This application requests funds for the Coordinating Center to extend follow-up of the functional and cognitive outcomes of old and very-old persons who have received cognitive interventions as part of the ACTIVE (Advanced Cognitive Training for independent and Vital Elderly) study. Findings at five years indicate the effects of the intervention on cognitive abilities are durable and that these intervention effects have transferred to maintenance of IADL function as hypothesized.
The Specific Aims of this extended follow-up are to: 1) To determine if the cognitive interventions continue to have protective effects up to 10 years after initial training: a) basic cognitive abilities of memory, reasoning, and speed or processing;b) self-reported and performance-based instrumental activities of daily living;and c) health-related quality of life. 2) To determine if the cognitive interventions have beneficial effects on the distal outcomes of driving safety, personal care activities of daily living, health service utilization, and mortality. 3) To examine heath, genetic and cognitive moderators in individual response to training, including such factors as low cognitive function, cardiovascular status, engagement, and ApoE genotype. 4) To estimate and project the effects of ACTIVE training to the general population of older adults by linking the measures and outcomes of ACTIVE to the Health and Retirement Study. This application affords a unique opportunity to prospectively study lagged effects of three types of cognitive interventions on functional decline in this well-characterized cohort that, given its advancing age, is now at imminent risk for both IADL and ADL decline. We will be able to test the basic question in this study: For older adults exposed to these cognitive interventions, can disability in the performance of key everyday activities be delayed and independence maintained as subjects age into their 80s. We estimate power to detect effect sizes of 0.2 over 10 years for the cognitive abilities, everyday problem solving, and everyday speed and an effect size of 0.4 for everyday functioning. The ACTIVE study will determine if cognitive training can help older adults to continue functioning and living independently for a longer period of time.
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