Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences

OBJECTIVES

This study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences.

METHODS

2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences.

RESULTS

Internet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men.

DISCUSSION

This study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.

The Effects of Sustained Literacy Engagement on Cognition and Sentence Processing Among Older Adults

Considerable evidence suggests that language processing depends on memory processes, which are vulnerable to declines with aging. Yet little is known about the effects of language processing in the form of sustained literacy engagement on memory and other aspects of cognition. In the current study, adults (60-79 years of age) were randomly assigned to an 8-week program of leisure reading (n = 38) or to an active puzzle control (n = 38). Relative to the control, the experimental group showed differential improvement in verbal working memory and episodic memory. The experimental group also showed evidence of enhanced conceptual integration in sentence processing. These effects did not vary as a function of personality characteristics (e.g., openness) hypothesized to be compatible with literacy engagement. These findings support the idea that the exercise of cognitive capacities in the context of everyday life may offset age-related impairment in areas of cognition engaged by the activity, regardless of dispositional fit.

Effects of Cognitive Training on Cognitive Performance of Healthy Older Adults

The purpose of this study was to determine the immediate effects of cognitive training on healthy older adults and verify the transfer effects of targeted and non-targeted abilities. The design consisted of a semi-randomized clinical controlled trial. The final sample was composed of 80 volunteers recruited from a Brazilian community (mean age = 69.69; SD = 7.44), which were separated into an intervention group (N = 47; mean age = 69.66, SD = 7.51) and a control group (N = 33; mean age = 69.73, SD = 7.45). Intervention was characterized by adaptive cognitive training with 12 individual training sessions of 60 to 90 minutes (once a week). Eight instruments were used to assess effects of cognitive training. Five were used to assess trained abilities (near effects), including: Memorization Tests (List and History), Picture Completion, Digit Span, Digit Symbol-Coding, and Symbol Search (the last four from WAIS-III). Two instruments assessed untrained abilities (far effects): Arithmetic and Matrix Reasoning (WAIS-III). The non-parametric repeated measures ANOVA test revealed a significant interaction between group by time interaction for Picture Completion [F(74) = 14.88, p = .0002, d = 0.90, CLES = 73.69%], Digit Symbol-Coding [F(74) = 5.66, p = .019, d = 0.55, CLES = 65.21%] and Digit Span [F(74) = 5.38, p = .02, d = 0.54, CLES = 64.85%], suggesting an interventional impact on these performance tasks. The results supported near transfer effects, but did not demonstrate a far transfer effects.

Cognitive Interventions for Cognitively Healthy, Mildly Impaired, and Mixed Samples of Older Adults: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years). Interventions trained a single cognitive domain (e.g., memory) or were multi-domain training, and outcomes were assessed immediately post-intervention using standard neuropsychological tests. In total, 279 effects from 97 studies were pooled based on a random-effects model and expressed as Hedges' g (unbiased). Overall, results indicated that cognitive interventions produce a small, but significant, improvement in the cognitive functioning of older adults, relative to active and passive control groups (g = 0.298, p < .001, 95% CI = 0.248-0.347). These results were confirmed using multi-level analyses adjusting for nesting of effect sizes within studies (g = 0.362, p < .001, 95% CI = 0.275, 0.449). Age, education, and cognitive status (healthy vs. MCI) were not significant moderators. Working memory interventions proved most effective (g = 0.479), though memory, processing speed, and multi-domain interventions also significantly improved cognition. Effects were larger for directly trained outcomes but were also significant for non-trained outcomes (i.e., "transfer effects"). Implications for future research and clinical practice are discussed. This project was pre-registered with PROSPERO (#42016038386).

Treino Cognitivo para Idosos: Uma Revisão Sistemática dos Estudos Nacionais

Resumo Este artigo de revisão sistemática sobre treino cognitivo para idosos saudáveis objetivou analisar 23 estudos nacionais em seus aspectos metodológicos e quanto às evidências de eficácia das intervenções. Os estudos foram publicados entre os anos 2000 e 2015. Uma busca foi feita nas bases SciELO, PubMed e PsycInfo utilizando-se os termos (português e inglês): “treino cognitivo”, “estimulação cognitiva”, “envelhecimento”, “idoso” e “brasileiro”. Em uma segunda etapa, as referências dos artigos encontrados foram consultadas para identificar quaisquer estudos pertinentes adicionais. A quase totalidade dos estudos utilizou a modalidade coletiva de intervenção (n = 20). O número de sessões com os participantes variou de 2 a 48 encontros. Em relação às habilidades cognitivas que foram alvo de intervenção, 60,8% dos estudos (n = 14) tiveram como foco o treino de memória episódica. Como medidas cognitivas, 90,4% dos estudos (n = 20) incluíram escalas de domínio comum (não restritas a psicólogos). No tocante aos resultados, 47,6% dos estudos (n = 10) identificaram efeitos de treino para pelo menos uma medida cognitiva utilizada. Conclui-se que o panorama nacional em treino cognitivo para idosos destaca-se por uma tendência a intervenções coletivas e voltadas à estimulação da memória episódica. Discute-se a importância de um avanço na área em relação à ampliação das pesquisas e à testagem da eficácia das intervenções padronizadas para o contexto brasileiro.

