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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on January 30, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(4):468-472; doi:10.1093/gerona/gln044
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

The Effect of Speed-of-Processing Training on Depressive Symptoms in ACTIVE

Fredric D. Wolinsky1,2, Mark W. Vander Weg1,2, Rene Martin1,2, Frederick W. Unverzagt3, Karlene K. Ball4, Richard N. Jones5 and Sharon L. Tennstedt6

1 Iowa City VAMC, Iowa
2 University of Iowa, Iowa City
3 Indiana University School of Medicine, Indianapolis
4 University of Alabama at Birmingham
5 Hebrew SeniorLife, Boston, Massachusetts
6 New England Research Institutes, Boston, Massachusetts

Address correspondence to Fredric D. Wolinsky, PhD, Department of Health Management and Policy, College of Public Health, University of Iowa, 200 Hawkins Drive, E205 General Hospital, Iowa City, IA 52242. Email: fredric-wolinsky{at}uiowa.edu


  Abstract

Objective: We evaluated the effects of three cognitive training interventions on depressive symptoms at 1 and 5 years.

Methods: Advanced Cognitive Training for Independent and Vital Elderly is a multisite randomized controlled trial (age ≥ 65 years), with four groups (memory, reasoning, speed-of-processing, and no-contact control). Complete data were available for 2,014 (72%) and 1,516 (54%) of 2,802 participants at 1 and 5 years. Separate propensity score models adjusted for potential attrition bias. Clinically important increases in depressive symptoms were defined as: (a) Center for Epidemiological Studies–Depression scale (CES-D)-12 score increases ≥0.5 SD and (b) CES-D-12 score increases ≥1.0 SD. Multivariable logistic regression was used.

Results: The speed-of-processing group (vs the no-contact control group) was 30% less likely to experience clinically important increases in depressive symptoms at 1-year (adjusted odds ratio [AOR] = 0.700, p = .012) and 5-year (AOR = 0.698, p = .023) posttraining for the ≥0.5 SD threshold. Similar results (AOR = .669 with p = .039 at 1 year; AOR = 0.651 with p = .059 at 5 years) were obtained for the ≥1.0 SD threshold. No differences were observed among the control, memory, or reasoning groups at either time period or at either threshold.

Conclusion: The speed-of-processing intervention reduced the risk of clinically important increases in depressive symptoms at 1- and 5-years postbaseline.

Keywords Cognitive training; Depression; Randomized controlled trial; Speed-of-processing

Received: May 9, 2008; Accepted: August 5, 2008

Decision Editor: Darryl Wieland, MD, PhD


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