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Older adults with mild memory impairment still benefit from cognitive training in areas not reliant on memorization



November 30, 2007

NINR Press Office| 301-496-0207 | info@ninr.nih.gov

Peggy Vaughn, NIA | 301-496-1752 | nianews3@mail.nih.gov



Older adults with pre-existing mild memory impairment benefit as much as those with normal memory function from certain forms of cognitive training that don't rely on memorization, according to a study published this week in the "Journal of the International Neuropsychological Society". These findings could indicate the ability for older adults to maintain skills that allow them to carry out daily tasks and lead a higher quality of life.

In the study supported by the National Institutes of Health (NIH), older adults who were otherwise healthy and living independently received training focused on targeted cognitive skills. A small number of participants in the study were found to have a decline in their ability to form new memories of experiences or facts, an ability called declarative memory. These individuals were unable to improve their memorization skills, but were able to improve their reasoning skills and become faster at processing visual information.

This study was conducted as part of the multi-site Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) clinical trial, which was co-funded by the National Institute of Nursing Research (NINR) and the National Institute on Aging (NIA) -- both components of the NIH. The ACTIVE research authors of this paper were headed by Dr. Frederick Unverzagt of Indiana University-Purdue University at Indianapolis (IUPUI).

"Our previously published studies have found that the ACTIVE protocols improve the function of older adults in certain target skills of cognitive training," said Dr. Unverzagt. "These skills -- memory, reasoning, and speed-of-processing -- were emphasized because they are thought to be important in allowing elders to maintain independent living. The current study builds on the previous findings by focusing on those adults who already have experienced some loss of memory."

"Research such as this is critical to discovering ways to help older individuals stay independent and take charge of their own lives and health for many years to come," said NINR Director Dr. Patricia A. Grady, Ph.D., RN. "Persons with mild memory impairment may have difficulty improving in this one area, but may still benefit from different types of learning and mental activities to improve their quality of life and functioning -- a major goal of the NINR mission."

"The notion that interventions can be designed and demonstrated to maintain cognitive skills with age is of enormous interest in the research community right now," said NIA Director Richard J. Hodes, M.D. "This study tests that hypothesis and shows the potential promise of continued research in this area."

The ACTIVE study followed more than 2,800 healthy, community-dwelling older adults from six cities -- Baltimore; Birmingham, Ala.; Boston; Detroit; State College, Pa.; and Indianapolis. The participants averaged 74 years of age and 14 years of education, 76 percent were female, 74 percent were white, and 26 percent were African-American. At the outset of the study, those potential participants with cognitive impairment were excluded. But over time, roughly 200 were found to have declined in their cognitive function, and they were the primary subjects of the current report.

The participants were divided into treatment groups to receive cognitive training in one of the three target skills. The memory training focused on methods to learn and remember new information such as word lists and short narratives; the reasoning training emphasized pattern detection and inductive skills to solve problems; and the speed-of-processing training addressed the speed of responses to visual and manual prompts on a computer screen. Only the memory training component relied on the participant's declarative memory ability. Training was conducted in 10 sessions of 60-75 minutes over a period of 5-6 weeks.

Compared to a control group that received no training, participants who received the memory training and had normal memory ability at the start of the study showed significant improvement in memorization skills. However, among the participants with declines in memory function, those in the memory training group showed no benefit, while those who received the reasoning or the speed-of-processing training showed improvement in these areas comparable to normal-memory participants.

In the article, Dr. Unverzagt stated that a further step for this research would be to "examine the effect of other cognitive subgroups (low reasoning, low speed-of-processing) on trainability."


Reference:

Unverzagt FW, Kasten L, Johnson KE, Rebok GW, Marsiske M, Mann Koepke K, Elias JW, Morris KN, Willis SL, Ball K, Rexroth DF, Smith DM, Wolinsky FD, Tennstedt SL. Effect of memory impairment on training outcomes in ACTIVE. Journal of the International Neuropsychological Society 2007;13:953-960.

The primary mission of the NINR, one of 27 Institutes and Centers at the National Institutes of Health, is to support clinical and basic research and establish a scientific basis for the care of individuals across the life span. For additional information, visit the NINR web site at www.ninr.nih.gov.

The National Institute on Aging (NIA) leads the federal government effort conducting and supporting research on the biomedical and social and behavioral aspects of aging and the problems of older people. For more information on aging-related research and the NIA, please visit the NIA web site at www.nia.nih.gov.

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- is comprised of 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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