L’entrainement cognitif retarde les effets du vieillissement

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A clinical trial evaluating the efficacy during 10 years of cognitive training programs on cognitive abilities and activities of daily living of seniors.

A US randomized controlled trial of Rebok and colleagues published in the Journal of The American Geriatrics Society in 2014 evaluated the effectiveness of three cognitive training programs supervised sessions among 14 healthy people over 65 years. A program is based on memory exercises on a second reasoning exercises and a third on reaction time exercises. After 10 years, the results show that the benefits are best for groups who participated in the training programs reasoning or speed of processing compared to control groups and drive to the store.

The Study Rationale

Cognitive decline is related to aging. It reduces autonomy in daily instrumental activities such as meal preparation, personal hygiene and household chores.

The cognitive training proved useful in reducing cognitive decline in normal aging. But the evidence of its effectiveness in delaying the daily operations management problems abound. It is possible that the improvement of cognitive functioning is transferred in increasing independence in activities of daily life, but must still demonstrate a sufficiently long period.

Furthermore, the content of the programs there is no consensus. Some think it is necessary to make reasoning exercises, other reaction speed drills, and still others memory exercises. Again, only one randomized controlled trial may demonstrate the superiority of content over another.

The Question

Cognitive workouts based on reasoning exercises, reaction or memory speed it can delay the decline of autonomy in activities of daily living of elderly people even after 10 years?

The Method

The American randomized controlled trial of Rebok and colleagues is called ACTIVE. It compares three types of cognitive training based on reasoning, processing speed or memory, to a control group with no special training. 5000 people were contacted for this study. 2832 healthy people aged 73.6 years on average have accepted to participate in this study. They were randomly assigned into one of four groups (memory, reasoning, processing speed or control). The measurements were performed at the beginning and end of the procedure, and then at 1, 2, 3, 5 and 10 years after surgery. Cognitive abilities were assessed using specific neuropsychological tests in memory, reasoning and speed of reaction. The autonomy in the tasks of daily living was assessed by a self-administered questionnaire assessing the ability to handle daily tasks of 19 for 7 days (MDS Home Care) such as meal preparation, housework, finances, health care, using the telephone, shopping, traveling, need help with dressing, personal hygiene and shower.

The Non-Pharmacological Intervention (NPI) assessed

Cognitive training was conducted in small groups of 10 people supervised by a professional. Each session lasted 60 to 75 minutes for a period of six weeks. 10 sessions were held.

The mnemonic training was to improve the verbal episodic memory through learning practical strategies storage.

The drive to the reasoning was an improvement in the ability to solve problems.

Training based on the processing speed was focused on visual search and the ability to process information increasingly complex presented in shorter and shorter inspection times.

A booster session (called “booster”) of 4 sessions was offered to participants interventional groups on the same modality between 11 and 35 months after the end of the initial intervention.

Main Results

The ACTIVE study shows that those three groups followed a cognitive training have a smaller decline at the vis-à-vis autonomy for daily activities compared to those in the control group after 10 years. Trainings reasoning and reaction time lead of cognitive performance than the control group. She returns to the performance level of 10 years ago (baseline). 60-70% of participants feel go as well as it was 10 years ago. This is not the case for training based on memory exercises.

What it means for Parents of Children Overweight

14 sessions of cognitive training based on the reaction time or reasoning, supervised and group improve cognitive abilities and autonomy in managing the tasks of daily life until 10 years after the program compared to individuals Seniors who do not cause or are on the memory training program.

What it means for Healthcare Professionals

Cognitive training 14 weeks for the elderly improves cognitive skills and management of daily life activities. While these improvements dissipate slowly over time, they persist up to 10 years for persons who have completed a training in reasoning or speed of processing.

What it means for Researchers

This clinical trial called ACTIVE is the first to show a profit in 10 years of cognitive training on cognitive abilities and managing daily life activities. The sample size is colossal, since 2832 people over 65 years participated in this study that began in 1998. These results offer Exploring the development of innovative interventions, particularly those targeting several cognitive abilities. These could have an even greater effect.

What it means for Policymakers

Taking into account the three groups trained, over 60% of people report less difficulty in activities of daily living compared to 49% of untrained people. Moreover, after 10 years, 60% to 70% of participants were both cognitively or better than at the beginning of intervention. The cognitive training programs have the potential to delay the onset of functional decline associated with aging. They are compatible with geriatric care to help maintain and support the independence and autonomy. With the introduction of this type of intervention, the number of older people affected by a functional deficit in 2050 would be reduced by 38%. Such an outcome would be a major advantage in terms of public health.

The Reference

Rebok GW, Ball K, Guey LT, Jones RN, Kim HY, King JW, Marsiske M, Morris JN, Tennstedt SL, Unverzagt FW, Willis SL (2014). Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. Journal of The American Geriatrics Society, 62, 16-24.

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To reference this Blog en Sante © article

Ninot G (2015). Cognitive training delays the effects of aging. Blog en Sante, A55.

© Copyright 2015 Gregory Ninot. All rights reserved.