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Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial

Published online by Cambridge University Press:  15 December 2009

Fredric D. Wolinsky ,
Henry Mahncke ,
Mark W. Vander Weg ,
Rene Martin ,
Frederick W. Unverzagt ,
Karlene K. Ball ,
Richard N. Jones  and
Sharon L. Tennstedt
Fredric D. Wolinsky*
Affiliation:
Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa, U.S.A.
Henry Mahncke
Affiliation:
Posit Science Corporation, San Francisco, California, U.S.A.
Mark W. Vander Weg
Affiliation:
Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, U.S.A.
Rene Martin
Affiliation:
Department of Adult Nursing, College of Nursing, University of Iowa, Iowa City, Iowa, U.S.A.
Frederick W. Unverzagt
Affiliation:
Department of Psychiatry, College of Medicine, Indiana University, Indianapolis, Indiana, U.S.A.
Karlene K. Ball
Affiliation:
Department of Psychology, College of Arts and Sciences, University of Alabama, Birmingham, Alabama, U.S.A.
Richard N. Jones
Affiliation:
Research Department, Hebrew Senior Life, Boston, Massachusetts, U.S.A.
Sharon L. Tennstedt
Affiliation:
Aging Studies, New England Research Institutes, Boston, Massachusetts, U.S.A.
*
Correspondence should be addressed to: Fredric D. Wolinsky, Department of Health Management, University of Iowa, 200 Hawkins Drive, E205-GH, Iowa City, IA 52242, U.S.A. Phone: +1 319 384 5129; Fax: +1 319 384 5125. Email: [email protected].
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Abstract

Background: We evaluated the effects of cognitive training on self-rated health at 1, 2, 3, and 5 years post-baseline.

Methods: In the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) randomized controlled trial, 2,802 older adults (≥65 years) were randomly assigned to memory, reasoning, speed of processing, or no-contact control intervention groups. Complete data were available for 1,804 (64%) of the 2,802 participants at five years. A propensity score model was adjusted for attrition bias. The self-rated health question was coded using the Diehr et al. (2001) transformation (E = 95/VG = 90/G = 80/F = 30/P = 15), and analyzed with change-score regression models.

Results: The speed of processing (vs. no-contact control) group had statistically significant improvements (or protective effects) on changes in self-rated health at the 2, 3 and 5 year follow-ups. The 5-year improvement was 2.8 points (p = 0.03). No significant differences were observed in the memory or reasoning groups at any time.

Conclusion: The speed of processing intervention significantly protected self-rated health in ACTIVE, with the average benefit equivalent to half the difference between excellent vs. very good health.

Keywords

randomized controlled trialcognitive trainingself-rated healthmemoryreasoningspeed of processing
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 3 , May 2010 , pp. 470 - 478
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Ball, K. et al. (2002). Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA, 288, 2271–2281.CrossRefGoogle ScholarPubMed
Cabeza, R. and Nyberg, L. (2000). Imaging cognition II: an empirical review of 275 PET and MRI studies. Journal of Cognitive Neuroscience, 12, 1–47.CrossRefGoogle Scholar
D'Agostino, R. B. (1998). Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Statistics in Medicine, 17, 2265–2281.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Diehr, P., Patrick, D. L., Spertus, J., Kiefe, C. I., McDonell, M. and Fihn, S. D. (2001). Transforming self-rated health and the SF-36 scales to include death and improve interpretability. Medical Care, 39, 670–680.CrossRefGoogle ScholarPubMed
Ferraro, K. F. and Kelley-Moore, J. A. (2001). Self-rated health and mortality among black and white adults: examining the dynamic evaluation thesis. Journal of Gerontology: Social Sciences, 56B, S195–S205.CrossRefGoogle Scholar
Folstein, M. R, Folstein, S. and 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, 189–198.CrossRefGoogle ScholarPubMed
Hanley, J. A. and McNeil, B. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 143, 29–36.CrossRefGoogle Scholar
Hosmer, D. W. and Lemeshow, S. (1989). Applied Logistic Regression. New York: Wiley.Google Scholar
Idler, E. L. and Benyamini, Y. (1997). Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.CrossRefGoogle ScholarPubMed
Idler, E. L. and Kasl, S. V. (1995). Self-ratings of health: do they predict change in functional ability? Journal of Gerontology: Social Sciences, 50, S344–S353.CrossRefGoogle ScholarPubMed
Jobe, J. B. et al. (2001). ACTIVE: a cognitive intervention trial to promote independence in older adults. Controlled Clinical Trials, 22, 453–479.CrossRefGoogle ScholarPubMed
Kessler, R. C. and Greenberg, D. F. (1981). Linear Panel Analysis: Models of Quantitative Change. New York: Academic Press.Google Scholar
Maddox, G. L. (1962). Some correlates of differences in self-assessment of health status among the elderly. Journal of Gerontology, 17, 180–185.CrossRefGoogle ScholarPubMed
Maddox, G. L. and Douglass, E. B. (1973). Self-assessment of health: a longitudinal study of elderly subjects. Journal of Health and Social Behavior, 14, 87–93.CrossRefGoogle Scholar
Morris, J. and Morris, S. (1997). ADL assessment for use with frail elders. Journal of Mental Health and Aging, 3, 19–45.Google Scholar
Morris, J. N. et al. (1997). Comprehensive clinical assessment in community setting: applicability of the MDS-HC. Journal of the American Geriatrics Society, 45, 1017–1024.CrossRefGoogle ScholarPubMed
Nunnally, J. C. (1967). Psychometric Theory. New York: McGraw Hill.Google Scholar
Salthouse, T. A. (1996). The processing-speed theory of adult age differences in cognition. Psychological Review, 103, 403–428.CrossRefGoogle ScholarPubMed
Salthouse, T. A. (2009). When does age-related cognitive decline begin? Neurobiology and Aging, 30, 507–514.CrossRefGoogle ScholarPubMed
Ware, J. R. Jr., Snow, K. S., Kosinski, M. and Gandek, B. (1993). The SF-36 Health Survey Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center.Google Scholar
Willis, S. L. et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 296, 2805–2814.CrossRefGoogle ScholarPubMed
Wolinsky, F. D. et al. (2006a). The effects of the ACTIVE cognitive training interventions on clinically relevant declines in health-related quality of life. Journal of Gerontology: Social Sciences, 61, S281–S287.CrossRefGoogle ScholarPubMed
Wolinsky, F. D. et al. (2006b). The ACTIVE cognitive training trial and health-related quality of life: protection that lasts for five years. Journal of Gerontology: Medical Sciences, 61, 1324–1329.Google Scholar
Wolinsky, F. D. et al. (2009a). The effect of speed of processing training on depressive symptoms in ACTIVE. Journal of Gerontology: Medical Sciences, 64, 468–472.Google ScholarPubMed
Wolinsky, F. D. et al. (2009b). The ACTIVE cognitive training trial and predicted medical expenditures. BMC Health Services Research, 9, 109.CrossRefGoogle ScholarPubMed
Wolinsky, F. D. et al. (2009c). The ACTIVE cognitive training interventions and the onset of clinically relevant depressive symptoms. Journals of Gerontology: Psychological Sciences and Social Sciences, 64B, 577–585.CrossRefGoogle Scholar
Wolinsky, F. D. et al. (2009d). Does cognitive training improve internal locus of control among older adults? Journals of Gerontology: Psychological Sciences and Social Sciences, 64B, in press.Google Scholar