Enhancing Cognitive Functioning in Healthly Older Adults: a Systematic Review of the Clinical Significance of Commercially Available Computerized Cognitive Training in Preventing Cognitive Decline

Successfully assisting older adults to maintain or improve cognitive function, particularly when they are dealing with neurodegenerative disorders such as Alzheimer's disease (AD), remains a major challenge. Cognitive training may stimulate neuroplasticity thereby increasing cognitive and brain reserve. Commercial brain training programs are computerized, readily-available, easy-to-administer and adaptive but often lack supportive data and their clinical validation literature has not been previously reviewed. Therefore, in this review, we report the characteristics of commercially available brain training programs, critically assess the number and quality of studies evaluating the empirical evidence of these programs for promoting brain health in healthy older adults, and discuss underlying causal mechanisms. We searched PubMed, Google Scholar and each program's website for relevant studies reporting the effects of computerized cognitive training on cognitively healthy older adults. The evidence for each program was assessed via the number and quality (PEDro score) of studies, including Randomized Control Trials (RCTs). Programs with clinical studies were subsequently classified as possessing Level I, II or III evidence. Out of 18 identified programs, 7 programs were investigated in 26 studies including follow-ups. Two programs were identified as possessing Level I evidence, three programs demonstrated Level II evidence and an additional two programs demonstrated Level III evidence. Overall, studies showed generally high methodological quality (average PEDro score = 7.05). Although caution must be taken regarding any potential bias due to selective reporting, current evidence supports that at least some commercially available computerized brain training products can assist in promoting healthy brain aging.

Development of a cognitive training program for the elderly

Abstract Introduction: Plasticity in intellectual functioning has been the target of significant research investment. Among non-pharmacological interventions, cognitive training appears as a promising option for delaying the effects of aging on cognition. Objective: The present study describes the procedures of a cognitive training program for healthy Brazilian elderly persons (without diagnosis of dementia). Method: Cognitive tasks for the training of attention, processing speed, episodic memory and working memory were carried out. The program training was performed over 12 individual sessions, and included an Instruction Book, a Stimulus Book and Protocol Record. To assess the effects of training, five subtests of the WAIS-III test were used: Picture completion, Coding, Arithmetic, Matrix Reasoning and Digit Span. The cognitive training program was tested with 15 individuals, divided into an experimental group (EG), which received training, and a control group (CG). The EG was formed of seven participants, aged between 70 and 82 years (M=73.57, SD=4.11) and with an average schooling of 5.8 years (SD=1.02). The CG was formed by 8 participants, aged 69-77 years (M=74.00, SD=4.58), and who had an average schooling of 2.88 years (SD=2.58). Results: Repeated measures ANOVA revealed a training effect for three subtests: Coding: [F(1)=5.40, p=0.03, η2G=0.09], Arithmetic [F(1)=9.03, p=0.01, η2G=0.004] and Picture completion [F(1)=8.01, p=0.01, η2G=0.19]. There were no gain effects for Matrix Reasoning [F(1)=1.43, p=0.25] and Digit Span [F(1)=10.04, p<0.001]. Conclusion: The results of this pilot study show the importance of testing the impact of cognitive training through a randomized clinical trial to verify its effects on the mental performance of older adults. The importance of greater disclosure in literature of the construction procedures involved in cognitive training tasks, as well as the formulation of intervention strategies, is highlighted.

Comparing the Cognitive Ability Models of Spearman, Horn and Cattell, and Carroll

In recent years, researchers have focused on the development of hierarchical theories of intelligence. Flanagan and McGrew (1998) recently tested the appropriateness of Carroll's (1993a) hierarchical theory, the three-stratum theory, on the KAIT and WJ-R. Their results suggested that the KAIT is best interpreted from Carroll's theory rather than the test's recommended Gf-Gc theory, yet their sample had limited generalizability. The current study compared a single-factor model, Gf-Gc, and Carroll's hierarchical model on data from the KAIT and K-BIT standardization and validation sample. Results indicated that the Gf-Gc model was the only appropriate interpretive model for the KAIT and KAIT/K-BIT models.

A Patient With Bipolar Illness and Her Neuropsychological Signature

This article describes a case study in which neuropsychological assessment was carried out on a 30-year-old, previously diagnosed, bipolar female to determine existence of specific deficits in cognitive function. The patient, whose mood cycles were 12 hours to 24 hours, was subsequently evaluated 8 hours per day for 5 consecutive days (a complete work week of neuropsychological assessment). Neuropsychological results showed motor slowing, right hemispheric dysfunctioning, and memory problems during depressive periods and attentional and executive problems during hypomanic and manic periods. The most normal performance was found during euthymic periods. In addition, left and right hemi visual neglect, aphasia, and sensorimotor problems were present across all mood states. Treatment implications are subsequently described.

