Advanced Cognitive Training For Independent And Vital Elderly Research Articles

COGNITIVE TRAINING ATTENUATES AGE-RELATED DECLINE IN PHYSICAL FUNCTION ACROSS 10 YEARS

Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrate that cognitive training reduces age-related declines in physical function, only one has examined effects beyond immediate posttest changes. The current study assessed the impact of three cognitive training programs on physical function measures across 10 years. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, older adults randomized to a no-contact control condition (n = 698) were compared to those randomized to processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat and treatment-received analyses were conducted for grip strength, Digit Symbol Copy, and Turn 360. There were no significant effects of being assigned to processing speed, memory, or reasoning training to any physical function outcome (p > .05). Treatment-received models indicated that processing speed training attenuated age-related declines in Digit Symbol Copy (b = -.005, p < .01) and Turn 360 (b = -.011, p < .001), memory training attenuated age-related declines in Digit Symbol Copy (b = -.009, p < .001) and Turn 360 (b = -.011, p < .001), and reasoning training attenuated age-related declines in Digit Symbol Copy (b = -.012, p < .001) and Turn 360 (b = -.012, p < .001). There was no significant transfer to grip strength. This is the first study to demonstrate beneficial effects of cognitive training to some physical functions across 10 years. Future work should examine moderators and mediators of transfer effects.

Health literacy, sociodemographic factors, and cognitive training in the active study of older adults.

Health literacy is critical for understanding information from health-care providers and correct use of medications and includes the capacity to filter other information in navigating health care systems. Older adults with low health literacy exhibit more chronic health conditions, worse physical functioning, and poorer mental health. This study examined the relationship between sociodemographic variables and health literacy, and the impact of cognitive training on change in health literacy over 10years in older adults. Participants (N=2,802) aged 65years and older completed assessments, including reading and numeracy health literacy items, as part of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. We evaluated baseline sociodemographic variables and change in health literacy over a 10-year period in individuals exposed to cognitive training in reasoning, processing speed, memory, or a no-contact control condition. Age, sex, race, education level, and general cognitive functioning at baseline were all associated with baseline health literacy in older adults. Predictors of change in health literacy over the 10-year follow-up were age, race, education level, general cognitive functioning, and neighborhood income; disparities in health literacy because of race attenuated over time, while the effect of age increased over time. Health literacy was generally stable across the ACTIVE intervention groups over 10years. The present study showed important disparities in health literacy level and change over 10years. Cognitive training did not significantly impact health literacy, suggesting that alternative approaches are needed to reduce the disparities.

The ACTIVE conceptual framework as a structural equation model

ABSTRACTBackground/Study Context: Conceptual frameworks are analytic models at a high level of abstraction. Their operationalization can inform randomized trial design and sample size considerations.Methods: The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) conceptual framework was empirically tested using structural equation modeling (N=2,802). ACTIVE was guided by a conceptual framework for cognitive training in which proximal cognitive abilities (memory, inductive reasoning, speed of processing) mediate treatment-related improvement in primary outcomes (everyday problem-solving, difficulty with activities of daily living, everyday speed, driving difficulty), which in turn lead to improved secondary outcomes (health-related quality of life, health service utilization, mobility). Measurement models for each proximal, primary, and secondary outcome were developed and tested using baseline data. Each construct was then combined in one model to evaluate fit (RMSEA, CFI, normalized residuals of each indicator). To expand the conceptual model and potentially inform future trials, evidence of modification of structural model parameters was evaluated by age, years of education, sex, race, and self-rated health status.Results: Preconceived measurement models for memory, reasoning, speed of processing, everyday problem-solving, instrumental activities of daily living (IADL) difficulty, everyday speed, driving difficulty, and health-related quality of life each fit well to the data (all RMSEA < .05; all CFI > .95). Fit of the full model was excellent (RMSEA = .038; CFI = .924). In contrast with previous findings from ACTIVE regarding who benefits from training, interaction testing revealed associations between proximal abilities and primary outcomes are stronger on average by nonwhite race, worse health, older age, and less education (p < .005).Conclusions: Empirical data confirm the hypothesized ACTIVE conceptual model. Findings suggest that the types of people who show intervention effects on cognitive performance potentially may be different from those with the greatest chance of transfer to real-world activities.

