This application is a renewal of the application rifled """"""""ACTIVE Phase II: UAB Field Site"""""""". This application is for the Field Site at the University of Alabama at Birmingham. Phase I of ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) was a randomized controlled trial of three cognitive intervention arms, addressing the question of whether improving basic cognition aided in maintaining functional independence in elders. As to be reported in JAMA (11/12/02), Phase I found strong, broad and durable cognitive ability-specific training effects. The effect sizes were comparable to or greater than the amount of cognitive decline observed in other longitudinal studies, suggesting that the interventions have the potential to reverse age-related decline. There was minimal transfer of training effects to everyday activities (i.e., functional competence). However, it should be noted that through the two year followup, there was no evidence of a significant decline in ADL and IADL status. Therefore, to adequately understand the cognitive transfer effects of the training interventions, a longer followup period is required, particularly to see whether there is a separation of the change trajectories for everyday activities of trained and untrained participants over time. Phase II of ACTIVE is proposed as a followup study focused on measuring the long-term impact of training effects on cognitive function and cognitively demanding everyday activities. The Phase II followup will consist of one assessment to include the Phase I post-test battery and a clinical assessment. The ACTIVE cohort (n = 2832) is a special sample, containing substantial oversampling of African American, socioeconomically poor, and very old adults.
The Specific Aims of Phase II of ACTIVE are: 1) to determine whether the cognitive interventions (as initial treatment or as a consequence of repeated boosters) have long-term protective effects on functional outcomes; 2) to document any delayed transfer of the cognitive training to secondary outcomes; and 3) to identify individual factors that affect response to intervention. As in Phase I, the primary analytical approach to detecting treatment effects on both cognitive and functional abilities will be a repeated-measures, mixed-effects model incorporating all design features as fixed effects and individual-level variability as random effects. Other multivariate analyses including lagged and cross-lagged analyses of change using latent change analysis, structural equation modeling, and growth curve analyses will also be used as appropriate to characterize relationships between individual difference factors and change in functional competence. Retention is projected conservatively at 72% with 65% of the cohort providing full data and another 7% providing partial data at year 5. Power analysis shows that extending the study will make it possible to observe effect sizes on the order of 0.05-0.10 with excellent power, in the range of at least 80-90%.
|Ross, Lesley A; Sprague, Briana N; Phillips, Christine B et al. (2018) The Impact of Three Cognitive Training Interventions on Older Adults' Physical Functioning Across 5 Years. J Aging Health 30:475-498|
|Tomaszewski Farias, Sarah; Giovannetti, Tania; Payne, Brennan R et al. (2018) Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study. J Int Neuropsychol Soc 24:104-112|
|Thomas, Kelsey R; Marsiske, Michael (2017) Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions. Neuropsychol Rehabil 27:522-539|
|Ross, Lesley A; Freed, Sara A; Edwards, Jerri D et al. (2017) The Impact of Three Cognitive Training Programs on Driving Cessation Across 10 Years: A Randomized Controlled Trial. Gerontologist 57:838-846|
|Meyer, Oanh L; Sisco, Shannon M; Harvey, Danielle et al. (2017) Neighborhood Predictors of Cognitive Training Outcomes and Trajectories in ACTIVE. Res Aging 39:443-467|
|Parisi, Jeanine M; Gross, Alden L; Marsiske, Michael et al. (2017) Control beliefs and cognition over a 10-year period: Findings from the ACTIVE trial. Psychol Aging 32:69-75|
|Ross, Lesley A; Edwards, Jerri D; O'Connor, Melissa L et al. (2016) The Transfer of Cognitive Speed of Processing Training to Older Adults' Driving Mobility Across 5 Years. J Gerontol B Psychol Sci Soc Sci 71:87-97|
|Choi, Moon; O'Connor, Melissa L; Mingo, Chivon A et al. (2016) Gender and Racial Disparities in Life-Space Constriction Among Older Adults. Gerontologist 56:1153-1160|
|Phillips, Christine B; Sprague, Briana N; Freed, Sara A et al. (2016) Longitudinal Associations Between Changes in Physical Function and Driving Mobility Behaviors of Older Adults. Transp Res Rec 2584:70-76|
|Zahodne, Laura B; Meyer, Oanh L; Choi, Eunhee et al. (2015) External locus of control contributes to racial disparities in memory and reasoning training gains in ACTIVE. Psychol Aging 30:561-72|
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