Enhancing the Cognitive Vitality of Older Adults

Aging is associated with decline in a multitude of cognitive processes and brain functions. However, a growing body of literature suggests that age-related decline in cognition can sometimes be reduced through experience, cognitive training, and other interventions such as fitness training. Research on cognitive training and expertise has suggested that age-related cognitive sparing is often quite narrow, being observed only on tasks and skills similar to those on which individuals have been trained. Furthermore, training and expertise benefits are often realized only after extensive practice with specific training strategies. Like cognitive training, fitness training has narrow effects on cognitive processes, but in the case of fitness training, the most substantial effects are observed for executive-control processes.

Cognitive Rehabilitation with Older Adults

The proportion of older adults seeking rehabilitation services are certain to rise as the population ages. Cognitive rehabilitation techniques can be successfully adapted and used with older adults with a range of clinical diagnoses. An understanding of cognitive changes which could be expected as a result of “normal” (non-disease-related) aging is essential for both assessment and treatment planning for this group. Age-related changes in attention, memory and executive functioning are briefly noted. Common cognitive sequelae of head-injury, depression and dementia are discussed, and useful assessment and rehabilitation strategies described. Case illustrations are used to illustrate major points.

Reasoning training in the ACTIVE study: how much is needed and who benefits?

OBJECTIVE

To characterize change through 5-year follow-up, associated with training, booster, adherence, and other characteristics.

METHODS

Sample included all individuals randomly assigned to reasoning training (N = 699). Piecewise latent growth modeling was used to examine trajectory of performance on outcome measures.

RESULTS

Training resulted in improved reasoning performance through Year 5. A significant third annual booster effect was one-half the size of the training effect. Training adherence resulted in greater training effects. Higher education, Mini-Mental State Exam (MMSE), better health, and younger age related to higher baseline performance. Higher MMSE was related to larger training effects, larger linear slopes, and smaller booster effects. Significant functional outcomes included a training effect for complex reaction time (CRT), and first annual booster effects for the CRT and observed tasks of daily living.

DISCUSSION

Initial training gain was comparable with magnitude of age-related cognitive decline over 5 years with no training. Neither age nor gender predicted training or booster effects, indicating the generality of training effects across age (65-90 years).

Individual differences in cognitive plasticity: an investigation of training curves in younger and older adults

To date, cognitive intervention research has provided mixed but nevertheless promising evidence with respect to the effects of cognitive training on untrained tasks (transfer). However, the mechanisms behind learning, training effects and their predictors are not fully understood. Moreover, individual differences, which may constitute an important factor impacting training outcome, are usually neglected. We suggest investigating individual training performance across training sessions in order to gain finer-grained knowledge of training gains, on the one hand, and assessing the potential impact of predictors such as age and fluid intelligence on learning rate, on the other hand. To this aim, we propose to model individual learning curves to examine the intra-individual change in training as well as inter-individual differences in intra-individual change. We recommend introducing a latent growth curve model (LGCM) analysis, a method frequently applied to learning data but rarely used in cognitive training research. Such advanced analyses of the training phase allow identifying factors to be respected when designing effective tailor-made training interventions. To illustrate the proposed approach, a LGCM analysis using data of a 10-day working memory training study in younger and older adults is reported.

Variation in cognitive functioning as a refined approach to comparing aging across countries

Comparing the burden of aging across countries hinges on the availability of valid and comparable indicators. The Old Age Dependency Ratio allows only a limited assessment of the challenges of aging, because it does not include information on any individual characteristics except age itself. Existing alternative indicators based on health or economic activity suffer from measurement and comparability problems. We propose an indicator based on age variation in cognitive functioning. We use newly released data from standardized tests of seniors' cognitive abilities for countries from different world regions. In the wake of long-term advances in countries' industrial composition, and technological advances, the ability to handle new job procedures is now of high and growing importance, which increases the importance of cognition for work performance over time. In several countries with older populations, we find better cognitive performance on the part of populations aged 50+ than in countries with chronologically younger populations. This variation in cognitive functioning levels may be explained by the fact that seniors in some regions of the world experienced better conditions during childhood and adult life, including nutrition, duration and quality of schooling, lower exposure to disease, and physical and social activity patterns. Because of the slow process of cohort replacement, those countries whose seniors already have higher cognitive levels today are likely to continue to be at an advantage for several decades to come.

Practice-oriented retest learning as the basic form of cognitive plasticity of the aging brain

It has been well documented that aging is associated with declines in a variety of cognitive functions. A growing body of research shows that the age-related cognitive declines are reversible through cognitive training programs, suggesting maintained cognitive plasticity of the aging brain. Retest learning represents a basic form of cognitive plasticity. It has been consistently demonstrated for adults in young-old and old-old ages. Accumulated research indicates that retest learning is effective, robust, endurable and could occur at a more conceptual level beyond item-specific memorization. Recent studies also demonstrate promisingly broader transfer effects from retest practice of activities involving complex executive functioning to other untrained tasks. The results shed light on the development of self-guided mental exercise programs to improve cognitive performance and efficiency of the aging brain. The relevant studies were reviewed, and the findings were discussed in light of their limitations, implications, and future directions.

