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Regular Research Article| Volume 30, ISSUE 6, P717-726, June 2022

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Improvements in Cognitive Performance With Computerized Training in Older People With and Without Cognitive Impairment: Synergistic Effects of Skills-Focused and Cognitive-Focused Strategies

Published:November 21, 2021DOI:https://doi.org/10.1016/j.jagp.2021.11.008

      Highlights

      • What is the primary question addressed by this study? This study addressed the question of whether computerized functional skills training improved cognition in older people with normal cognition or cognitive impairments.
      • What is the main finding of this study? Computerized functional skills training alone was associated with improvements in four of six cognitive domains assessed in participants with cognitive impairments. Overall, combined computerized cognitive and functional skills training led to greater improvements in all six domains of cognition across the two participant groups.
      • What is the meaning of the finding? These data suggest that both older people with cognitive impairments and normal cognition show evidence of plasticity in their cognitive functioning and that combining functional skills and cognitive training leads to wide-ranging cognitive improvements.

      Abstract

      Objectives

      Both cognitively impaired (CI) and nonimpaired (NC) older people have challenges in performing everyday tasks. Previous skills training efforts in NC individuals have led to improvements in both functional skills and cognitive functioning. We evaluated the cognitive benefits of combining computerized cognitive training (CCT) with a computer-based functional skills assessment and training (CFSAT) program in a sample of CI and NC older adults.

      Design

      Randomized parallel clinical trial with two treatment conditions: up to 24 sessions of CFSAT training alone or CFSAT plus speed focused CCT.

      Participants

      NC (n = 62) and CI (n = 55) older adults, ranging in age from 60–86 years (M = 73.12), primarily female (90%), and ethnically diverse (21% Hispanic, 52% African American). Participants were divided based on Montreal Cognitive Assessment scores and cognitive complaints.

      Setting

      Three different community centers in Miami, FL.

      Measurements

      The Brief Assessment of Cognition, app version, was used to measure cognitive performance across six different cognitive domains before and after training.

      Results

      All six cognitive domains improved from baseline. Multivariate analyses found the effects of the combined CFSAT and CCT to be superior. The interaction of training condition and cognitive status was not statistically significant, indicating no global impact of cognitive status on improvements in cognition across training conditions.

      Conclusions

      CFSAT training was associated with cognitive benefits, particularly in CI participants. The combined intervention led to greater improvements. Consistent with results of previous studies, there is considerable evidence of cognitive plasticity in older adults, including those with CI.

      Key Words

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