ACTIVE Memory Training and Proximal Outcome Measures Friday Harbor Conference June 9-13, 2014
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ACTIVE Memory Training and Proximal Outcome Measures
Friday Harbor ConferenceJune 9-13, 2014
Presenter: George W. Rebok, PhD, MASupported By: U01 AG14260
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ACTIVE Steering Committee
University of Alabama-Birmingham Karlene Ball, PhD
Hebrew SeniorLife BostonJohn Morris, PhDRichard Jones, ScD
Indiana UniversityFredrick Unverzagt, PhD
Johns Hopkins UniversityGeorge Rebok, PhD
Pennsylvania State UniversitySherry Willis, PhD
University of Florida/Wayne State UniversityMichael Marsiske, PhD
New England Research Institutes, Coordinating CenterSharon Tennstedt, PhD
National Institute on AgingJonathan King, PhD
National Institute of Nursing Research Susan Marden, PhD
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Disclosure
Dr. Rebok is an Investigator with Compact Disc Incorporated for the development of an electronic version of the ACTIVE memory intervention.
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Acknowledgements
• Funded in part by Grant R13 AG030995 from the National Institute on Aging
• The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Friday Harbor Psychometrics, 2014
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Overview
1. Background Previous studies of memory training with older adults
2. Memory training
Description of the ACTIVE memory training protocol
3. Results Overview of the results of the ACTIVE memory training
4. Conclusion Implications for further analysis of the ACTIVE memory training data
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05
1015
Per
cent
1970 1980 1990 2000 2010Year
Histogram of 402 scientific studies of memory training
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Study Selection
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Study-Specific Effect Sizes
Overall (I-squared = 12.4%, p = 0.261)
Calero-Garcia, 2007b
Scogin, 1985
Derwinger, 2005b
Calero, 2007b
Dunlosky, 2003
Caprio-Prevette, 1996Carretti, 2007
Ball, 2002Becker, 2008
Hill, 1991a
Mohs, 1998
Fabre, 2002
McDougall, 2008
Stigsdotter, 1989Woolverton, 2001a
Flynn, 1990
Calero, 2007a
Lustig, 2008
Derwinger, 2005a
Woolverton, 2001b
Hill, 1990
Hill, 1991b
Yesavage, 1983
Scogin, 1998
Craik, 2007
Yesavage, 1984
Smith, 2009
Scogin, 1992
Best, 1992Buschkuel, 2008
Andrewes, 1996
Dahlin, 2008
Calero-Garcia, 2007a
Rapp, 2002
Hill, 1997
0.31 (0.22, 0.39)
0.53 (-0.09, 1.16)
0.26 (-0.32, 0.84)
effect size (95% CI)
0.24 (-0.38, 0.86)
0.54 (-0.00, 1.07)
0.39 (-0.10, 0.88)
0.43 (0.06, 0.80)0.55 (-0.19, 1.30)
0.26 (0.16, 0.36)0.14 (-0.28, 0.55)
0.51 (-0.10, 1.11)
0.06 (-0.27, 0.39)
Overall pre-post
0.51 (-0.48, 1.51)
0.08 (-0.16, 0.32)
0.46 (-0.43, 1.35)0.41 (-0.15, 0.97)
0.52 (-0.11, 1.16)
0.41 (0.02, 0.80)
-0.14 (-0.83, 0.56)
0.00 (-0.62, 0.62)
0.85 (0.26, 1.44)
1.78 (0.90, 2.66)
0.08 (-0.49, 0.65)
0.38 (-0.18, 0.94)
0.29 (-0.31, 0.89)
0.31 (-0.26, 0.87)
0.64 (-0.01, 1.28)
0.20 (0.03, 0.38)
0.15 (-0.44, 0.74)
1.55 (0.53, 2.57)0.49 (-0.19, 1.16)
0.08 (-0.54, 0.70)
0.74 (0.03, 1.46)
0.52 (-0.03, 1.08)
0.08 (-0.82, 0.98)
0.31 (-0.35, 0.96)
0.31 (0.22, 0.39)
0.53 (-0.09, 1.16)
0.26 (-0.32, 0.84)
effect size (95% CI)
0.24 (-0.38, 0.86)
0.54 (-0.00, 1.07)
0.39 (-0.10, 0.88)
0.43 (0.06, 0.80)0.55 (-0.19, 1.30)
0.26 (0.16, 0.36)0.14 (-0.28, 0.55)
0.51 (-0.10, 1.11)
0.06 (-0.27, 0.39)
Overall pre-post
0.51 (-0.48, 1.51)
0.08 (-0.16, 0.32)
0.46 (-0.43, 1.35)0.41 (-0.15, 0.97)
0.52 (-0.11, 1.16)
0.41 (0.02, 0.80)
-0.14 (-0.83, 0.56)
0.00 (-0.62, 0.62)
0.85 (0.26, 1.44)
1.78 (0.90, 2.66)
0.08 (-0.49, 0.65)
0.38 (-0.18, 0.94)
0.29 (-0.31, 0.89)
0.31 (-0.26, 0.87)
0.64 (-0.01, 1.28)
0.20 (0.03, 0.38)
0.15 (-0.44, 0.74)
1.55 (0.53, 2.57)0.49 (-0.19, 1.16)
0.08 (-0.54, 0.70)
0.74 (0.03, 1.46)
0.52 (-0.03, 1.08)
0.08 (-0.82, 0.98)
0.31 (-0.35, 0.96)
0-2 -1 0 1 2
Standardized difference in pre-post changebetween memory and control groups
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Overview
1. Background Previous studies of memory training with older adults
2. Memory training
Description of the ACTIVE memory training protocol
3. Results Overview of the results of the ACTIVE memory training
4. Conclusion Implications for further analysis of the ACTIVE memory training data