Perceived Strategies and Activities for Successful Later Aging

This study investigated perceived strategies and activities for successful later aging. Participants were 242 members of the Terman Study of the Gifted who responded to an open-ended question concerning how they make the most of their aging years. Data were collected in 1996 and 1999, when the participants were average ages of 84 and 86. Longitudinal analyses examined changes over time and cross-sectional analyses examined correlates of strategies and activities. Results showed that strategies emphasized emotion regulation and adaptation. Activities emphasized family involvement, social relationships, leisure, productive and intellectual activity, and health maintenance. Reports of emotion regulation and adaptation increased over time and mention of an intellectual orientation declined over time. Variations in activity mention were found according to gender, age, self-rated health, health limitations, and life satisfaction. History of higher-level occupations was related to more productive activities. Results are discussed in terms of the challenges of later aging.

WICS: A new model for school psychology

This article presents a unified model for cognitive processing, WICS, which is an acronym for wisdom, intelligence, and creativity, synthesized. The model can be applied to identification/admissions, diagnosis, instruction, and assessment. I discuss why there is a need for such a model. Then I describe traditional models, after which I describe the WICS model. The article attempts to show how the WICS model can be applied to admissions/identification as well as to instruction and assessment.

Measurement of Activity in the Elderly: The Activities Checklist

Cette étude a pour but l'évaluation de la fidélité et de la validité du Questionnaire d'activités (Reid & Ziegler, 1981) ainsi que la vérification de son utilité comme prédicteur du fonctionnement cognitif des gens âgés. Les sujets proviennent de deux études longitudinales lors desquelles ils ont été testés à deux reprises espacées d'environ cinq ans. La fidélité test-retest est de .54 pour l'échantillon de 158 sujets et de .43 pour celui de 76 sujets. La validité est démontrée par le changement lié à l'âge vers des activités plus passives et par des corrélations positives avec le niveau de scolarité, l'occupation, la santé et le bien-être. Des versions pondérées des scores d'activité ne s'avèrent pas supérieures aux versions non pondérées pour prédire le fonctionnement cognitif. Les niveaux d'activité prédisent la performance à certaines tâches cognitives. Ces résultats suggèrent que le Questionnaire d'activités est un outil potentiellement utile pour étudier les différences individuelles dans le vieillissement cognitif.

Social involvement, behavioural risks and cognitive functioning among older people

This study analyses the relationships between cognitive performance, social participation and behavioural risks, taking into account age and educational attainment. We examine individual data for 11 European countries and Israel from the first wave of the Survey on Health, Ageing and Retirement in Europe (SHARE). The stochastic frontier approach methodology enables us to identify different sources of plasticity on cognitive functioning while taking into account age-related decline in cognitive performance. Several social participation variables were examined: employment status, attending educational courses, doing voluntary or charity work, providing help to family, friends or neighbours, participating in sports, social or other clubs, in a religious organisation and in a political or community organisation, and we controlled for age, education, income, physical activity, body-mass index, smoking and drinking. In the pooled sample, the results clearly show that all kinds of social involvement enhance cognitive functions, in particular in work. Moreover, behavioural risks such as physical inactivity, obesity, smoking or drinking were clearly detrimental to cognitive performance. Models for men and women were run separately. For both genders, all social involvement indicators associated with better cognitive performance. The results varied by countries, however, particularly the signs of the associations with a number of indicators of social involvement and behavioural risks.

Aging, training, and the brain: a review and future directions

As the population ages, the need for effective methods to maintain or even improve older adults' cognitive performance becomes increasingly pressing. Here we provide a brief review of the major intervention approaches that have been the focus of past research with healthy older adults (strategy training, multi-modal interventions, cardiovascular exercise, and process-based training), and new approaches that incorporate neuroimaging. As outcome measures, neuroimaging data on intervention-related changes in volume, structural integrity; and functional activation can provide important insights into the nature and duration of an intervention's effects. Perhaps even more intriguingly, several recent studies have used neuroimaging data as a guide to identify core cognitive processes that can be trained in one task with effective transfer to other tasks that share the same underlying processes. Although many open questions remain, this research has greatly increased our understanding of how to promote successful aging of cognition and the brain.

Long-term maintenance of retest learning in young old and oldest old adults

This study examined the maintenance of retest learning benefits in young old and oldest old adults over an 8-month period in 3 cognitive abilities: reasoning, perceptual-motor speed, and visual attention. Twenty-four young old (aged 70-79 years, M = 74.2) and 23 oldest old adults (aged 80-90 years, M = 83.6) who participated in a previously published study (Yang, L., Krampe, R. T., & Baltes, P. B. [2006]. Basic forms of cognitive plasticity extended into the oldest-old: Retest learning, age, and cognitive functioning. Psychology and Aging, 21, 372-378) returned after an 8-month delay to complete 2 follow-up retest sessions. The results demonstrated that both young old and oldest old groups maintained about 50% of the original retest learning benefits. This extends the earlier findings of substantial long-term cognitive training maintenance in young old adults to a context of retest learning with oldest old adults, and thus portrays a positive message for cognitive plasticity of the oldest old.

