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Original Title
Cognitive changes after working memory training in healthy
older adults: Evidence from a multi-site, randomized
controlled trial
Simon S., Tusch E., Hakansson K., Mohammed A., Daffner K.
Neurology 2017 88:16 Supplement 1

Original Abstract
Objective: To evaluate the efficacy of computerized cognitive training (CCT) focused on
working memory (WM) compared to an active control condition in healthy older adults.
Background: Developing effective interventions to attenuate age-related cognitive
decline is a major public health goal. CCT has been marketed increasingly to older
adults, but its efficacy remains unclear. WM, a key determinant of higher order cognitive
abilities, is susceptible to age-related decline, which makes WM a relevant target for CCT
in elders. Design/Methods: Seventy-six cognitively normal adults, 65 years and older,
from two sites (US and Sweden) were randomly assigned to Cogmed Adaptive or Non-
Adaptive (active control) CCT groups. Training was performed in participants' homes
during sessions lasting ∼40 minutes, 5 days per week over 5 weeks. In Adaptive CCT,
difficulty level was continually adjusted, while for the Non-Adaptive group, difficulty level
remained the same. At baseline, subjects underwent a neuropsychological evaluation.
The outcome measures included changes in age-adjusted percentile scores of Trails A
and B, Digit Symbol, COWAT and Semantic Fluency. Results: The intervention groups
were comparable at baseline, although the adaptive CCT group tended to have slightly
higher estimated IQs. ANOVA demonstrated a group-by-time interaction for Trails B and
Digit Symbol, with significant improvement only after Adaptive training. After controlling
for IQ (ANCOVA), the interactions remained significant. In addition, although subjects at
the 2 sites differed in terms of demographs and neuropsychological performance at
baseline, the magnitude of the intervention effect was similar at both sites. Conclusions:
Adaptive WM training effectively improved executive functioning and processing speed in
older adults from different cultural backgrounds. The benefits over the active control
group suggest that the adaptive CCT gains were not simply due to practice effects or a
non-specific outcome of participating in an intervention program, but were linked to
providing a continuously challeging level of WM difficulty.

Other Terms
adult, aged, analysis of covariance, analysis of variance, clinical trial, control group,
controlled clinical trial, controlled oral word association test, controlled study,
digit (body part) , executive function , female, human, major clinical study, male,
normal human, randomized controlled trial, Sweden, velocity, working memory

Correspondence Address
Simon S.: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States.

Author Addresses
Simon S., Tusch E., Daffner K.: Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States.
Hakansson K., Mohammed A.: Neurobiology, Karolinska Institutet, Stockholm,
Sweden.
Hakansson K., Mohammed A.: Psychology, Linnaeus Unversity, Stockholm, Sweden.

Copyright
Copyright 2017 Elsevier B.V., All rights reserved.

Additional Information
Embase identification number (PUI) L616550970
Abbreviated Journal Title Neurology
ISSN 1526632X
Source Type Journal
69th American Academy of Neurology Annual
Conference Name
Meeting, AAN 2017
Conference Location Boston, MA, United States
Conference Date 2017-04-22 to 2017-04-28
Source Publication Date 2017-04-01
Entry Date 2017-06-06 (Full record)
Publication Type Conference Abstract
Page Range
Country of Author United States
Country of Source Netherlands
Language of Article English
Language of Summary English
Cited by in Scopus

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