ACTIVE Cognitive Training Trial: 20-Yr Follow-up of Functioning, Health, & Dementia

摘要 独立和活力老年人高级认知训练（ACTIVE）研究是最大的随机 临床试验（N = 2802），以检查认知训练是否能提高认知能力和日常生活能力。 在正常老年人中发挥作用。受试者接受记忆、推理或处理速度训练， 在5年和10年随访时显著高于对照组。此外，受过训练的受试者报告说， 在10年随访时执行IADL任务。速度和推理训练与减少 车祸和停止驾驶。最近的初步但有希望的发现表明， 阿尔茨海默氏症和相关痴呆症的发病率。虽然这些发现为这些益处提供了强有力的支持， 在认知训练中，结果只关注短期结果。这一拟议的20年后续行动将 使我们能够解决与医疗保健和公共政策高度相关的问题，这些问题只有在 大多数样本死亡：是训练相关的认知和日常功能的增强 与长期减少残疾，丧失独立性和痴呆事件有关， 老年和减少相关的财务费用？我们建议采用广泛的联系数据 包括：医疗保险和医疗补助索赔，国家死亡指数，驾驶记录和信用报告。本研究 将评估ACTIVE干预措施对关键真实的生活结果的长期影响和可持续性 和相关费用，包括1）维持独立功能; 2）身体 健康、残疾、虚弱和死亡率; 3）阿尔茨海默病和相关痴呆的发病率和持续时间， 萧条

Abstract The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study is the largest randomized clinical trial (N = 2802) to examine whether cognitive training enhanced both cognitive abilities and everyday functioning in normal older adults. Subjects trained on memory, reasoning, or processing speed performed significantly above controls at 5- and 10-year follow-ups. In addition, trained subjects reported less difficulty in performing IADL tasks at 10-year follow-up. Speed and reasoning training was associated with reduction in auto crashes and in driving cessation. Recent preliminary, but promising findings suggest an effect of training on incidence of Alzheimer's and related dementias. While these findings provide strong support for the benefits of cognitive training, the results focus on only short-term outcomes. This proposed 20-year follow-up would allow us to address questions highly relevant to health care and public policy that can only be addressed when the majority of the sample is deceased: Is training-related enhancement of cognition and everyday functioning associated with a long-term reduction in disability, loss of independence, and incident dementia in advanced old age and a reduction in associated financial costs? We propose to employ a wide range of linked data including: Medicare and Medicaid Claims, National Death Index, driving records, and credit reports. This study will assess the long-term impact and sustainability of the ACTIVE interventions on critical real life outcomes and related costs in advanced old age, including 1) Maintenance of independent functioning; 2) Physical health, disability, frailty, and mortality; 3) Incidence and duration of Alzheimer's and related dementias and depression.