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

摘要 独立和有活力的老年人的高级认知训练(主动)研究是最大的随机研究 临床试验(N=2802)，以检查认知训练是否提高了认知能力和日常生活能力 在正常的老年人中发挥作用。受试者接受记忆、推理或处理速度方面的训练 在5年和10年的随访中显著高于对照组。此外，受过训练的受试者报告说在 在10年的随访中执行IADL任务。速度和推理训练与减少 汽车相撞和驾驶停止。最近的初步但有希望的发现表明，训练的效果 阿尔茨海默病及相关痴呆症的发病率。虽然这些发现为这些好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。这项拟议的20年后续行动将 允许我们解决与医疗保健和公共政策高度相关的问题，这些问题只有在以下情况下才能解决 样本中的大部分都已经死亡：是与训练有关的认知增强和日常功能 与长期减少残疾、丧失独立性和晚期痴呆症有关 老龄化和相关财务成本的降低？我们建议使用广泛的关联数据 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 将评估积极干预对关键现实生活结果的长期影响和可持续性 高龄时的相关费用，包括1)维持独立功能；2)身体 健康、残疾、虚弱和死亡率；3)阿尔茨海默氏症和相关痴呆的发生率和持续时间 抑郁症。

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.