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Training Improves Cognitive Abilities of Older Adults


With appropriate training and practice, adults over age 65 can significantly improve their memory, concentration, and problem solving, according to the findings of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) nationwide clinical trial. In addition, researchers from multiple sites, including the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins School of Nursing, found that improvements in cognitive ability roughly counteract the degree of long-term cognitive decline typical among older people without dementia. The ACTIVE trial is the nation's largest study of cognitive training. The results are published in the November 13, 2002, issue of the Journal of the American Medical Association (JAMA).

“These findings are important in showing that training and practice can lead to significant improvements in older adults’ thinking and mental abilities. The magnitude of the training gains is comparable to the magnitude of aging-related decline that might be expected over a 7- to 14-year period,” said George W. Rebok, PhD, one of the ACTIVE principal investigators and associate research professor with the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health.

The ACTIVE trial was designed to test the effectiveness of three techniques to improve the ability of older people to think and reason. As part of the trial, the Johns Hopkins researchers recruited 189 study participants from Baltimore and 271 from Cumberland and surrounding areas in Western Maryland. The total study sample was 2,802. All of the study participants were 65 years or older and in good health. The participants were divided into four groups. Three groups received training that provided exercises and strategies for improving memory, reasoning, or processing speed, while the fourth group received no training. Training sessions were given twice a week over the 5-week study period, with each session lasting 60 to 75 minutes. All of the training related to everyday tasks, such as using the telephone, shopping, food preparation, housekeeping, transportation, and personal finance. The researchers assessed the participants’ cognitive abilities before the training, immediately after training, and again one and two years later.

According to the results, 87 percent of the participants in speed training showed increases in cognitive ability, as did 74 percent of participants in reasoning training, and 26 percent of those in memory training. The training effects continued through 24 months, especially for the participants who received additional training.

“Whether these training improvements can help older adults in carrying out everyday tasks and functioning independently remains an open question. The next real challenge will be to see if the gains that accompanied the training are maintained as the sample ages physically and mentally and if those gains transfer to mentally demanding everyday activities,” said Dr. Rebok.

The ACTIVE Trial was funded by the National Institute on Aging and the National Institute of Nursing Research. Other participants included: University of Alabama at Birmingham; National Institute on Aging; National Institute of Nursing Research; National Heart, Lung and Blood Institute; University of Florida; Hebrew Rehabilitation Center for the Aged; Indiana University School of Medicine; New England Research Institutes; Indiana University School of Medicine; and the Department of Human Development and Family Studies, Pennsylvania State University.

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