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Common Structural Features Small-groups (3-5 participants per group) Led by a certified trainer with a scripted
manual 10 sessions over a 6-week period 60-75 minutes per session Pre-specified order of sessions and rules for
make-ups 80% adherence for successful completion
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Shared Intervention Components Focus on strategies for solving problems or
responding quickly to information Modeling and demonstration of strategy
usage Practice on exemplar problems Individual and group exercises Immediate feedback on performance
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Shared Intervention Components Fostering of self-efficacy Application of strategies to real-world
tasks Provision of individualized training
experiences Activities focused on social interaction
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ACTIVE Memory Training Aims Improve cognitive processes involved in
two types of episodic memory (verbal list learning and text recall)
Enhance mnemonic strategies relevant to both types of memory
Reduce anxiety and increase confidence in ability to deal with memory failures
Increase awareness of the importance of memory abilities in activities of daily life
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ACTIVE Memory Training TechniquesTraining involves instruction, guided practice, and immediate feedback in the use of memory techniques such as: Grouping items into meaningful
categories Creating visual imagery and
associations Using hierarchical text organization Using external aids and
environmental modifications
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ACTIVE Memory Training TechniquesTechniques are based on the M.O.V.A. principles of memory: Meaningfulness Organization Visualization Association
Remembering to Pay Attention
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ACTIVE Memory Training Techniques Begin with use of simple memory strategies
(such as grouping) and move to more complex techniques (such as method of loci) , progressively fading out external/retrieval cues
Subjects get at least 3 individual and group practice exercises per session, involving both lab-type tasks (word lists) and real-world tasks (shopping lists)
Work with certified trainers in small groups of 3-5 with a manual, posters, and handouts.
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VisualizationSeeing something in your ‘mind’s eye’
How many windows are in the house you grew up in?
• Picture yourself walking through a familiar place and noticing items
Describe the directions for completing a familiar task
• Recipe or cooking instructions• VCR, remote control• Computer: turning on and setting up
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AssociationCombining two objects in a meaningful way Choose two unconnected words and
form a visualization between them• Strange associations are more powerfulPenny & Banana: penny balancing on the tip of the banana…it falls off when you reach for it
• Motion in the association will make it easier to remember
Sailboat & Tree: sailboat rocking in the breeze on a tree limb
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Memory Man
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Memory Man
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Do Older Adults Use Method of Loci?
0
.05
.1
.15
.2
AV
LT S
kipp
ing,
%
0 1 2 3 5Years since memory training
MemoryControl
Legend. Time trend plots of the probability of skipping spaces on the AVLT in the memory trained (solid line) and control (dashed line) groups. The percentage of participants who skipped a space on an AVLT trial is shown on the ordinate. 95% confidence bands are shown for each group.Source: Gross, A., et al (2014). Do older adults use the Method of Loci?: Results from the ACTIVE study. Experimental Aging Research, 40, 140-163.
Probability of Skipping Spaces on AVLT for Each Assessment by Training Status: Results from ACTIVE (N=1,401)
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Overview
1. Background Previous studies of memory training with older adults
2. Memory training
Description of the ACTIVE memory training protocol
3. Results Overview of the results of the ACTIVE memory training
4. Conclusion Implications for further analysis of the ACTIVE memory training data
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Jobe et al., Control. Clin. Trials 22, 453 (2001).