Preserving cognition through an integrated cognitive stimulation and training program

BACKGROUND

Cognitive decline leads to disability and increased health care expenditures.

METHODS

Effectiveness of an intervention to stimulate multiple cognitive domains was determined using a format combining traditional and computer-based activities (Integrated Cognitive Stimulation and Training Program), 45 minutes a day, 2 days a week, for 6 weeks. Nonimpaired, mildly, and moderately-impaired participants > age 65 (n = 32) were randomly allocated into a control or experimental group. Using a repeated measures design participants were tested again postintervention and at 8 weeks follow-up.

RESULTS

Statistically significant improvement on Dementia Rating Scale scores occurred for mildly and moderately impaired treatment participants (n = 15). Statistical significance was demonstrated on subscales of the WMS-III: Logical Memory I and Logical Memory II.

CONCLUSION

Blending computer-based with traditional cognitive stimulation activities shows promise in preserving cognitive function in elders. Future studies to explore efficacy in larger, more diverse samples are needed.

Engaged Lifestyle, Personality, and Mental Status Among Centenarians

This study assessed engaged lifestyle activities (e.g., volunteering, traveling, and public speaking) for centenarians of the Georgia Centenarian Study. A total of 285 centenarians and near-centenarians (i.e., 98 years and older) and their proxy informants participated in this study. The Mini-Mental Status Examination (MMSE) was assessed for all centenarians, and proxy informants reported on lifestyle activities and personality traits of the centenarians. Results suggested that participants who had volunteered, traveled, and those who had given public talks and balanced their checkbooks were more likely to show relatively high mental status scores (i.e., MMSE > 17). Personality traits were found to be moderators in the relationship between engaged lifestyle and mental status: Participants with high levels of Emotional Stability, Extraversion, Openness, and Conscientiousness and with high levels of engaged lifestyle were more likely to show relatively high mental status scores (i.e., MMSE > 17), whereas participants with low levels of Emotional Stability, Extraversion, Openness, Agreeableness, and Conscientiousness and with low levels of engaged lifestyle were more likely to show relatively low mental status scores (i.e., MMSE < 18). The results suggest that engaged lifestyle, particularly in combination with personality traits, plays an important role in the level of cognitive functioning among oldest old adults.

Age and flexible thinking: an experimental demonstration of the beneficial effects of increased cognitively stimulating activity on fluid intelligence in healthy older adults

The disuse hypothesis of cognitive aging attributes decrements in fluid intelligence in older adults to reduced cognitively stimulating activity. This study experimentally tested the hypothesis that a period of increased mentally stimulating activities thus would enhance older adults' fluid intelligence performance. Participants (N=44, mean age 67.82) were administered pre- and post-test measures, including the fluid intelligence measure, Cattell's Culture Fair (CCF) test. Experimental participants engaged in diverse, novel, mentally stimulating activities for 10-12 weeks and were compared to a control condition. Results supported the hypothesis; the experimental group showed greater pre- to post-CCF gain than did controls (effect size d=0.56), with a similar gain on a spatial-perceptual task (WAIS-R Blocks). Even brief periods of increased cognitive stimulation can improve older adults' problem solving and flexible thinking.

Effects of computer training and internet usage on cognitive abilities in older adults: a randomized controlled study

BACKGROUND AND AIMS

According to the concepts of 'use it or lose it' and cognitive reserve, cognitively challenging activities may boost cognitive abilities in older adults. Using computers and the internet provides divergent cognitive challenges to older persons, and the positive effects of computers and internet use on the quality of life have been found in earlier studies.

METHODS

We investigated whether prolonged guided computer use by healthy older adults (64-75) may be beneficial to cognitive ability in a randomized controlled study. The intervention consisted of brief training and subsequent use of a personal computer with an internet connection at home for a 12-month period. 191 participants were randomly assigned to three groups: Intervention, Training/No intervention, or No training/No intervention. A fourth group consisted of 45 participants with no interest in computer use. The effect of the intervention was assessed by a range of well-established cognitive instruments that probed verbal memory, information processing speed, and cognitive flexibility. Data were collected at baseline and after four and twelve months.

RESULTS

Intensive interaction with a personal computer with standard software applications had no effect on cognitive measures; no differences in changes in cognitive parameters over time were found between groups.

CONCLUSION

Learning to use a computer and the internet does not benefit healthy, communitydwelling older adults with respect to many domains of cognitive functions. The implications of these findings for future studies that use cognitive challenge to counteract usual cognitive aging are discussed.

Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced?

