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

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.

The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: A systematic review and meta-analysis

“…Contrary to prior reports (Owen et al, 2010;Papp et al, 2009) Papp et al, 2009;van Muijden et al, 2012;West, 2000), training most reliably produced transfer to tasks within the same cognitive domain, although seven cognitive training studies also reported transfer to untrained cognitive domains (Ball et al, 2002;Borella et al, 2010;Carretti et al, 2012;Cheng et al, 2012;Mozolic et al, 2011;Richmond et al, 2011;Smith et al, 2009). Consistent with research reporting that transfer depends on the type and duration of training (Klingberg, 2010;Owen et al, 2010;van Muijden et al, 2012), interventions using adaptive and repetitive training sessions (Borella et al, 2010;Carretti et al, 2012;Mozolic et al, 2011;Richmond et al, 2011;Smith et al, 2009) Maintenance was reported in nine out of ten cognitive training interventions, lasting between 3 and 6 months.…”

“…In individual studies (table 2), significant improvements for intervention groups were reported in seven out of 15 memory outcome measures (Legault et al, 2011;Mahncke et al, 2006;Mozolic et al, 2011;Peretz et al, 2011;Richmond et al, 2011;Smith et al, 2009), 17 out of 29 measures of executive function (Borella et al, 2010;Carretti et al, 2012;Legault et al, 2011;Mahncke et al, 2006;Mozolic et al, 2011;Nouchi et al, 2012;Peretz et al, 2011;Richmond et al, 2011;Smith et al, 2009), and six out of nine composite measures of cognitive function (McDougall et al, 2010). None of the studies included measures of everyday functioning.…”

“…None of the studies included measures of everyday functioning. For secondary outcomes, significant improvements were reported for training versus control in three out of four subjective measures of cognitive performance (McDougall et al, 2010;Richmond et al, 2011;Smith et al, 2009). Transfer of training effects were reported in nine out of ten trials: five reported transfer to untrained tasks within the same domain (Borella et al, 2010;Carretti et al, 2012;Mahncke et al, 2006;Nouchi et al, 2012;Peretz et al, 2011) and six to other cognitive domains (Borella et al, 2010;Carretti et al, 2012;McDougall et al, 2010;Mozolic et al, 2011;Richmond et al, 2011;Smith et al, 2009).…”

“…Transfer of training effects were reported in nine out of ten trials: five reported transfer to untrained tasks within the same domain (Borella et al, 2010;Carretti et al, 2012;Mahncke et al, 2006;Nouchi et al, 2012;Peretz et al, 2011) and six to other cognitive domains (Borella et al, 2010;Carretti et al, 2012;McDougall et al, 2010;Mozolic et al, 2011;Richmond et al, 2011;Smith et al, 2009). Four out of five trials that included follow-up assessments reported maintenance of training effects (Borella et al, 2010;Carretti et al, 2012;Mahncke et al, 2006;Smith et al, 2009). …”

Consciousness, brain, neuroplasticity

“…It can change itself and it has a self healing capacity which means that in general it can both improve and cure itself—at least to a certain extent. These capabilities of consciousness have been utilized in rehabilitation plans for patients who suffered brain strokes, or for improvement of attention and memory decline in old adults by cognitive training programs (Smith et al, 2009). …”