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Effect of memory impairment on training outcomes in ACTIVE

Published online by Cambridge University Press:  18 October 2007

FREDERICK W. UNVERZAGT
Affiliation:
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
LINDA KASTEN
Affiliation:
New England Research Institutes, Watertown, Massachusetts
KATHY E. JOHNSON
Affiliation:
Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
GEORGE W. REBOK
Affiliation:
Department of Mental Health, Johns Hopkins University, Baltimore, Maryland
MICHAEL MARSISKE
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
KATHY MANN KOEPKE
Affiliation:
National Institute of Nursing Research, Bethesda, Maryland
JEFFREY W. ELIAS
Affiliation:
National Institute on Aging, Bethesda, Maryland
JOHN N. MORRIS
Affiliation:
Hebrew Senior Life, Boston, Massachusetts
SHERRY L. WILLIS
Affiliation:
Department of Human Development and Family Studies, Pennsylvania State University, State College, Pennsylvania
KARLENE BALL
Affiliation:
Department of Psychology, University of Alabama, Birmingham, Alabama
DANIEL F. REXROTH
Affiliation:
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
DAVID M. SMITH
Affiliation:
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
FREDRIC D. WOLINSKY
Affiliation:
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa
SHARON L. TENNSTEDT
Affiliation:
New England Research Institutes, Watertown, Massachusetts

Abstract

Cognitive training improves mental abilities in older adults, but the trainability of persons with memory impairment is unclear. We conducted a subgroup analysis of subjects in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial to examine this issue. ACTIVE enrolled 2802 non-demented, community-dwelling adults aged 65 years and older and randomly assigned them to one of four groups: Memory training, reasoning training, speed-of-processing training, or no-contact control. For this study, participants were defined as memory-impaired if baseline Rey Auditory Verbal Learning Test (AVLT) sum recall score was 1.5 SD or more below predicted AVLT sum recall score from a regression-derived formula using age, education, ethnicity, and vocabulary from all subjects at baseline. Assessments were taken at baseline (BL), post-test, first annual (A1), and second annual (A2) follow-up. One hundred and ninety-three subjects were defined as memory-impaired and 2580 were memory-normal. Training gain as a function memory status (impaired vs. normal) was compared in a mixed effects model. Results indicated that memory-impaired participants failed to benefit from Memory training but did show normal training gains after reasoning and speed training. Memory function appears to mediate response to structured cognitive interventions in older adults. (JINS, 2007, 13, 953–960.)

Type
Research Article
Copyright
© 2007 The International Neuropsychological Society