Covariate adjustments in randomized controlled trials increased study power and reduced biasedness of effect size estimation

ObjectivesThis study aims to show that under several assumptions, in randomized controlled trials (RCTs), unadjusted, crude analysis will underestimate the Cohen's d effect size of the treatment, and an unbiased estimate of effect size can be obtained only by adjusting for all predictors of the outcome. Study Design and SettingFour simulations were performed to examine the effects of adjustment on the estimated effect size of the treatment and power of the analysis. In addition, we analyzed data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (older adults aged 65–94), an RCT with three treatment arms and one control arm. ResultsWe showed that (1) the number of unadjusted covariates was associated with the effect size of the treatment; (2) the biasedness of effect size estimation was minimized if all covariates were adjusted for; (3) the power of the statistical analysis slightly decreased with the number of adjusted noise variables; and (4) exhaustively searching the covariates and noise variables adjusted for can lead to exaggeration of the true effect size. Analysis of the ACTIVE study data showed that the effect sizes adjusting for covariates of all three treatments were 7.39–24.70% larger than their unadjusted counterparts, whereas the effect size would be elevated by at most 57.92% by exhaustively searching the variables adjusted for. ConclusionAll covariates of the outcome in RCTs should be adjusted for, and if the effect of a particular variable on the outcome is unknown, adjustment will do more good than harm.

Gender and Racial Disparities in Life-Space Constriction Among Older Adults.

"Life-space" is the spatial area through which a person experiences and interacts with the world. Life-space constriction, the shrinking of the spatial area that a person traverses, is associated with negative health outcomes in later life. Racial and gender disparities in mobility as indicated by life-space constriction are thought to contribute to broader disparities in health and functioning among older adults. Data come from the 5-year follow-up of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (N = 2,765; mean age = 73.6; 75.8% women; 73.7% White). Life-space constriction was defined as "not traveling beyond one's town." A series of logistic regression and Cox proportional hazard models were used to estimate risk for incident life-space constriction by race and gender. Blacks and women had greater likelihood of life-space constriction at baseline. Women were more likely to experience incident life-space constriction at follow-up relative to men (Hazard ratio [HR]: 1.89, 95% Confidence interval [CI]: 1.26-2.83). Blacks were associated with lower risk of life-space constriction over time (HR: 0.67, 95% CI: 0.45-0.99) relative to Whites. Disparities in life-space constriction by gender and race exist in later life. Understanding the processes underlying these mobility restrictions is important to developing intervention programs to enhance health and functioning for older adults.

Early Lifestyle Intervention Improves Elder Care

Early Lifestyle Intervention Improves Elder Care

Does Self-Efficacy Affect Responsiveness to Cognitive Speed of Processing Training?

Older adults with higher self-efficacy may be more likely to benefit from some cognitive training approaches. We examined whether self-efficacy serves as a mediator or moderator of responsiveness to cognitive speed of processing training (SOPT). We used data from the Staying Keen in Later Life (SKILL) study (N = 128) and the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 1,400). Both studies assessed cognitive speed of processing (Useful Field of View Test-UFOV) and self-efficacy among community-dwelling older adults who were either randomized to SOPT or control conditions. We constructed regression models examining self-efficacy as a predictor of training responsiveness. Analyses from both studies indicated that participants' self-efficacy scores were not predictive of training gains from SOPT, as measured by UFOV performance. Self-efficacy does not affect older adults' ability to benefit from cognitive SOPT.

