Ten‐Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults
Open accessAbstract
Objectives: To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. Design: Ten‐year follow‐up of a randomized, controlled single‐blind trial (Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE )) with three intervention groups and a no‐contact control group. Setting: Six U.S. cities. Participants: A volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently. Intervention: Ten training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial training. Measurements: Objectively measured cognitive abilities and self‐reported and performance‐based measures of everyday function. Results: Participants in each intervention group reported less difficulty with instrumental activities of daily living ( IADL s) (memory: effect size = 0.48, 99% confidence interval ( CI ) = 0.12–0.84; reasoning: effect size = 0.38, 99% CI = 0.02–0.74; speed of processing: effect size = 0.36, 99% CI = 0.01–0.72). At a mean age of 82, approximately 60% of trained participants, versus 50% of controls ( P < .05), were at or above their baseline level of self‐reported IADL function at 10 years. The reasoning and speed‐of‐processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size = 0.23, 99% CI = 0.09–0.38; speed of processing: effect size = 0.66, 99% CI = 0.43–0.88). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size = 0.21, 99% CI = 0.01–0.41) and the speed‐of‐processing intervention for speed‐of‐processing performance (effect size = 0.62, 99% CI = 0.31–0.93). Conclusion: Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention resulted in less decline in self‐reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.
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Mental stimulation and cognitive training improve memory in older adults.
“Findings showing that mental stimulation and cognitive training improve memory in older adults43,44 have led to the development of several memory apps and computer games.”
From Brain health consequences of digital technology use (2020) · cites this paper as [44]
In the ACTIVE study, reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.
“based on the results of a previous study, ACTIVE, where reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years [188].”
From Treatment of Alzheimer’s Disease: Beyond Symptomatic Therapies (2023) · cites this paper as [188]
The ACTIVE study found that cognitive training groups demonstrated improvements on trained tasks which remained over time and evidence of transfer to functional tasks.
“The Advanced Cognitive Training in Vital Elderly (ACTIVE) study examined the longitudinal effects of cognitive training in 2,832 older adults [10]. Cognitive training groups demonstrated improvements on trained tasks which remained over time and evidence of transfer to functional tasks [10–12].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [11]
Findings for transfer effects of cognitive training on untrained cognitive domains and daily functioning are less consistent.
“While a variety of cognitive training studies have identified post-intervention gains on trained tasks and on tasks within similar domains [13–15], findings for transfer effects on untrained cognitive domains and daily functioning are less consistent, presenting a need to improve the efficacy of cognitive training interventions in producing clinically meaningful outcomes [11, 15–18].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [11]
Computerized cognitive training is a recognized way to enhance cognition in healthy older adults.
“CCT is an established method to improve cognitive functioning in older healthy adults47, 48”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [48]
Mindfulness meditation training improves cognitive problems and psychiatric symptoms in older adults.
“MMT improves cognitive dysfunction and psychopathology in older adults.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [48]
Assistive technologies and cognitive stimulation activities have been found to promote independent living and to help protect against age-related cognitive decline.
“Assistive technologies (also called gerontechnologies) and cognitive stimulation activities (e.g., games) have been found to promote independent living and to help protect against age-related cognitive decline [6].”
From Participatory Design, Development, and Testing of Assistive Health Robots with Older Adults: An International Four-year Project (2022) · cites this paper as [6]
The present meta-analysis is in line with the general skepticism about the alleged benefits of commercial cognitive-training programs expressed by Simon et al. (2016) and reported in large trials (e.g., ACTIVE; Rebok et al., 2014).
“In this respect, the present meta-analysis is in line with the general skepticism about the alleged benefits of commercial cognitive-training programs expressed by Simon et al. (2016) and reported in large trials (e.g., ACTIVE; Rebok et al., 2014).”
From The cognitive and academic benefits of Cogmed: A meta-analysis (2019) · cites this paper as Rebok et al., 2014
The science of cognitive training has proven effective in laboratory settings across a number of large clinical trials.
