Mental Exercise Helps Maintain Some Seniorsí Thinking
Certain mental exercises can offset some of the expected decline
in older adults' thinking skills and show promise for maintaining
cognitive abilities needed to do everyday tasks such as shopping,
making meals and handling finances, according to a new study. The
research, funded by the National Institutes of Health (NIH) and
published in the Dec. 20, 2006, Journal of the American Medical
Association, showed that some of the benefits of short-term
cognitive training persisted for as long as five years.
The Advanced Cognitive Training for Independent and Vital Elderly,
or ACTIVE, Study is the first randomized, controlled trial to demonstrate
long-lasting, positive effects of brief cognitive training in older
adults. However, testing indicated that the training did not improve
the participants’ ability to tackle everyday tasks, and more
research is needed to translate the findings from the laboratory
into interventions that prove effective at home.
The ACTIVE trial was funded by the National Institute on Aging
(NIA) and the National Institute of Nursing Research (NINR), both
components of NIH. Sherry L. Willis, Ph.D., of Pennsylvania State
University in State College, Pa., and co-authors report the findings
on behalf of ACTIVE investigators at the study’s six sites:
Hebrew SeniorLife, Boston; Indiana University School of Medicine,
Indianapolis; Johns Hopkins University, Baltimore; Pennsylvania
State University; University of Alabama at Birmingham; and University
of Florida, Gainesville (in collaboration with Wayne State University,
Detroit), and the data coordinating center at the New England Research
Institutes, Watertown, Mass.
“This large trial found that community-dwelling seniors
who received cognitive training had less of a decline in certain
thinking skills than their peers who did not have training. The
study addresses a very important hypothesis — that interventions
can be designed to maintain cognitive function,” says NIA
Director Richard J. Hodes, M.D. “The challenge now is to
further examine these interventions and others to see how they
can be employed in real-world settings.”
“Cognitive decline is known to precede loss of functional
ability in older adults. It affects everyday activities such as
driving or following instructions on a medicine bottle,” says
NINR Director Patricia A. Grady, Ph.D., R.N. “Research to
identify effective ways of delaying this decline is important because
it may help individuals, and our aging citizenry, maintain greater
independence as they grow older.”
The ACTIVE Study included 2,802 adults aged 65 and older who were
living independently and had normal cognitive and functional status
at the beginning of the study. Participants were randomly assigned
to four groups. Three groups took part in training that targeted
a specific cognitive ability — memory, reasoning or speed
of processing. The fourth group received no cognitive training.
People in the three intervention groups attended up to 10 training
sessions lasting 60 to 75 minutes each, over a five- to six-week
time period. The memory group learned strategies for remembering
word lists and sequences of items, text, and story ideas and details.
The reasoning group learned strategies for finding the pattern
in a letter or word series and identifying the next item in a series.
The speed-of-processing group learned ways to identify an object
on a computer screen at increasingly brief exposures, while quickly
noting where another object was located on the screen.
After the initial training, 60 percent of those who completed
the initial training took part in 75-minute “booster” sessions
designed to maintain improvements gained from the initial sessions.
The investigators tested the participants at baseline, after the
intervention and annually over five years. They found:
- Immediately after the initial training, 87 percent of the speed-training
group, 74 percent of the reasoning group and 26 percent of the
memory group showed improvement in the skills taught.
- After five years, people in each group performed better on
tests in their respective areas of training than did people in
the control group. The reasoning-training and speed-training
groups who received booster training had the greatest benefit.
“The improvements seen after the training roughly counteract
the degree of decline in cognitive performance that we would expect
to see over a seven- to 14-year period among older people without
dementia,” says Dr. Willis.
The researchers also looked at the training’s effects on
participants’ everyday lives. After five years, all three
intervention groups reported less difficulty than the control group
in tasks such as preparing meals, managing money and doing housework.
Only the effect of reasoning training on self-reported performance
of daily tasks was statistically significant. Those who received
speed-of-processing training and follow-up booster training scored
better on how quickly and accurately they could find items on a
pantry shelf, make change, read medicine dosing instructions, place
telephone calls and react to road traffic signs.
“Beyond middle age, people worry about their mental sharpness
getting ‘rusty.’ This study offers hope that cognitive
training may be useful,” notes Richard Suzman, Ph.D., director
of the NIA’s Behavioral and Social Research Program, which
sponsored the work. “ACTIVE has shown that relatively brief
targeted cognitive exercises can produce durable changes in the
skills taught. I would now like to see studies aimed at producing
more generalized changes, perhaps through more intensive and broader
To reach Sherry Willis, Ph.D., or co-author Michael Marsiske,
Ph.D., University of Florida, contact Jill Pease at 352-273-5816
The NIA leads the federal effort supporting and conducting research
on aging and the medical, social and behavioral issues of older
people. For more information on research and aging, go to www.nia.nih.gov.
Publications on research and on a variety of topics of interest
on health and aging can be viewed and ordered by visiting the NIA
Web site or can be ordered by calling toll-free 1-800-222-2225.
The primary mission of the NINR is to support clinical and basic
research to 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 Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 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 it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.