In this monograph, we ask whether various kinds of intellectual, physical, and social activities produce cognitive enrichment effects-that is, whether they improve cognitive performance at different points of the adult life span, with a particular emphasis on old age. We begin with a theoretical framework that emphasizes the potential of behavior to influence levels of cognitive functioning. According to this framework, the undeniable presence of age-related decline in cognition does not invalidate the view that behavior can enhance cognitive functioning. Instead, the course of normal aging shapes a zone of possible functioning, which reflects person-specific endowments and age-related constraints. Individuals influence whether they function in the higher or lower ranges of this zone by engaging in or refraining from beneficial intellectual, physical, and social activities. From this point of view, the potential for positive change, or plasticity, is maintained in adult cognition. It is an argument that is supported by newer research in neuroscience showing neural plasticity in various aspects of central nervous system functioning, neurochemistry, and architecture. This view of human potential contrasts with static conceptions of cognition in old age, according to which decline in abilities is fixed and individuals cannot slow its course. Furthermore, any understanding of cognition as it occurs in everyday life must make a distinction between basic cognitive mechanisms and skills (such as working-memory capacity) and the functional use of cognition to achieve goals in specific situations. In practice, knowledge and expertise are critical for effective functioning, and the available evidence suggests that older adults effectively employ specific knowledge and expertise and can gain new knowledge when it is required. We conclude that, on balance, the available evidence favors the hypothesis that maintaining an intellectually engaged and physically active lifestyle promotes successful cognitive aging. First, cognitive-training studies have demonstrated that older adults can improve cognitive functioning when provided with intensive training in strategies that promote thinking and remembering. The early training literature suggested little transfer of function from specifically trained skills to new cognitive tasks; learning was highly specific to the cognitive processes targeted by training. Recently, however, a new generation of studies suggests that providing structured experience in situations demanding executive coordination of skills-such as complex video games, task-switching paradigms, and divided attention tasks-train strategic control over cognition that does show transfer to different task environments. These studies suggest that there is considerable reserve potential in older adults' cognition that can be enhanced through training. Second, a considerable number of studies indicate that maintaining a lifestyle that is intellectually stimulating predicts better maintenance of cognitive skills and is associated with a reduced risk of developing Alzheimer's disease in late life. Our review focuses on longitudinal evidence of a connection between an active lifestyle and enhanced cognition, because such evidence admits fewer rival explanations of observed effects (or lack of effects) than does cross-sectional evidence. The longitudinal evidence consistently shows that engaging in intellectually stimulating activities is associated with better cognitive functioning at later points in time. Other studies show that meaningful social engagement is also predictive of better maintenance of cognitive functioning in old age. These longitudinal findings are also open to important rival explanations, but overall, the available evidence suggests that activities can postpone decline, attenuate decline, or provide prosthetic benefit in the face of normative cognitive decline, while at the same time indicating that late-life cognitive changes can result in curtailment of activities. Given the complexity of the dynamic reciprocal relationships between stimulating activities and cognitive function in old age, additional research will be needed to address the extent to which observed effects validate a causal influence of an intellectually engaged lifestyle on cognition. Nevertheless, the hypothesis that an active lifestyle that requires cognitive effort has long-term benefits for older adults' cognition is at least consistent with the available data. Furthermore, new intervention research that involves multimodal interventions focusing on goal-directed action requiring cognition (such as reading to children) and social interaction will help to address whether an active lifestyle enhances cognitive function. Third, there is a parallel literature suggesting that physical activity, and aerobic exercise in particular, enhances older adults' cognitive function. Unlike the literature on an active lifestyle, there is already an impressive array of work with humans and animal populations showing that exercise interventions have substantial benefits for cognitive function, particularly for aspects of fluid intelligence and executive function. Recent neuroscience research on this topic indicates that exercise has substantial effects on brain morphology and function, representing a plausible brain substrate for the observed effects of aerobic exercise and other activities on cognition. Our review identifies a number of areas where additional research is needed to address critical questions. For example, there is considerable epidemiological evidence that stress and chronic psychological distress are negatively associated with changes in cognition. In contrast, less is known about how positive attributes, such as self-efficacy, a sense of control, and a sense of meaning in life, might contribute to preservation of cognitive function in old age. It is well known that certain personality characteristics such as conscientiousness predict adherence to an exercise regimen, but we do not know whether these attributes are also relevant to predicting maintenance of cognitive function or effective compensation for cognitive decline when it occurs. Likewise, more information is needed on the factors that encourage maintenance of an active lifestyle in old age in the face of elevated risk for physiological decline, mechanical wear and tear on the body, and incidence of diseases with disabling consequences, and whether efforts to maintain an active lifestyle are associated with successful aging, both in terms of cognitive function and psychological and emotional well-being. We also discuss briefly some interesting issues for society and public policy regarding cognitive-enrichment effects. For example, should efforts to enhance cognitive function be included as part of a general prevention model for enhancing health and vitality in old age? We also comment on the recent trend of business marketing interventions claimed to build brain power and prevent age-related cognitive decline, and the desirability of direct research evidence to back claims of effectiveness for specific products.

An arts intervention for older adults living in subsidized retirement homes

A theatrically based intervention was given to 122 older adults who took lessons twice a week for 4 weeks. The training consisted of multi-modal activities (cognitive-affective-physiological) typically employed in college acting classes. Comparison groups consisted of no-treatment controls and participants instructed in a different performing art, singing. Assessment of effectiveness was performed using a battery of 11 cognitive/affective test measures that included word recall, prose comprehension/recall, word generation, digit-span ability, and problem-solving. It was found that the acting group improved significantly from pretest to posttest over both other groups. Digit-span was the only measure that failed to improve. The gains were achieved despite the fact that no aspects of the intervention supplied specific training or practice on the test measures. Previous versions of the intervention with community-dwelling adults had produced similar findings but the current participants were older, less well-educated, and lived in subsidized, primarily low-income, retirement homes.

