Aging Lessons: Training gives elderly practical assistance

Sessions aimed at improving memory, reasoning, or visual concentration in healthy elderly people yield notable cognitive returns, even 5 years later, a long-term study suggests. The training largely protected the participants from age-related declines in the ability to perform everyday tasks such as preparing meals, doing housework, and managing money.

A handful of booster sessions in reasoning or visual concentration, administered about 1 year and 3 years after the initial sessions, offered an even better defense against cognitive losses that interfere with daily activities, says a team led by psychologist Sherry L. Willis of Pennsylvania State University in State College.

“It’s surprising to see such durable effects of cognitive interventions on general abilities in the elderly,” says psychologist and study coauthor Michael Marsiske of the University of Florida in Gainesville. “It’s intriguing to think about what the effects might be with more training.”

The new findings appear in the Dec. 20 Journal of the American Medical Association.

Willis and her colleagues studied 2,802 adults, ages 65 and older, living independently in six U.S. cities. The volunteers were randomly assigned to one of three training groups or to a control group that received no training.

People in the training groups attended 10 twice-weekly, roughly 1-hour sessions. One course taught ways to improve memory for word lists and stories. Another focused on developing reasoning strategies to discern patterns in series of letters and words. A third coached volunteers to identify objects shown in increasingly brief computer displays.

Nearly a year later, 879 individuals completed four booster sessions based on their prior training. Two years after that, 723 people completed four more booster sessions.

Initial findings indicated that any cognitive training, even without booster sessions, yielded improved scores 2 years later on tests of memory, reasoning, or visual concentration (SN: 11/16/02, p. 307: Available to subscribers at Thoughtful Lessons: Training may enhance intellect in elderly).

The new study shows that, after 5 years, people in each training group performed better on tests in their respective areas of training than did those in the control group. Participants who received booster training in reasoning and visual concentration scored highest on tests reflecting those skills.

Moreover, after 5 years, members of the three training groups reported less difficulty than did people in the control group in carrying out everyday tasks. Booster training in reasoning produced additional improvement in activities such as comprehending medication-dosage instructions. Further training in visual concentration yielded additional gains on tasks such as reacting quickly to road signs.

Overall, training-related improvements counteracted much of the decline in cognitive performance that would typically occur over a 7-to-14-year stretch among people of those ages who had no diagnosed brain disorder, Willis says.

“This is the most rigorous test of cognitive training for the elderly to date,” remarks psychologist Jeffrey Elias of the National Institute on Aging in Bethesda, Md. Further research should explore more-intensive and broader courses of mental training, he says.

In an editorial published with the new report, psychologist Sally A. Shumaker of Wake Forest University Health Sciences in Winston–Salem, N.C., and her coworkers note that Willis’ group didn’t track physical activity among volunteers, which can also boost thinking skills (SN: 2/21/04, p. 115: Neural Aging Walks Tall: Aerobic activity fuels elderly brains, minds). Shumaker’s team recommends that further studies examine possible general effects of cognitive training, such as increased feelings of self-control, that may spark reports of improved daily functioning.