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Cognitive Abilities
Reasoning Word Series Letter Series Letter Sets
Speed of Processing Useful Field of View
Memory Auditory Verbal Learning
Test Hopkins Verbal Learning
Test Rivermead Paragraph
Recall
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Daily Function
Everyday Problem Solving Observed Tasks of Daily
Living Everyday Problems Test
Everyday Speed Complex Reaction Time Timed IADL Test
IADL/ADL Functioning
Perceived IADL Performance
Perceived IADL Capacity
Perceived ADL Performance
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Training effects at 2 years
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Initial Effect Sizes (JAMA 2002)
Baseline 7 Years 14 years
-1.5
-1.2
-0.9
-0.6
-0.3
0
0.3
0.6
0.9
1.2
1.5
Baseline Immediate 2 Years
-1.5
-1.2
-0.9
-0.6
-0.3
0
0.3
0.6
0.9
1.2
1.5
Memory
Reason-ing
Speed
Expected Decline Training Gains
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Effect Sizes at 5 Years (JAMA 2006)
-0.1
0
0.1
0.2
0.3
0.4
0.5
0.6
Memory trained Reasoning trained Speed trained
Stan
dard
ized
Trai
ning
Eff
ect S
ize(C
ontr
ol G
roup
as
Refe
renc
e)
Training Group
MemorycompositeReasoningcompositeSpeedcomposite
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Self-Reported IADL at 5 Years
-0.8
-0.7
-0.6
-0.5
-0.4
-0.3
-0.2
-0.1
0
0.1
0.2
Mea
n IA
DL D
ifficu
lty S
core
TimeMemory trained Reasoning trained Speed trained Control
Baseline Year 1 Year 2 Year 3 Year 4 Year 5 (N=2802) (N=2325) (N=2234) (N=2101) (N=1877)
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Effect on Cognitive & Functional Outcomes at 10 years (JAGS 2014)
MEMORY(n=703)
REASONING(n=699)
SPEED OF PROCESSING
(n=702)
CONTROL(n=698)
MEMORY (possible range: 0 to 132, N=943)Effect size (99% CI)* 0.06 (-0.14,0.27) -0.11 (-0.31,0.10) -0.05 (-0.25,0.15)% at or above baseline level § 35.9% 28.6% 31.0% 31.0%
REASONING (possible range: 0 to 75, N=938)Effect size (99% CI)* -0.02 (-0.17,0.12) 0.23 (0.09,0.38) -0.06 (-0.20,0.08)% at or above baseline level § 60.0% 73.6% (p<.01) 59.3% 61.7%
SPEED OF PROCESSING (possible range: 0 to 1500, N=883)Effect size (99% CI)* -0.07 (-0.29,0.16) 0.005 (-0.22,0.23) 0.66 (0.43,0.88)% at or above baseline level § 47.2% 48.5% 70.7% (p<.01) 47.8%
IADL DIFFICULTY (possible range: 0 to 38**, N=1211)Effect size (99% CI)* 0.48 (0.12,0.84) 0.38 (0.02,0.74) 0.36 (0.01,0.72)% at or above baseline level § 61.6% (p<.01) 60.2% (p<.01) 58.5% (p<.05) 49.3%
EVERYDAY PROBLEM SOLVING (possible range: 0 to 56, N=1104)Effect size (99% CI)* 0.004 (-0.23,0.24) -0.02 (-0.25,0.22) 0.008 (-0.23,0.24)% at or above baseline level § 59.6% 63.1% 61.0% 61.4%
EVERYDAY SPEED OF PROCESSING (possible range: -3 to 100, N=938)Effect size (99% CI)* 0.02 (-0.19,0.23) -0.004 (-0.21,0.21) -0.05 (0.26,0.16)% at or above baseline level § 34.9% 30.5% 29.0% 30.2%
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Memory
10-year Trajectory of Memory, Separately by Training Group
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Self-Reported IADL Difficulty
10-year Trajectory of Self-Reported IADL Difficulty, Separately by Training Group
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Who Benefits from Memory Training?
