Is Computerized Working Memory Training Effective in Healthy Older Adults? Evidence from a Multi-Site, Randomized Controlled Trial
Simon, S.S., Tusch, E.S., Feng, N.C., Hakansson, K., Mohammed, A.H., Daffner, K.R..
(2018)Journal of Alzheimer's Disease.
DOI: 10.3233/JAD-180455
Abstract
Background: Developing effective interventions to attenuate age-related cognitive decline and prevent or delay the onset
of dementia are major public health goals. Computerized cognitive training (CCT) has been marketed increasingly to older
adults, but its efficacy remains unclear. Working memory (WM), a key determinant of higher order cognitive abilities, is
susceptible to age-related decline and a relevant target for CCT in elders.
Objective: To evaluate the efficacy of CCT focused on WM compared to an active control condition in healthy older adults.
Methods: Eighty-two cognitively normal adults from two sites (USA and Sweden) were randomly assigned to Cogmed
Adaptive or Non-Adaptive (active control) CCT groups. Training was performed in participants’ homes, five days per week
over five weeks. Changes in the performance of the Cogmed trained tasks, and in five neuropsychological tests (Trail Making
Test Part A and Part B, Digit Symbol, Controlled Oral Word Association Test and Semantic Fluency) were used as outcome
measures.
Results: The groups were comparable at baseline. The Adaptive group showed robust gains in the trained tasks, and there was
a time-by-group interaction for the Digit Symbol test, with significant improvement only after Adaptive training. In addition,
the magnitude of the intervention effect was similar at both sites.
Conclusion: Home-based CCT Adaptive WM training appears more effective than Non-Adaptive training in older adults
from different cultural backgrounds. We present evidence of improvement in trained tasks and on a demanding untrained
task dependent upon WM and processing speed. The benefits over the active control group suggest that the Adaptive CCT
gains were linked to providing a continuously challenging level of WM difficulty.
Aims This study aimed to see if five weeks of computerised working memory (WM) training could help healthy older adults improve their thinking skills. Participants from the US and Sweden trained at home with a program called Cogmed. The researchers wanted to determine if the training, especially when it adjusted to challenge the individual, would lead to better performance on cognitive tests beyond the specific tasks they practiced.
Findings The results showed that those who did the adaptive training—where the difficulty increased as they improved—performed better on a specific test called the Digit Symbol task, which measures processing speed. This suggests that the training helped improve certain thinking skills. The study also found that training effects were similar across both US and Swedish participants, despite some cultural and demographic differences.
Strengths A key strength was that the study carefully compared adaptive training to non-adaptive training, allowing clear insights into the benefits of challenging the brain. It used a home-based, computer-supported program, which makes it accessible and practical for older adults. The high engagement and adherence rates also indicate that participants found the training manageable and motivating.
Limitations However, the study had some limitations. It was not registered as a clinical trial, which is important for transparency. The sample size was moderate, limiting the ability to explore why some people benefit more than others. Also, only one cognitive test showed improvement, so more measures are needed to confirm the overall benefits. Additionally, it’s unclear if these improvements last over time or transfer to everyday life tasks.
Aims This study aimed to see if five weeks of computerised working memory (WM) training could help healthy older adults improve their thinking skills. Participants from the US and Sweden trained at home with a program called Cogmed. The researchers wanted to determine if the training, especially when it adjusted to challenge the individual, would lead to better performance on cognitive tests beyond the specific tasks they practiced.
Findings The results showed that those who did the adaptive training—where the difficulty increased as they improved—performed better on a specific test called the Digit Symbol task, which measures processing speed. This suggests that the training helped improve certain thinking skills. The study also found that training effects were similar across both US and Swedish participants, despite some cultural and demographic differences.
Strengths A key strength was that the study carefully compared adaptive training to non-adaptive training, allowing clear insights into the benefits of challenging the brain. It used a home-based, computer-supported program, which makes it accessible and practical for older adults. The high engagement and adherence rates also indicate that participants found the training manageable and motivating.
Limitations However, the study had some limitations. It was not registered as a clinical trial, which is important for transparency. The sample size was moderate, limiting the ability to explore why some people benefit more than others. Also, only one cognitive test showed improvement, so more measures are needed to confirm the overall benefits. Additionally, it’s unclear if these improvements last over time or transfer to everyday life tasks.