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References

REFERENCES

Ball, K., Berch, D.B., Helmers, K.F., Jobe, J.B., Leveck, M.D., Marsiske, M., Morris, J.N., Rebok, G.W., Smith, D.M., Tennstedt, S.L., Unverzagt, F.W., Willis, S.L., & Advanced Cognitive Training for Independent and Vital Elderly Study Group (2002). Effects of cognitive training interventions with older adults: A randomized controlled trial. Journal of the American Medical Association, 288, 22712281.Google Scholar
Ball, K.K., Beard, B.L., Roenker, D.L., Miller, R.L., & Griggs, D.S. (1988). Age and Visual-Search—Expanding the Useful Field of View. Journal of the Optical Society of America A-Optics Image Science and Vision, 5, 22102219.Google Scholar
Baltes, P.B. & Willis, S.L. (1982). Plasticity and enhancement of intellectual functioning in old age: Penn State's Adult Development and Enrichment Project (ADEPT). In F. Craik & S. Trehub (Eds.), Aging and Cognitive Processes (pp. 353390). New York: Plenum Press.
Belleville, S., Gilbert, B., Fontaine, F., Gagnon, L., Menard, E., & Gauthier, S. (2006). Improvement of episodic memory in persons with Mild Cognitive Impairment and healthy older adults: Evidence from a cognitive intervention program. Dementia and Geriatric Cognitive Disorders, 22, 486499.Google Scholar
Blom, G. (1958). Statistical Estimates and Transformed Beta Variables. New York: John Wiley & Sons.
Brandt, J. (1991). The Hopkins Verbal Learning Test: Development of a new memory test with six equivalent forms. The Clinical Neuropsychologist, 5, 125142.Google Scholar
Callahan, C.M., Hendrie, H.C., & Tierney, W.M. (1995). Documentation and evaluation of cognitive impairment in elderly primary care patients. Annals of Internal Medicine, 122, 422429.Google Scholar
Camp, C.J., Foss, J.W., OHanlon, A.M., & Stevens, A.B. (1996). Memory interventions for persons with dementia. Applied Cognitive Psychology, 10, 193210.Google Scholar
Cavaco, S., Anderson, S.W., Allen, J.S., Castro-Caldas, A., & Damasio, H. (2004). The scope of preserved procedural memory in amnesia. Brain, 127, 18531867.Google Scholar
Cnaan, A., Laird, N.M., & Slasor, P. (1997). Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data. Statistics in Medicine, 16, 23492380.Google Scholar
Davis, R.N., Massman, P.J., & Doody, R.S. (2001). Cognitive intervention in Alzheimer disease: A randomized placebo-controlled study. Alzheimer Disease & Associated Disorders, 15, 19.Google Scholar
DiCarlo, A., Baldereschi, M., Amaducci, L., Maggi, S., Grigoletto, F., Scarlato, G., Inzitari, D., & for the Italian Longitudinal Study of Aging Working Group (2000). Cognitive impairment without dementia in older people: Prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. Journal of the American Geriatrics Society, 48, 775782.Google Scholar
Ekstrom, R., French, J., Harman, H., & Derman, D. (1976). Kit of Factor Referenced Cognitive Tests. (Revised ed.) Princeton, NJ: Educational Testing Service.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Ganguli, M., Dodge, H.H., Shen, C., & DeKosky, S.T. (2004a). Mild cognitive impairment, amnestic type: An epidemiologic study. Neurology, 63, 115121.Google Scholar
Ganguli, M., Rodriguez, E., Mulsant, B., Richards, S., Pandav, R., Bilt, J.V., Dodge, H.H., Stoehr, G.P., Saxton, J., Morycz, R.K., Rubin, R.T., Farkas, B., & DeKosky, S.T. (2004b). Detection and management of cognitive impairment in primary care: The Steel Valley Seniors Survey. Journal of the American Geriatrics Society, 52, 16681675.Google Scholar
Gonda, J. & Schaie, K. (1985). Schaie-Thurstone Mental Abilities Test: Word Series Test. Palo Alto, CA: Consulting Psychologists Press.
Graham, J.E., Rockwood, K., Beattie, L.B., Eastwood, R., Gauthier, S., Tuokko, H., & McDowell, I. (1997). Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet, 349, 17931796.Google Scholar
Grandmaison, E. & Simard, M. (2003). A critical review of memory stimulation programs in Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 130144.Google Scholar
Jobe, J.B., Smith, D.M., Ball, K., Tennstedt, S.L., Marsiske, M., Willis, S.L., Rebok, G.W., Morris, J.N., Helmers, K.F., Leveck, M.D., & Kleinman, K. (2001). ACTIVE: A cognitive intervention trial to promote independence in older adults. Controlled Clinical Trials, 22, 453479.Google Scholar
Lopez, O.L., Jagust, W.J., DeKosky, S.T., Becker, J.T., Fitzpatrick, A., Dulberg, C., Breitner, J., Lyketsos, C., Jones, B., Kawas, C., Carlson, M., & Kuller, L.H. (2003). Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: Part 1. Archives of Neurology, 60, 13851389.Google Scholar
Morris, J.C., Storandt, M., Miller, J.P., McKeel, D.W., Price, J.L., Rubin, E.H., & Berg, L. (2001). Mild cognitive impairment represents early-stage Alzheimer disease. Archives of Neurology, 58, 397405.Google Scholar
Owsley, C., Ball, K., McGwin, G., Sloane, M.E., Roenker, D.L., White, M.F., & Overley, E.T. (1998). Visual processing impairment and risk of motor vehicle crash among older adults. Journal of the American Medical Association, 279, 10831088.Google Scholar
Petersen, R. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194.Google Scholar
Rapp, S., Brenes, G., & Marsh, A.P. (2002). Memory enhancement training for older adults with mild cognitive impairment: A preliminary study. Aging & Mental Health, 6, 511.Google Scholar
Rebok, G.W. & Balcerak, L.J. (1989). Memory self-efficacy and performance differences in young and old adults—the effect of mnemonic training. Developmental Psychology, 25, 714721.Google Scholar
Rey, A. (1941). L'examen psychologique dans les cas d'encephalopathie traumatique. Archives de Psychologie, 28, 286340.Google Scholar
Squire, L.R. (1987). Memory and Brain. New York: Oxford University Press.
Squire, L.R., Knowlton, B., & Musen, G. (1993). The structure and organization of memory. Annual Review of Psychology, 44, 453495.Google Scholar
Thurstone, L. & Thurstone, T. (1949). Examiner Manual for the SRA Primary Mental Abilities Test (Form 10–14). Chicago, IL: Science Research Associates.
Unverzagt, F.W., Gao, S., Baiyewu, O., Ogunniyi, A.O., Gureje, O., Perkins, A., Emsley, C.L., Dickens, J., Evans, R., Musick, B., Hall, K.S., Hui, S.L., & Hendrie, H.C. (2001). Prevalence of cognitive impairment: Data from the Indianapolis Study of Health and Aging. Neurology, 57, 16551662.Google Scholar
Willis, S.L., Tennstedt, S.L., Marsiske, M., Ball, K., Elias, J., Koepke, K.M., Morris, J.N., Rebok, G.W., Unverzagt, F.W., Stoddard, A.M., & Wright, E. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. Journal of the American Medical Association, 296, 28052814.Google Scholar
Wilson, B., Cockburn, J., & Baddeley, A. (1985). The Rivermead Behavioral Memory Test. Reading, England: Thames Valley Test Co.