Journal of Aging and Health, 2013, 25, 21S-42S
Memory Training in the ACTIVE study: How Much is Needed and Who Benefits? George W. Rebok, Jessica B.S. Langbaum, Richard N. Jones, Alden L. Gross, Jeanine M. Parisi, Adam P. Spira, Alexandra M. Kueider, Hanno Petras, and Jason Brandt
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Definition of Training Adherence
Non-adherent A: completed <8 of 10 initial training sessions
Adherent A: completed >8 of 10 initial training sessions
Non-adherent B: completed <3 of 4 booster training sessions
Adherent B: completed >3 of 4 booster training sessions
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Baseline
Intercept, i
Immediate post-test
1 1 11
1 1
Linear slope, s
0.23 1.23 2.23 3.23 5.23
Covariates
AgeSex
EthnicityHealth Status
Education
5th annual1st annual 2nd annual 3rd annual
ImmediateTraining gain, t
0.23 0.23 0.230.23
_
LGM ModelMultiple Group Latent Growth Curve Model of Composite Memory Performance
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Figure 3Model-estimated Trajectories of Composite Memory Performance by Adherence: Results from ACTIVE (n = 629)
-1.5
-1-.5
0.5
1M
emor
y co
mpo
site
1 2 3 4 5Time from training (Years)
Non-adherent A Adherent ANon-adherent B Adherent B
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Summary and Conclusions
Adherence to initial memory training was associated with immediate training benefits
Memory training was associated with improved memory performance through year 5
Neither booster training nor training adherence significantly influenced this effect
Higher education and better self-rated health were associated with greater change in memory performance after training
Booster training and adherence to training do not appear to attenuate rates of normal age-related memory decline.
Main Findings
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Modeling Learning and Memory
Journal of Gerontology: Psychological Sciences, 2013, 68, 153-167
Modeling Learning and Memory Using Verbal Learning Tests: Results from ACTIVE Alden L. Gross, George W. Rebok, Jason Brandt, Doug Tommet, Michael Marsiske, and Richard N. Jones
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SEM Diagram for a Second-Order LGM
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
Learning growth
Recall growth
Learning intercept
Recall intercept
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
Initial recall
T5T4T3T2T1
11111
Learning curve
λ5λ4λ3λ2
10.2
2 3 51 1 1 1 11
11
1 11
1 0.21
2 3 5
Learning prepost training
Initial prepost training
1 1 1 1 1
1 1 1 1 1
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LGM Results
6
7
8
9
10
11
Tria
l rec
all
1 2 3 4 5Baseline
1 2 3 4 5Post-training
1 2 3 4 5Year 1
1 2 3 4 5Year 2
1 2 3 4 5Year 3
1 2 3 4 5Year 5
Longitudinal Trajectories of AVLT Recall and Learning: Results from ACTIVE (n=1,401)
Dashed line: control group; solid red line: memory-trained group
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Summary and Conclusions
Trial-level increases in words recalled on the AVLT and HVLT at each follow-up visit followed an approximately logarithmic shape
Memory training was associated with slower decline in Trial 1 AVLT recall over 5 years
Memory training was also associated with steep pre- and post-training acceleration in learning
Results reveal that memory training delays the worsening of memory span and boosts learning.
Main Findings
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Memory for Short Stories
Journal of Aging and Health, 2013, 25, 230SD-248S
The Influence of Cognitive Training on Older Adults’ Recall for Short Stories Shannon M. Sisco, Michael Marsiske, Alden L. Gross, & George W. Rebok
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Memory Training Effects on Story Recall
Total Recall T-Scores by Training Group across Occasions
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Verbatim Recall T-Scores by Training Group across Occasions
Memory Training Effects on Story Recall
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Memory Training Effects on Story Recall
Paraphrase Recall T-Scores by Training Group across Occasions
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Summary and Conclusions
Memory-trained participants showed higher verbatim recall than non-memory-trained participants at immediate post-test
Booster-memory training led to higher verbatim recall at 1st and 3rd annual follow-ups
Memory training effects were evident immediately following training but not after 1 year following training
Results suggest that multifactorial memory training can improve verbatim recall for prose, but the effect does not last without continued intervention.