“the science of cognitive training has proven effective in laboratory settings across a number of large clinical trials (e.g., NIA-funded ACTIVE study).(Rebok, Ball, Guey, Jones, Kim, King, Marsiske, Morris, Tennstedt, Unverzagt, and Willis 2014)”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Rebok, Ball, Guey, Jones, Kim, King, Marsiske, Morris, Tennstedt, Unverzagt, and Willis 2014
The ACTIVE study showed significant improvement in driving performance and training measures lasting as long as ten years after initial training targeting processing speed and attention in over 1500 older adults.
“The ACTIVE study showed significant improvement in driving performance and training measures lasting as long as ten years after the initial training targeting processing speed and attention in over 1500 older adults.(Rebok, Ball, Guey, Jones, Kim, King, Marsiske, Morris, Tennstedt, Unverzagt, and Willis 2014)”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Rebok, Ball, Guey, Jones, Kim, King, Marsiske, Morris, Tennstedt, Unverzagt, and Willis 2014
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Investigating message framing to improve adherence to technology-based cognitive interventions.
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Hardcastle, C., Hausman, H. K., Kraft, J. N., Albizu, A., O’Shea, A., Boutzoukas, E. M., Evangelista, N. D., Langer, K., Van Etten, E. J., Bharadwaj, P. K., et al. (2022) · GeroScience · doi:10.1007/s11357-022-00535-1 · Cited by 22 · see citing works
Self-citationBoutzoukas, E. M., O’Shea, A., Kraft, J. N., Hardcastle, C., Evangelista, N. D., Hausman, H. K., Albizu, A., Van Etten, E. J., Bharadwaj, P. K., Smith, S. G., et al. (2022) · GeroScience · doi:10.1007/s11357-022-00538-y · Cited by 15 · see citing works
Self-citationHausman, H. K., Alexander, G. E., Cohen, R., Marsiske, M., DeKosky, S. T., Hishaw, G. A., O'Shea, A., Kraft, J. N., Dai, Y., Wu, S., et al. (2023) · Brain Stimulation · doi:10.1016/j.brs.2023.05.021 · Cited by 13 · see citing works
Self-citationLocke, D. E. C., Chandler Greenaway, M., Duncan, N., Fields, J. A., Cuc, A. V., Hoffman Snyder, C., Hanna, S., Lunde, A., & Smith, G. E. (2014) · The Journal of Prevention of Alzheimer's Disease · doi:10.14283/jpad.2014.27 · Cited by 11 · see citing works
- Authors
- Rebok, G. W., Ball, K., Guey, L. T., Jones, R. N., Kim, H., King, J. W., Marsiske, M., Morris, J. N., Tennstedt, S. L., Unverzagt, F. W., & Willis, S. L.
- Affiliations
- Johns Hopkins University (US)
- University of Alabama at Birmingham (US)
- New England Research Institutes (US)
- Hebrew SeniorLife (US)
- National Institutes of Health (US)
- University of Florida Health (US)
- Indiana University Indianapolis (US)
- University of Washington (US)
- Corresponding author
- Rebok, George W.
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2014-01
- Volume
- 62
- Issue
- 1
- Pages
- 16-24
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC4055506
- OpenAlex
- W2111301169
- Cited by
- 965
- References
- 49
- Citations by year
- 2026: 54 · 2025: 64 · 2024: 74 · 2023: 61 · 2022: 97 · 2021: 89 · 2020: 84 · 2019: 88 · 2018: 88 · 2017: 74 · 2016: 75 · 2015: 70 · 2014: 45
- FWCI
- 67.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Institute on Aging and the National Institute of Nursing Research to Hebrew Senior Life (U01 NR04507)
- Indiana University School of Medicine (U01NR04508)
- Johns Hopkins University (U01AG14260)
- New England Research Institute (U01 AG14282)
- Pennsylvania State University (U01 AG14263)
- University of Alabama at Birmingham (U01 AG14289)
- University of Florida (U01AG14276)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- cognitive training, older adults, long-term follow-up, daily functioning, instrumental activities of daily living, memory training, reasoning training, processing speed, booster training, cognitive decline, ACTIVE trial, self-reported function, retention of training effects, independent living, African American older adults, cognitive aging interventions
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Aging, Cognition Disorders, Female, Follow-Up Studies, Humans, Male, Memory Disorders, Mental Processes, United States, Cognitive Behavioral Therapy, Single-Blind Method, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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