Improvements in Cognitive Performance With Computerized Training in Older People With and Without Cognitive Impairment: Synergistic Effects of Skills-Focused and Cognitive-Focused Strategies

Abstract

ObjectivesBoth cognitively impaired (CI) and nonimpaired (NC) older people have challenges in performing everyday tasks. Previous skills training efforts in NC individuals have led to improvements in both functional skills and cognitive functioning. We evaluated the cognitive benefits of combining computerized cognitive training (CCT) with a computer-based functional skills assessment and training (CFSAT) program in a sample of CI and NC older adults. DesignRandomized parallel clinical trial with two treatment conditions: up to 24 sessions of CFSAT training alone or CFSAT plus speed focused CCT. ParticipantsNC (n = 62) and CI (n = 55) older adults, ranging in age from 60–86 years (M = 73.12), primarily female (90%), and ethnically diverse (21% Hispanic, 52% African American). Participants were divided based on Montreal Cognitive Assessment scores and cognitive complaints. SettingThree different community centers in Miami, FL. MeasurementsThe Brief Assessment of Cognition, app version, was used to measure cognitive performance across six different cognitive domains before and after training. ResultsAll six cognitive domains improved from baseline. Multivariate analyses found the effects of the combined CFSAT and CCT to be superior. The interaction of training condition and cognitive status was not statistically significant, indicating no global impact of cognitive status on improvements in cognition across training conditions. ConclusionsCFSAT training was associated with cognitive benefits, particularly in CI participants. The combined intervention led to greater improvements. Consistent with results of previous studies, there is considerable evidence of cognitive plasticity in older adults, including those with CI.