Ten‐Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults

To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control group. Six U.S. cities. A volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently. Ten training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial training. Objectively measured cognitive abilities and self-reported and performance-based measures of everyday function. Participants in each intervention group reported less difficulty with instrumental activities of daily living (IADLs) (memory: effect size = 0.48, 99% confidence interval (CI) = 0.12-0.84; reasoning: effect size = 0.38, 99% CI = 0.02-0.74; speed of processing: effect size = 0.36, 99% CI = 0.01-0.72). At a mean age of 82, approximately 60% of trained participants, versus 50% of controls (P < .05), were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size = 0.23, 99% CI = 0.09-0.38; speed of processing: effect size = 0.66, 99% CI = 0.43-0.88). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size = 0.21, 99% CI = 0.01-0.41) and the speed-of-processing intervention for speed-of-processing performance (effect size = 0.62, 99% CI = 0.31-0.93). Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.

Modelling longitudinal changes in older adults' memory for spoken discourse: Findings from the ACTIVE cohort

Episodic memory shows substantial declines with advancing age, but research on longitudinal trajectories of spoken discourse memory (SDM) in older adulthood is limited. Using parallel process latent growth curve models, we examined 10 years of longitudinal data from the no-contact control group (N = 698) of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomised controlled trial in order to test (1) the degree to which SDM declines with advancing age, (2) the predictors of these age-related declines and (3) the within-person relationship between longitudinal changes in SDM and longitudinal changes in fluid reasoning and verbal ability over 10 years, independent of age. Individuals who were younger, were White, had more years of formal education, were male and had better global cognitive function and episodic memory performance at baseline demonstrated greater levels of SDM on average. However, only age at baseline uniquely predicted longitudinal changes in SDM, such that declines accelerated with greater age. Independent of age, within-person decline in reasoning ability over the 10-year study period was substantially correlated with decline in SDM (r = .87). An analogous association with SDM did not hold for verbal ability. The findings suggest that longitudinal declines in fluid cognition are associated with reduced spoken language comprehension. Unlike findings from memory for written prose, preserved verbal ability may not protect against developmental declines in memory for speech.

