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Structured Cognitive Training Yields Best Results in Healthy Older Adults, and Their ApoE4 State and Baseline Cognitive Level Predict Training Benefits

Roheger, Mandy MSc*; Kessler, Josef PhD; Kalbe, Elke PhD*

Cognitive and Behavioral Neurology: June 2019 - Volume 32 - Issue 2 - p 76–86
doi: 10.1097/WNN.0000000000000195
Original Studies
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Background: Cognitive training has been shown to improve cognitive functions in healthy older adults. However, little is known about which specific variables are responsible for the improvement.

Objective: Our aim was to evaluate whether healthy older adults benefit more from a structured cognitive training program than an unstructured brain jogging program and to identify possible predictors for training success, including apolipoprotein E4 (apoE4).

Methods: In a randomized controlled trial, participants completed either a 6-week structured cognitive training program (n=35) or a 6-week unstructured brain jogging program (n=35). A control group received no training and was not part of the randomization procedure (n=35). Overall, 105 participants were included in the training data analyses, focusing on verbal memory, attention, and executive functions. Data from an additional 45 previously trained, healthy older adults were used for the predictor analysis.

Results: A significant Time×Training interaction in favor of the structured cognitive training program was found in verbal memory. Low baseline performance on neuropsychological tests was a significant predictor for benefits in verbal memory, attention, and executive functions. A subgroup analysis (n=35) revealed that only noncarriers of the apoE4 allele showed significant gains in long-term verbal memory and attention.

Conclusions: Our results support the greater effectiveness of structured cognitive training on verbal memory compared with brain jogging and no training. The success of this type of training program may be predicted by sociodemographic, cognitive, and genetic variables.

*Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention

Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany

Supported in part by budget resources of the Medical Faculty and University Hospital of Cologne and the University of Vechta.

J.K. and E.K. are authors of the NEUROvitalis program but do not receive royalties. M.R. declares no conflicts of interest.

Correspondence: Elke Kalbe, PhD, Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital of Cologne, Kerpener Str. 68 Cologne 50937, Germany (email: elke.kalbe@uk-koeln.de).

Received August 29, 2018

Accepted February 17, 2019

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