Today we are fortunate to interview Dr. Jerri Edwards, an
Associate Professor at University of South Florida's School
of Aging Studies and Co-Investigator of the influencial
ACTIVE study. Dr. Edwards was trained by Dr. Karlene K.
Ball, and her research is aimed toward discovering how
cognitive abilities can be maintained and even enhanced
with advancing age.
Alvaro Fernandez (AF): Please explain to our readers your
main research areas.
Jerri Edwards (JE): I am particularly interested in how
cognitive interventions may help older adults to avoid or
at least delay functional difficulties and thereby maintain
their independence longer. Much of my work has focused on
the functional ability of driving including assessing
driving fitness among older adults and remediation of
cognitive decline that results in driving difficulties.
Some research questions that interest me include, how can
we maintain healthier lives longer? How can training
improve cognitive abilities, both to improve those
abilities and also to slow-down, or delay, cognitive
decline? The specific cognitive ability that I have studied
the most is processing speed, which is one of the cognitive
skills that decline early on as we age.
AF: Can you explain what cognitive processing speed is, and
why it is relevant to our daily lives?
JE: Processing speed is mental quickness. Just like a
computer with a 486 processor can do a lot of the same
things as a computer with a Pentium 4 processor, but it
takes much longer, our minds tend to slow down with age as
compared to when we were younger. We can do the same tasks,
but it takes more time. Quick speed of processing is
important for quick decision making in our daily lives.
When you are driving, if something unexpected happens, how
quickly can you notice the situation and decide how to
react?
AF: Please describe how the ACTIVE trial used the cognitive
training program, and what the results were found to be
when they were published in the Journal of the American
Medical Association in December 2006?
JE: I was a co-investigator of the ACTIVE study, a
multi-site, controlled study, with thousands of adults over
sixty-five, to evaluate the effectiveness of three
different cognitive training methods with three different
groups:
- The first group used a memory training program including
a variety of traditional memory techniques such as
mnemonics and the method of loci.
- The second group was trained in learn inductive reasoning
skills.
- The third group was exposed to computer-based programs to
train processing speed.
All 3 groups spent the same amount of time in their
respective training programs, around 2 hours a week for 5
weeks, going through exercises of increasing difficulty.
The ACTIVE study was designed to track participants'
performance over a number of years, so, after this initial
5-week intervention, some groups received training booster
sessions, after 1 year and again after 3 years.
Willis and colleagues published the 5-year results in JAMA
last December and the results were very positive. All 3
types of cognitive programs were shown to have an effect
immediately after the program, after 3 years, and after 5.
But, the results of the group that used a computer-based
program to train processing speed showed clear short-term
and long-term results. Individuals who experienced improved
speed of processing also showed better performance on tasks
of instrumental activities of daily living such as quickly
finding an item on a crowded pantry shelf and reading
medication bottles. They also reacted to road signs more
quickly. We found this transfer of training in our prior
studies using the training protocol as well.
In short, significant percentages of the participants
improved their memory, reasoning and information-processing
speed across all three methods. The most impressive result
was that, when tested five years later, the participants in
the computer-based program had less of a decline in the
skill they were trained in than did a control group that
received no cognitive training.
AF: The results of the ACTIVE study were quite impressive
and contributed in large part to the amount of media
coverage about brain fitness last year. However, as you
have probably seen, there is a good deal of confusion about
brain fitness among the media and the public at large. Can
you help our readers understand two common questions: 1)
Why are new programs better than, say, doing crosswords
puzzles?, and 2) Can one really say that these programs can
reverse age-related decline?
To answer the first question, I would say that a crossword
puzzle is not a form of cognitive training. It can be
stimulating, but it is not a form of structured mental
exercise that has been shown to improve specific cognitive
skills - other than the skill of doing crossword puzzles,
of course.
In terms of the second question, it is too early to say
whether we can really reverse decline in a permanent way.
There are many skills involved and the studies are not long
enough to really compare different trajectories. What we
can say is that by doing some exercises, one can improve
cognitive speed of processing by 146-250%, and that a
significant portion of that improvement stays even after 5
years. We cannot say more definitively.
But I think it is noteworthy to be able to say that, in all
of the programs tested, the payoff from cognitive training,
or what we can call "mental exercise", seemed far greater
than we are accustomed to getting from physical exercise.
Just imagine if you could say that 10 hours of workouts at
the gym every day this month was enough to help keep you
fit five years from now.
AF: Research like this seems to present major opportunities
for society. For example, wouldn't insurance companies, or
the AARP, want to sponsor more research and evaluate
whether to offer this type of training to their members?
Won't major employers see opportunities to improve the
performance of older employees by identifying the cognitive
skills that may need the most improvement and offering
tailored training? We could speculate that a person with
faster processing abilities will also be able to make
faster decisions and learn faster...
JE: That makes sense, based on what we know. Cognitive
abilities evolve in different ways as we age, and some
typically start to decline in our thirties. Cognitive
interventions may help train and improve those abilities,
and there is already research that strongly indicates where
and how training can be useful. More research is still
required to deliver more precise and tailored interventions
in a variety of environments. I suspect we will see the
field grow significantly - and not just for aging-related
priorities. Cognitive training may become useful for a
variety of health conditions, such as Parkinson's and
Alzheimer's patients, for example. More research will help
researchers refine assessments and training programs.
----------------------------------------------------
Alvaro Fernandez is the CEO and Co-Founder of
SharpBrains.com, which provides the latest science-based
information for Brain Fitness combined with fun brain
teasers. SharpBrains has been recognized by Scientific
American Mind, Newsweek, Forbes. Alvaro holds MA in
Education and MBA from Stanford University, and teaches The
Science of Brain Health at UC-Berkeley Lifelong Learning
Institute. You can learn more at
http://www.sharpbrains.com/blog
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