The ACTIVE Study

In response to data indicating that persons over age 65 account for almost half of all days of care in short stay hospitals (Graves & Kozak, 1999), constitute the majority of residents of nursing homes (Strahan, 1997), and account for over 75% of required formal home-based care supports (Levit et al., 1997; Office, 1996), the National Institute on Aging and the National Institute for Nursing Research funded an initiative to test the effectiveness of cognitive interventions in maintaining cognitive health and functional independence in older adults. This initiative was based on evidence that the cognitive performance of older adults can be improved through systematic training focused on cognitive skills (Baltes, Kuhl, Gutzmann, & Sowarka, 1995; Caprio-Prevette & Fry, 1996; Hayslip, Maloy, & Kohl, 1995; Kramer, Larish, & Strayer, 2002; Mohs et al., 1998; Neely & Backman, 1995; Noice, Noice, & Staines, 2004; Oswald, Rupprecht, Gunzelmann, & Tritt, 1996) paired with evidence of the importance of cognitive functioning for performing activities of daily living (Allaire & Marsiske, 1999; Backman & Hill, 1996; Burdick et al., 2005; Cahn-Weiner, Malloy, Boyle, Marran, & Salloway, 2000; Owsley, Sloane, McGwin, & Ball, 2002) and maintaining health related quality of life among older adults (Hultsch, Hammer, & Small, 1993; Swan, Carmelli, & LaRue, 1995; Wolinsky & Johnson, 1991). At that time, essentially no research had been conducted demonstrating training transfer to real-world functional outcomes in later adulthood. The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial addressed this gap. The goal of ACTIVE was to test the effectiveness of three cognitive interventions (memory, reasoning, and visual speed of processing) in maintaining cognitive health and functional independence in older adults. The targeted abilities-- memory, reasoning, and speed of processing—were selected based on evidence that they exhibit relatively early age-related decline, beginning on average in the mid-sixties (Schaie, 1996), that interventions have been shown to be effective in training these abilities (K Ball, 1997; K. Ball & Owsley, 2000; Kliegl, Smith, & Baltes, 1990; Lachman, Weaver, Bandura, Elliott, & Lewkowicz, 1992; McDougal, 1999; Mohs et al., 1998; Oswald et al., 1996; Rasmusson, Rebok, Bylsma, & Brandt, 1999; Rebok & Balcerak, 1989; S. Willis, 1990; S. Willis, Cornelius, Blow, & Baltes, 1983; S. Willis & Nesselroade, 1990; S. Willis & Schaie, 1986, 1994), and that performance on these abilities is associated with performance of cognitively demanding instrumental activities of daily living, critical for independent living (K. Ball & Owsley, 2000; K. Ball, Owsley, Sloane, Roenker, & Bruni, 1993; Diehl, Willis, & Schaie, 1995; S. L. Willis, 1996; S. L. Willis, Jay, Diehl, & Marsiske, 1992). ACTIVE began in September, 1996 at six field centers: the University of Alabama at Birmingham, the Boston Hebrew Rehabilitation Center for Aged (now Hebrew Senior Life), the Indiana University School of Medicine, the Johns Hopkins University, the Pennsylvania State University, and Wayne State University, with a data coordinating center at the New England Research Institutes. The conceptual model that informed the design of ACTIVE (Figure 1) was based on prior evidence showing that cognitive training would be domain specific. That is, each intervention was expected to result in specific improvement on measures of the trained ability relative to the other interventions and control group. For example, training in memory was expected to improve memory function (the proximal outcome) but was not expected to improve reasoning or speed of processing skills. On the other hand, intervention effects were expected to show some level of general transfer to daily function (the primary outcome) based on the critical assumption that declines in cognitive function lead to declines in activities in daily living. In other words, improvement in cognitive ability should result in maintenance of functional independence. In turn, maintained functional independence could result in a positive cascade of effects including improvements in quality of life, mobility, and health service utilization. Figure 1 Hypothesized mode of effects in ACTIVE trial. Influence of intervention on primary and secondary outcomes is mediated through trained abilities. Bold lines represent specific effects of training. Dashed lines represent non-specific effects of training ...

Gender and Racial Disparities in Driving Cessation Among Older Adults

To longitudinally examine gender and racial disparities in driving cessation among older adults. Data came from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (N = 1,789). Logistic generalized estimating equations (GEE) were used to identify predictors of driving cessation; stratified analysis and interaction terms were used to determine whether factors differed by gender and race. Two hundred and five (11.5%) participants stopped driving over the study period. Education was associated with increased risk of cessation for men (adjusted odds ratio [AOR] =1.40, 95% confidence interval [CI] =1.10 to 1.78), but decreased risk for women (AOR = 0.90, 95% CI = 0.82-0.98). Being married was associated with lower risk of cessation for men (AOR = 0.18, 95% CI = 0.06-0.56) but was unrelated to cessation for women (AOR = 1.00, 95% CI = 0.56-1.80). Results were consistent with the hypothesis that racial disparities in cessation widen with increasing age. Factors predictive of driving cessation vary by gender. Racial disparities in cessation are wider at older ages. Transportation policies and programs should account for social determinants and aim to address social disparities in driving mobility among older adults.

The Influence of Cognitive Training on Older Adults’ Recall for Short Stories

This article investigated how a multicomponent memory intervention affected memory for prose. We compared verbatim and paraphrased recall for short stories immediately and 1, 2, 3, and 5 years post-intervention in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) sample. We studied 1,912 ACTIVE participants aged 65 to 91. Participants were randomized into one of three training arms (Memory, Reasoning, Speed of Processing) or a no-contact Control group; about half of the trained participants received additional booster training 1 and 3 years post-intervention. Memory-trained participants showed higher verbatim recall than non-memory-trained participants. Booster-memory training led to higher verbatim recall. Memory training effects were evident immediately following training and not after 1 year following training. Results suggest that multifactorial memory training can improve verbatim recall for prose, but the effect does not last without continued intervention.

