ACTIVE Continuation

The ACTIVE study is the first large-scale, randomized trial to show that cognitive training improves cognitive function in well-functioning older adults and that this improvement lasts up to 5 years from the beginning of the intervention. In addition, this is the first trial to provide limited evidence that improvements in cognitive function can have a positive effect on daily function. Participants who received cognitive training reported less difficulty with instrumental activities of daily living (IADL) 5 years after training compared with those in the control group. Participants in the 3 training groups reported an IADL decline of at least 0.20 SD less than the participants in the control group. The effect size reached statistical significance only for the reasoning training group but the effect sizes seen for memory and speed of processing training were similar to that for reasoning. We consider the relative comparability of the training effects across the 3 interventions to support the clinical meaningfulness of these results. Self-report of functioning repeatedly has been shown to predict loss of independence, increased use of health services, and mortality. Participants in the intervention groups reported similarly lower declines in function compared with participants in the control group.
 

Continuting Research: 

We now propose a single assessment 10 years after the initial training (A10). A particular asset of ACTIVE is the large (over 2,800 participants at baseline) and socioeconomically and racially diverse sample.  ACTIVE participants have been well-characterized behaviorally, cognitively, and functionally using a wide array of objective and performance-based measures.  At the A10 assessment, almost 50% of the cohort will be age 85 years or older, an age associated with markedly increased functional loss and dementia.  The age of the cohort also means that this will be a final opportunity to capture long-term training effects.

This proposed assessment is a unique opportunity to prospectively study the long-term effects of three types of cognitive interventions on basic mental and functional abilities in a well-characterized cohort that, given its advancing age, is at increasing risk for both cognitive and functional decline.  Most importantly, we will be able to test the basic question in this study: For older adults exposed to three cognitive interventions, can disability in the performance of key everyday activities be delayed and independence in the community maintained as they age into their 80s?