A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) Study

Authors

  • Glenn E. Smith PhD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Patricia Housen PhD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Kristine Yaffe MD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Ronald Ruff PhD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Robert F. Kennison PhD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Henry W. Mahncke PhD,

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author
  • Elizabeth M. Zelinski PhD

    1. From the *Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CaliforniaDepartments of Psychiatry§NeurologyEpidemiology, University of California, San Francisco, San Francisco, California#Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, California**Department of Psychology, California State University, Los Angeles, California; and ††Posit Science Corporation, San Francisco, California.
    Search for more papers by this author

  • Portions of this research were presented as a poster presentation at the 60th Annual Scientific Meeting of the Gerontological Society of America, November 16–20, 2007, San Francisco, CA; 36th Annual Scientific Meeting of the International Neuropsychological Society, February 6–9, 2008, Waikoloa, HI; Annual Meeting of the American Academy of Neurology, April 12–19, 2008, Chicago, IL; 2008 American Geriatrics Society Annual Scientific Meeting (Encore), April 30–May 5, 2008, Washington, DC; and 6th International Conference of the International Society for Gerotechnology, June 4–6, 2008, Pisa, Italy.

Address correspondence to Glenn E. Smith, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: smitg@mayo.edu

Abstract

OBJECTIVES: To investigate the efficacy of a novel brain plasticity–based computerized cognitive training program in older adults and to evaluate the effect on untrained measures of memory and attention and participant-reported outcomes.

DESIGN: Multisite randomized controlled double-blind trial with two treatment groups.

SETTING: Communities in northern and southern California and Minnesota.

PARTICIPANTS: Community-dwelling adults aged 65 and older (N=487) without a diagnosis of clinically significant cognitive impairment.

INTERVENTION: Participants were randomized to receive a broadly-available brain plasticity–based computerized cognitive training program (intervention) or a novelty- and intensity-matched general cognitive stimulation program modeling treatment as usual (active control). Duration of training was 1 hour per day, 5 days per week, for 8 weeks, for a total of 40 hours.

MEASUREMENTS: The primary outcome was a composite score calculated from six subtests of the Repeatable Battery for the Assessment of Neuropsychological Status that use the auditory modality (RBANS Auditory Memory/Attention). Secondary measures were derived from performance on the experimental program, standardized neuropsychological assessments of memory and attention, and participant-reported outcomes.

RESULTS: RBANS Auditory Memory/Attention improvement was significantly greater (P=.02) in the experimental group (3.9 points, 95% confidence interval (CI)=2.7–5.1) than in the control group (1.8 points, 95% CI=0.6–3.0). Multiple secondary measures of memory and attention showed significantly greater improvements in the experimental group (word list total score, word list delayed recall, digits backwards, letter–number sequencing; P<.05), as did the participant-reported outcome measure (P=.001). No advantage for the experimental group was seen in narrative memory.

CONCLUSION: The experimental program improved generalized measures of memory and attention more than an active control program.

Ancillary