Mediators of the Association Between Driving Cessation and Mortality Among Older Adults

The present study examined health and physical performance as mediators of the association between driving cessation and mortality among older residents of small and large cities. Participants (N = 2,793) were from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. Participants' driving status and health were measured at baseline, and mortality rates were observed across the subsequent 5 years. Overall, mortality risk was 1.68 times higher for nondrivers versus drivers; this relationship was significantly mediated by physical performance and social, physical, and general health. For large-city residents, mediation effects for all mediators were significant and complete. For small-city residents, only physical and general health were significant mediators, and these effects were partial. Health difficulties that accompany or follow driving cessation may explain the association between driving cessation and mortality, particularly for residents of large cities, where alternative transportation options may be more numerous.

Memory Training in the ACTIVE Study

Data from the memory training arm (n = 629) of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial were examined to characterize change in memory performance through 5 years of follow-up as a function of memory training, booster training, adherence to training, and other characteristics. Latent growth model analyses revealed that memory training was associated with improved memory performance through Year 5 but that neither booster training nor training adherence significantly influenced this effect. Baseline age was associated with change in memory performance attributable to the passage of time alone (i.e., to aging). Higher education and better self-rated health were associated with greater change in memory performance after training. These findings confirm that memory training can aid in maintaining long-term improvements in memory performance. Booster training and adherence to training do not appear to attenuate rates of normal age-related memory decline.

Longitudinal relationships between subjective fatigue, cognitive function, and everyday functioning in old age

The present study examined the prospective relationships between subjective fatigue, cognitive function, and everyday functioning. A cohort study with secondary data analysis was conducted using data from 2,781 community-dwelling older adults without dementia who were enrolled to participate in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized intervention trial. Measures included demographic and health information at baseline, and annual assessments of subjective fatigue, cognitive function (i.e. speed of processing, memory, and reasoning), and everyday functioning (i.e. everyday speed and everyday problem-solving) over five years. Four distinct classes of subjective fatigue were identified using growth mixture modeling: one group complaining fatigue "some of the time" at baseline but "most of the time" at five-year follow-up (increased fatigue), one complaining fatigue "a good bit of the time" constantly over time (persistent fatigue), one complaining fatigue "most of the time" at baseline but "some of the time" at five-year follow-up (decreased fatigue), and the fourth complaining fatigue "some of the time" constantly over time (persistent energy). All domains of cognitive function and everyday functioning declined significantly over five years; and the decline rates, but not the baseline levels, differed by the latent class of subjective fatigue. Except for the decreased fatigue class, there were different degrees of significant associations between the decline rates of subjective fatigue and all domains of cognitive function and everyday functioning in other classes of subjective fatigue. Future interventions should address subjective fatigue when managing cognitive and functional abilities in community-dwelling older adults.

The Effects of Cognitive Speed of Processing Training Among Older Adults with Psychometrically- Defined Mild Cognitive Impairment

Despite the growing interest in cognitive training programs as a potential non-pharmacological approach to slowing cognitive decline in mild cognitive impairment (MCI), there has been little research on the differential effectiveness of training among subtypes of MCI (i.e., amnestic, single non-amnestic, and multi-domain). The current study examined the longitudinal effects of cognitive speed of processing training (SOPT) among older adults with psychometricallydefined MCI from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. Mixed model ANOVAs examined the effectiveness of SOPT in participants with MCI relative to controls and also compared training effectiveness in MCI subgroups to appropriate controls. A mixed effects model compared SOPT training effects longitudinally across five years relative to controls. A second mixed effects model compared the durability of training gains between the MCI subtypes across 5 years. All subtypes of MCI showed immediate improvement post-training relative to controls, with the single non-amnestic subtype showing the most benefit. Additionally, all subtypes showed similar trajectories across five years. There were no significant changes in performance across time, indicating initial training gains were maintained. These results provide support for the effectiveness and potential durability of SOPT among persons with MCI regardless of subtype. Future research should investigate if SOPT transfers to improvements in the everyday functioning of those with MCI.

