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Cited by 200Dementia and Cognitive Impairment ResearchCognitive Abilities and TestingCognitive Functions and Memory

The ACTIVE Cognitive Training Trial and Health-Related Quality of Life: Protection That Lasts for 5 Years

Wolinsky, Fredric D., Unverzagt, Frederick W., Smith, David M., Jones, Richard, Stoddard, Anne, Tennstedt, Sharon L.·2006·The Journals of Gerontology: Series A
DOI 10.1093/gerona/61.12.1324
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Abstract

OBJECTIVE: We evaluated the ability of the three cognitive training interventions (memory, reasoning, or speed of processing) fielded in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) multisite randomized controlled trial to protect against two thresholds of extensive decline in health-related quality of life (HRQoL) at 2 and 5 years post-training. METHOD: Adults aged 65 years or older (2802) were enrolled and randomized to three cognitive interventions or a no-contact control group. Data on 1804 participants were available at both the 2- and 5-year follow-ups. HRQoL was measured by the eight MOS 36-Item Short-Form Health Survey (SF-36) scales. Clinically relevant decline on each scale was defined as a drop of > or = 0.5 standard deviations from baseline. Extensive HRQoL decline was defined as clinically relevant drops on (i) > or = 4 SF-36 scales, and (ii) > or = 3 SF-36 scales, and was assessed using multiple logistic regressions, weighted to adjust for potential attrition bias. Results. At 2 years post-training, 23.7% and 36.6% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. At 5 years post-training, 32.9% and 47.3% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. Participants in the speed of processing intervention arm were significantly less likely to have extensive HRQoL decline compared to participants in the control group regardless of the threshold or time period, whereas participants in the memory and reasoning intervention arms were significantly less like to have extensive HRQoL decline only at 5 years post-training and only at the lower threshold. Conclusion. The effect of the speed of processing intervention was stronger and evident earlier than those for the memory and reasoning interventions. This result stems from the speed of processing intervention being the most procedural intervention, operating through sensory-motor elaboration and repetition, bringing about a broader pattern of regional brain activation. At 5 years post-training, however, all three interventions were successful in protecting against a lower threshold of age-related extensive declines in HRQoL.

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  • Clinically meaningful cognitive decline is defined as a decline in cognitive function of 0.5 or more SDs from baseline cognitive scores.

    “Experts have defined clinically meaningful cognitive decline as a decline in cognitive function of 0.5 or more SDs from baseline cognitive scores.36,37,38”

    From Sex differences in cognitive decline among US adults (2021) · cites this paper as [36]

    The HRQoL section defines a clinically relevant decline as a drop of 0.50 SD from baseline on an SF-36 health-related quality-of-life scale. It does not define that threshold for cognitive function or cognitive scores; page numbers are unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Authors
Wolinsky, F. D., Unverzagt, F. W., Smith, D. M., Jones, R., Stoddard, A., & Tennstedt, S. L.
Affiliations
  • Iowa City VA Health Care System (US)
  • Indiana University Indianapolis (US)
  • New England Research Institutes (US)
Corresponding author
Wolinsky, Fredric D.
ORCID
Venue
The Journals of Gerontology: Series A
Publisher
Oxford University Press (OUP)
Published
2006-12
Volume
61
Issue
12
Pages
1324-1329
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/61.12.1324
OpenAlex
W2126084914
Cited by
200
References
4
Citations by year
2026: 8 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 15 · 2021: 12 · 2020: 10 · 2019: 17 · 2018: 9 · 2017: 12 · 2016: 5 · 2015: 16 · 2014: 11 · 2013: 13 · 2012: 10
FWCI
4.26
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Health Services Research and Development
  • University of Florida
  • National Institutes of Health
  • School of Medicine, Indiana University
  • National Institute on Aging (R03AG023042, R01 AG14260, R01 AG 14263, R01 AG14289, R01 AG14282, R01 AG014276)
  • National Institute of Nursing Research (R01 NR04508, R01 NR 04507)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Keywords
cognitive training, health-related quality of life, older adults, processing speed, memory training, reasoning training, cognitive decline, ACTIVE trial, long-term follow-up, SF-36, attrition bias
MeSH terms
Aged, Aging, Female, Health Surveys, Humans, Male, Quality of Life, Regression Analysis, Time Factors, Cognitive Behavioral Therapy

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