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Memory Impairment Effects
Journal of the International Neurospychological Society, 2007, 13, 953-960
Effect of Memory Impairment on Training Outcomes in ACTIVE F. Unverzagt, L. Kasten, K.E. Johnson, G.W. Rebok, M. Marsiske, K.M. Koepke, J.W. Elias, J.N. Morris, S.L. Willis, K. Ball, D.F. Rexroth, D.M. Smith, F.D. Wolinsky, & S.L. Tennstedt
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Memory Processes
Cognitive interventions vary in the type of memory processes invoked
Memory System ACTIVE
Declarative
Procedural
Memory Training
Reasoning Training
Speed Training
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MCI Subgroup Response to Training
Subgroups based on memory ability:• Rey-AVLT • T1+T2+T3+T4+T5 = Sum Recall• Age, education, ethnicity, ETS Vocabulary
regressed on baseline Sum Recall score• Memory Impaired: actual Sum Recall 1.5 SD
below predicted level• Memory Normal: actual Sum Recall at or
above -1.5 SD of predicted level
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Responsiveness to Training
Memory and Reasoning training are mediated by declarative memory systems
Hypothesis: S’s with impaired declarative memory will have smaller training gains on Memory and Reasoning than non-memory impaired subjects
Speed training is mediated by procedural memory systems
Hypothesis: S’s with impaired declarative memory will not differ from non-memory impaired subjects on Speed training gains
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Normal ImpairedInterven Tim
eMemory Reasoning Speed
MemoryPT .300*** -.009 -0.050A1 .254*** .033 -0.061A2 .214*** .052 -0.057
ReasonPT .001 .477*** 0.025A1 .013 .416*** -0.026A2 -.003 .262*** -0.021
SpeedPT .004 -.017 -1.488***A1 .004 .009 -1.238***A2 -.024 -.013 -0.886***
Inteven Time
Memory Reasoning Speed
Memory
PT -.012 -.117 0.105A1 -.175 -.163 0.107A2 -.100 -.015 0.400*
Reason
PT -.048 .573*** -0.277A1 -.230 .208 -0.155A2 -.331 .276* -0.434*
Speed
PT -.108 -.111 -1.420***A1 -.163 -.097 -1.100***A2 -.298 .079 -0.755***
(Unverzagt et al., 2007, JINS)
Memory Impairment Impact on Cognitive Training
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Overview
1. Background Previous studies of memory training with older adults
2. Memory training
Description of the ACTIVE memory training protocol
3. Results Overview of the results of the ACTIVE memory training
4. Conclusion Implications for further analysis of the ACTIVE memory training data
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Summary and Conclusions
Memory training effects were maintained up to 5 years but were no longer significant at 10 years
Booster training did not produce additional and durable improvement for the memory intervention for memory performance
Participants in the memory training group reported less IADL difficulty at 10 years
Training effects were found for both word list-recall and story memory
Memory impairment at baseline attenuates memory training effects on memory performance
Main Findings
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Summary and Conclusions
Results provide support for the development of other interventions, particularly those that target multiple memory and cognitive abilities
Such interventions hold potential to delay onset of functional decline and possibly dementia
Even small delays in the onset of functional impairment may have a major public health impact
Implications
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Challenges
Challenges in Analyzing and Interpreting the ACTIVE Memory Training Data
Non-equivalence of alternate forms of the memory tests (see Gross et al., 2012)
Non-standard administration of the memory tests
Differences in Replicate 1 vs Replicates 2-6 administration of word list-recall tests
No delayed recall data available No formal diagnostic assessment of AD
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ACTIVE Memory Works Study
Proposal responds to PA-11-124 Translational Research to Help Older Adults Maintain Their Health and Independence in the Community (R21)
Seeks to test a web-based version of the ACTIVE memory training intervention for use by community organizations to promote memory health and fitness among the elderly.
Study will field test an online program called ACTIVE Memory Works (AMW) to help older adult users increase and monitor changes in memory and cognition and assess their effects on daily functional activities.
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User Performance-Specific Feedback
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References: Main Outcomes 1 Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M,
Morris JN, Rebok GW, Smith DM, Tennstedt SL, Unverzagt FW, Willis SL. Effects of cognitive training interventions with older adults: A randomized controlled trial. JAMA, 2002; 288(18):2271-81.
2 Rebok GW, Ball K, Guey LT, Jones RN, Kim H-Y, King JW, Marsiske M, Morris JN, Tennstedt SL, Unverzagt FW, Willis SL. Ten-year effects of the ACTIVE cognitive training trial on cognition and everyday functioning in older adults. Journal of the American Geriatrics Society, 2014; Jan 13 [Epub ahead of print].
3Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Mann Koepke K, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 2006; 296(23):2805-14.
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References: Memory Training Outcomes
4Cahn-Weiner DA, Malloy PF, Rebok GW, Ott BR. Results of a randomized placebo-controlled study of memory training for mildly impaired Alzheimer’s disease patients. Applied Neuropsychology, 2003; 10:215-23.