Realizing complex delayed intentions in young and old adults: the role of planning aids

Although it has been suggested that the delayed realization of intended actions should benefit from appropriate intention planning, empirical evidence on this issue is scarce. In three experiments, we examined whether and which planning aids provided in the intention formation phase affect delayed intention realization in young and old adults. One finding was that intention planning directly affected delayed intention realization: instructing participants to include the cue for appropriate intention initiation in their plans benefited delayed performance. Another finding was that older adults' performance was improved when they were guided in structuring their plan in combination with guidance in implementing this plan after a delay. In sum, the results point to the importance of plan-related factors for understanding the delayed realization of intended actions.

The Impact of Speed of Processing Training on Cognitive and Everyday Functions

We combined data from six studies, all using the same speed of processing training program, to examine the mechanisms of training gain and the impact of training on cognitive and everyday abilities of older adults. Results indicated that training produces immediate improvements across all subtests of the Useful Field of View test, particularly for older adults with initial speed of processing deficits. Age and education had little to no impact on training gain. Participants maintained benefits of training for at least 2 years, which translated to improvements in everyday abilities, including efficient performance of instrumental activities of daily living and safer driving performance.

An Engagement Model of Cognitive Optimization Through Adulthood

The engagement hypothesis suggests that social and intellectual engagement may buffer age-related declines in intellectual functioning. At the same time, some have argued that social structures that afford opportunities for intellectual engagement throughout the life span have lagged behind the demographic shift toward an expanding older population. Against this backdrop, we developed the Senior Odyssey, an existing team-based program of creative problem solving. We tested the engagement hypothesis in a field experiment. Relative to controls, Senior Odyssey participants showed improved speed of processing, marginally improved divergent thinking, and higher levels of mindfulness and need for cognition after the program. This pilot translational project suggests that the Senior Odyssey program may serve as one effective model of engagement with good scaling-up potential.

Effects of Cognitive Training on Change in Accuracy in Inductive Reasoning Ability

We investigated cognitive training effects on accuracy and number of items attempted in inductive reasoning performance in a sample of 335 older participants (M = 72.78 years) from the Seattle Longitudinal Study. We assessed the impact of individual characteristics, including chronic disease. The reasoning training group showed significantly greater gain in accuracy and number of attempted items than did the comparison group; gain was primarily due to enhanced accuracy. Reasoning training effects involved a complex interaction of gender, prior cognitive status, and chronic disease. Women with prior decline on reasoning but no heart disease showed the greatest accuracy increase. In addition, stable reasoning-trained women with heart disease demonstrated significant accuracy gain. Comorbidity was associated with less change in accuracy. The results support the effectiveness of cognitive training on improving the accuracy of reasoning performance.

The relevance of situation awareness in older adults’ cognitive functioning: a review

Age-related declines in cognition may have detrimental effects on older adults’ ability to complete everyday activities that young- and middle-aged individuals perform automatically. Theories of cognitive aging have found deficits in older adults’ fluid intelligence, capacity for inhibition, number of processing resources, and speed of processing, and in recent years, studies have proposed cognitive strategies to ameliorate these declines. However, few strategies directly train the cognitive strategies necessary to improve performance in dynamic environments and physical activities. One such strategy may be the enhancement of situation awareness, the capability to perceive and understand one’s environment. Although the term has typically been applied to pilots and other expert performers, situation awareness may also be relevant to cognitive aging, where older adults’ perception and comprehension of their environment become critical to everyday functioning and physical activities. If older adults’ situation awareness can be facilitated, then it may be possible to reduce the impact of age-related cognitive declines, allowing older adults to successfully participate in dynamic situations and sports where the environment is constantly changing (e.g., driving and tennis). The following review outlines cognitive deficits in aging, details their relation to situation awareness, and discusses how training in situation awareness may reduce cognitive declines.

Cognitive Training Gain as a Predictor of Mental Status

We examined the association of proximal and distal training gain to subsequent mental status ratings in 302 participants (M = 76.62 years) trained on inductive reasoning or spatial orientation in the Seattle Longitudinal Study. Only training effects on reasoning ability were predictive of mental status group membership. Participants subsequently rated as probably demented did not significantly differ from nondemented participants in magnitude of reasoning training gain 14 years prior to assessment, but they did 7 years prior to status ratings. Proximal training gain 1 year prior to assessment was 0.40 SD for nondemented participants, compared with 0.25 and 0.10 SD for at-risk and probably demented participants, respectively. The combination of reasoning ability training and increased proximal training gain on reasoning ability was associated with a decreased likelihood of being rated as probably demented.