Depressive Symptoms and Memory Performance Among Older Adults

Cognitive performance benefits from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study may differ for individuals who exhibit a greater number of depressive symptoms. Using data from ACTIVE memory training and control conditions, we evaluated the effect of depressive symptomatology on memory scores across a 5-year period. Of 1,401 participants, 210 had elevated depressive symptoms at baseline, as measured by a 12-item version of the Center for Epidemiological Studies-Depression Scale (CES-D). Participants with elevated depressive symptoms scored significantly lower at baseline and had faster decline in memory performance than those exhibiting fewer depressive symptoms. Memory score differences among depressive symptom categories did not differ between training conditions. Findings suggest that elevated depressive symptoms may predict declines in memory ability over time, but do not attenuate gains from training. Training provides a potential method of improving memory which is robust to effects of depression.

Gender and Racial Disparities in Driving Cessation Among Older Adults

To longitudinally examine gender and racial disparities in driving cessation among older adults. Data came from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (N = 1,789). Logistic generalized estimating equations (GEE) were used to identify predictors of driving cessation; stratified analysis and interaction terms were used to determine whether factors differed by gender and race. Two hundred and five (11.5%) participants stopped driving over the study period. Education was associated with increased risk of cessation for men (adjusted odds ratio [AOR] =1.40, 95% confidence interval [CI] =1.10 to 1.78), but decreased risk for women (AOR = 0.90, 95% CI = 0.82-0.98). Being married was associated with lower risk of cessation for men (AOR = 0.18, 95% CI = 0.06-0.56) but was unrelated to cessation for women (AOR = 1.00, 95% CI = 0.56-1.80). Results were consistent with the hypothesis that racial disparities in cessation widen with increasing age. Factors predictive of driving cessation vary by gender. Racial disparities in cessation are wider at older ages. Transportation policies and programs should account for social determinants and aim to address social disparities in driving mobility among older adults.

ACTIVE Cognitive Training and Rates of Incident Dementia

Systematic cognitive training produces long-term improvement in cognitive function and less difficulty in performing activities of daily living. We examined whether cognitive training was associated with reduced rate of incident dementia. Participants were from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 2,802). Incident dementia was defined using a combination of interview- and performance-based methods. Survival analysis was used to determine if ACTIVE treatment affected the rate of incident dementia during 5 years of follow-up. A total of 189 participants met criteria for incident dementia. Baseline factors predictive of incident dementia were older age, male gender, African American race, fewer years of education, relationship other than married, no alcohol use, worse MMSE, worse SF-36 physical functioning, higher depressive symptomatology, diabetes, and stroke (all p < .05). A multivariable model with significant predictors of incident dementia and training group revealed that cognitive training was not associated with a lower rate of incident dementia. Cognitive training did not affect rates of incident dementia after 5 years of follow-up. Longer follow-up or enhanced training may be needed to fully explore the preventive capacity of cognitive training in forestalling onset of dementia.

Neighborhood Influences on Late Life Cognition in the ACTIVE Study

Low neighborhood-level socioeconomic status has been associated with poorer health, reduced physical activity, increased psychological stress, and less neighborhood-based social support. These outcomes are correlates of late life cognition, but few studies have specifically investigated the neighborhood as a unique source of explanatory variance in cognitive aging. This study supplemented baseline cognitive data from the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study with neighborhood-level data to investigate (1) whether neighborhood socioeconomic position (SEP) predicts cognitive level, and if so, whether it differentially predicts performance in general and specific domains of cognition and (2) whether neighborhood SEP predicts differences in response to short-term cognitive intervention for memory, reasoning, or processing speed. Neighborhood SEP positively predicted vocabulary, but did not predict other general or specific measures of cognitive level, and did not predict individual differences in response to cognitive intervention.