5Gross AL, Brandt J, Bandeen-Roche K, Carlson MC, Stuart EA, Marsiske M, Rebok GW. Do older adults use the Method of Loci? Results from the ACTIVE study. Experimental Aging Research, 2014; 40:140-63.
6Gross AL, Parisi JM, Spira AP, Kueider AM, Ko JY, Saczynski JS, Samus QM, Rebok GW. Memory training interventions for older adults: A meta-analysis. Aging and Mental Health, 2012; 16:722-34.
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References: Memory Training Outcomes
7Gross AL, Rebok GW. Memory training and strategy use in older adults: Results from the ACTIVE study. Psychology and Aging, 2011; 26:503-17.
8Gross AL, Rebok GW, Brandt J, Tommet D, Marsiske M, Jones RN. Modeling learning and memory using verbal learning tests: Results from ACTIVE. Journal of Gerontology: Psychological Sciences, 2013; 68:153-67.
9Gross AL, Rebok GW, Unverzagt FW, Willis SL, Brandt J. Cognitive predictors of everyday functioning in older adults: Results from the ACTIVE cognitive intervention trial. Journal of Gerontology: Psychological Sciences, 2011; 66:557-66.
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References: Memory Training Outcomes
10Gross AL, Rebok GW, Unverzagt FW, Willis SL, Brandt J. Word list memory predicts everyday function and problem-solving in the elderly: Results from the ACTIVE cognitive intervention trial. Aging, Neuropsychology, and Cognition, 2011; 18:129-46.
11Jones R, Marsiske M, Ball K, Rebok G, Willis SL. The ACTIVE cognitive training interventions and trajectories of performance among older adults. Journal of Aging and Health, 2013; 25:186S-08S.
12Jones RN, Rosenberg AL, Morris JN, Allaire JC, McCoy KJM, Marsiske M, Kleinman KP, Rebok GW, Malloy PF. A growth curve model of learning acquisition among cognitively normal older adults. Experimental Aging Research, 2005; 31:291-12.
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References: Memory Training Outcomes
13Langbaum JB, Rebok GW, Bandeen-Roche K, Carlson MC. Predicting memory training response patterns: Results from
ACTIVE. Journal of Gerontology: Psychological Sciences, 2009; 64:14-23.
14Lohman M, Rebok GW, Spira AP, Parisi JM, Gross AL, Kueider AM. Depressive symptoms and memory performance
among older adults: Results from the ACTIVE memory training intervention. Journal of Aging and Health, 2013; 25:209S- 29S.15Payne BR, Gross AL, Parisi JM, Sisco S, Stine-Morrow EAL, Marsiske M, Rebok GW. Modeling longitudinal changes in older adults’ memory for spoken discourse: Findings from the ACTIVE cohort. Memory, 2013; Dec 4 [Epub ahead of print].
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References: Memory Training Outcomes
16Parisi JM, Gross AL, Rebok GW, Saczynski JS, Crowe M, Cook SE, Langbaum JBS, Sartori A, Unverzagt FW. Modeling change
in memory performance and memory perceptions: Findings from the ACTIVE study. Psychology and Aging, 2011;
26:518- 24. 17Rebok GW, Carlson MC, Langbaum JBS. Training and maintaining memory abilities in healthy older adults: Traditional and novel approaches. Journal of Gerontology: Psychological Sciences, 2007; Spec No.1:53-61.18Rebok GW, Langbaum JBS, Jones RN, Gross AL, Parisi JN, Spira
AP, Kueider AM, Petras H, Brandt J. Memory training in the ACTIVE study: How much is needed and who benefits?
Journal of Aging and Health, 2013; 25:21S-42S.
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References: Memory Training Outcomes
19Sisco SM, Marsiske M, Gross AL, Rebok GW. The influence of cognitive training on older adults’ recall for short stories. Journal of Aging and Health, 2013; 25:230S-48S.
20Unverzagt FW, Guey LT, Jones RN, Marsiske M, King J, Wadley V, Crowe M, Rebok GW, Tennstedt SL. ACTIVE cognitive training and rates of incident dementia. Journal of the International Neuropsychological Society, 2012; 18, 669-77.
21Unverzagt F, Kasten L, Johnson KE, Rebok GW, Marsiske M, Koepke KM, Elias JW, Morris JN, Willis SL, Ball K, Rexroth DF, Smith DM, Wolinsky FD, Tennstedt SL. Effect of memory impairment on training outcomes in ACTIVE. Journal of the International Neuropsychological Society, 2007; 13:953-60.