Cognitive Training Gains and Mobility Outcomes in ACTIVE

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DESCRIPTION (provided by applicant): This application proposes secondary analyses of the mobility outcome measures from the data set collected through the clinical trial entitled Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE). The ACTIVE trial was a rigorously designed and conducted study that addressed an important question not previously investigated on a large scale, i.e., whether training effects on cognitive abilities resulted in improved or maintained function in daily activities. Even though there is substantial evidence that many basic cognitive abilities and processes are related to measures of functional status, need for care, and quality of life, few studies have addressed whether improving such cognitive function might have short- or long-term effects on daily activities related to living independently. Interventions designed to delay or prevent the need for use of nursing homes, home care, and short stay hospitals can save health-care costs, while also ensuring the independence and dignity of the aging population. Because of its size and the carefully developed rigor, the ACTIVE datasets offer investigators a wealth of opportunities for secondary analyses. The purpose of the analyses proposed here is to answer a range of questions not addressed in the original funding cycle, but which may be addressed by this data set. Specifically, this application seeks to 1) Determine the associations between cognitive measures in the ACTIVE screening battery and a range of mobility outcome measures (including crash risks, falls, life space, etc.) after adjusting for demographic and other relevant personal characteristics, 2) Examine the impact of the three cognitive interventions on these same mobility outcome measures, 3) Examine the associations between mobility measures and other secondary outcomes such as quality of life and health service utilization, and 4) Evaluate the mediating role of intervention effectiveness on mobility outcomes.