The influence of physical and cognitive activities on simple and complex cognitive tasks in older adults

This study examined the relative benefits of physical and cognitive activities on simple and complex cognitive task performance in older adults. Participants were 24 young (18-27 years), 24 young-old (65-74 years), 24 middle-old (75-84 years), and 24 old-old (85-92 years) adults. Participants recorded the amount of time engaged in physically and cognitively stimulating activities as well as the effort exerted during these activities. They also completed a simple and complex version of a visual imagery task. Age-related declines were evident in activity and imagery performance. Both physical and cognitive activities were related to better cognitive performance. Furthermore, cognitive activity was a stronger predictor than physical activity of the complex, but not the simple task. However, within each activity domain there were no significant differences between performance on the simple and complex task. These results suggest that physical and cognitive stimulation are useful in protecting against cognitive decline with age, but that they may exert their influence via different paths.

Differential effects of single versus combined cognitive and physical training with older adults: the SimA study in a 5-year perspective

The present study evaluates the effect of cognitive training, of psychoeducational training and of physical training on cognitive functioning, physical functioning, physical health, independent living and well-being in older people. Also the combination of physical training with cognitive training or psychoeducational training, respectively, was evaluated. In contrast to most training studies with older people, training effects were evaluated in a longitudinal perspective over 5 years to analyse long-term-results of cognitive and physical activity on older adults. Training effects were evaluated compared to a no-treatment-control group. Subjects were 375 community residents aged 75-93 years. Up to 5 years after baseline examination, significant training effects were observed in the group exposed to the combined cognitive and physical training. The physical and cognitive status in the participants of this group could be preserved on a higher level compared to baseline, and the participants displayed fewer depressive symptoms than the no-treatment-control group. The results are discussed in the light of recent research regarding the effects of mental and physical activity on brain function in older adults.

In-home cognitive training with older married couples: individual versus collaborative learning

Research has demonstrated that older adults' cognitive performance can be enhanced via formal intervention, as well as more informal intervention including collaboration or working with a partner. The current study investigated the effects of an inductive reasoning training program adapted for in-home use among older adults assigned to individual training (n = 30), collaborative training (n = 34), or a no-treatment control group (n = 34). The training consisted of 10 sessions, and all participants completed a pretest followed by a post-test 6 weeks later. Findings suggest that older adults could effectively "train themselves" without the guidance of a formal instructor. The results, however, did not indicate immediate added benefit in reasoning performance for collaborative versus individual training using the current reasoning program.

An exploratory study of the effect of mahjong on the cognitive functioning of persons with dementia

OBJECTIVE

To explore the effect of an activity treatment-mahjong-on the cognitive functioning of persons with mild-to-moderate dementia.

METHOD

Participants were 62 older persons (M(age) = 83.94, SD = 7.58) who met DSM-IV diagnosis of any dementia condition, had an initial Mini-Mental State Examination (MMSE) score < or = 24, and were able to play, yet not having played mahjong for the past six months. They were randomly assigned to play either twice (n = 33) or four times (n = 29) a week over a 16-week duration. Digit forward span, digit forward sequence, verbal memory and MMSE were measured at baseline, post-test and 1-month follow-up.

RESULTS

Regardless of frequency of playing, mahjong produced consistent gains across all cognitive performance measures. It had large effect sizes on digit forward memory (1.0-1.4 for both span and sequence), moderate-to-large effect sizes on verbal memory (0.5-0.9), and a moderate effect size on MMSE (around 0.6). The effects lasted after mahjong had been withdrawn for a month, suggesting that constant practice is not necessary to achieve therapeutic effect once an initial threshold is attained.

CONCLUSION

Mahjong is a viable treatment option for dementia. Because mahjong therapy basically does not require professional supervision and can be implemented as widely as space allows at a given time, the potential benefits of integrating mahjong into the daily routines of an institution are enormous vis-à-vis minimal, if any, cost to the institution.

Basic forms of cognitive plasticity extended into the oldest-old: Retest learning, age, and cognitive functioning

To address the question of whether cognitive plasticity varies by age and level of cognitive functioning in the older population, the authors used a self-guided retest paradigm to assess the basic forms of plasticity of 34 young-olds (M=74.4 years, range=70-79) and 34 oldest-olds (M=84.0 years, range=80-91), with half in each age group screened for high or low (midrange) level of cognitive functioning. As a whole, members of the sample represent about the upper two thirds of their age cohorts. Results show persistent, though age-reduced, learning in all samples and across all tests. However, age is not differentially "kinder" to the more able with respect to the age-graded decline in learning.

Physical and cognitive activity and exercise for older adults: a review

Age-related reduction in musculoskeletal, cardiovascular, and central nervous system resilience can result in wide-ranging limitations in adaptive capacity associated with negative outcomes such as cognitive decline, increased risk of cardiovascular disease, mobility problems, and increased incidence of debilitating falls. This article reviews the benefits of both cognitive and physical activity within the broad context of multiple system resilience in adult aging. Research on a unique form of combined physical/cognitive exercise, Tai Chi Chuan, is presented. The relationship between physiological and psychological gain associated with an activity intervention program is discussed in light of principles of rehabilitation, intervention compliance, subjective and objective gain, and the hypothesized value of combining physical exercise, cognitive exercise, and relaxation into a single program designed to promote resilience in older adults.