neurocognitive measures of mental flexibility (p = 0.03, partial eta squared = 0.23); real-world setting functional performance measures of: task failures (p = 0.02, Cohen’s d = 0.88), task rule breaks (p = 0.02, Cohen’s d = 1.06), and execution (p = 0.04, Cohen’s d = 0.76); and in-lab functional assessment of goal-directed behaviour divergent thinking scale (p = 0.03, Cohen’s d = 0.95). All participants improved on a neurocognitive measure of planning (p = 0.01, partial eta squared = 0.031). BHE participants’ improvement over and above GOALS participants was limited to: rule adherence on the real world task (p = 0.04, Cohen’s d = 0.99), and evaluator rating (p = 0.03, Cohen’s d = 0.56), and average score (p = 0.02, Cohen’s d = 0.71) on the in-lab functional task.Conclusion: Participation in GOALS training can enhance executive control, and lead to real-world functional improvements, for cognitively normal older adults with self-reported attention difficulties.