Data_Sheet_5_Computerized Cognitive Training by Healthy Older and Younger Adults: Age Comparisons of Overall Efficacy and Selective Effects on Cognition.pdf

Among the non-pharmacological methods under development for maintaining cognitive function across the lifespan is computerized cognitive training (CCT). There has been considerable interest in using CCT to slow or remediate age-related cognitive decline, both normal and pathological. Toward these ends, it would be useful to know how the effects of CCT on cognitive function vary over the course of normal cognitive aging. Are there changes in either 1) the overall efficacy of CCT or 2) which cognitive faculties are affected? To address these two questions, we reanalyzed results from a large online study by Hardy et al. (1) of 4,715 adults between 18 and 80 that examined effects of CCT on both a neuropsychological test battery and self-reported ratings of cognition and affect in daily living. Combined across all participants, Hardy et al. found greater improvement on both types of assessment following 10 weeks of CCT with the commercial program Lumosity, as compared to practice with a control activity involving computerized crossword puzzles. The present study compared the size of these effects on the older (50–80) and younger (18–49) participants. To address the question of overall efficacy, we examined CCT effects (treatment minus control) on overall performance of the test battery and mean rating. No significant difference on either measure was found between the two age cohorts. To address the question of whether the same magnitude of overall effects on both age cohorts was due to equivalent effects on the same set of underlying cognitive functions, we examined the patterns of CCT effects across individual subtests and rated items. These patterns did not differ significantly between the two age cohorts. Our findings suggest that benefits from CCT can occur to a similar degree and in a similar way across an extended part of the adult lifespan. Moreover, the overall effects of CCT delivered over the internet were of the same small to medium size as those typically found in the lab or clinic. Besides improving access and reducing the cost of CCT for older adults, delivery over the internet makes long-term training more practicable, which could potentially yield larger benefits.

目前处于研发阶段、用于维持全生命周期认知功能的非药物干预手段中，计算机化认知训练（computerized cognitive training, CCT）是其中之一。学界对于利用计算机化认知训练延缓或改善与年龄相关的认知衰退（包括正常衰老性衰退与病理性衰退）抱有浓厚兴趣。为达成上述目标，明确计算机化认知训练对认知功能的影响在正常认知衰老过程中如何变化至关重要：一是计算机化认知训练的整体疗效是否会随衰老发生改变？二是其影响的认知领域是否会出现变化？为解答这两个问题，我们重新分析了Hardy等人（1）开展的一项大型在线研究的数据，该研究共纳入4715名18至80岁的成年人，探究了计算机化认知训练对神经心理学测试组合以及日常认知与情绪的自我报告评分的影响。在所有参与者的合并分析中，Hardy等人发现，与使用电脑填字游戏的对照活动训练相比，接受为期10周的商业化程序Lumosity的计算机化认知训练后，两类评估的表现均有显著提升。本研究对比了该训练对年长（50-80岁）与年轻（18-49岁）参与者的效应量差异。为探究整体疗效是否存在年龄差异，我们分析了计算机化认知训练的效应（训练组减对照组）在测试组合整体得分与平均评分上的差异。结果显示，两个年龄队列在这两项指标上均未出现显著差异。为解答“两个年龄队列的整体效应幅度一致，是否源于其对同一组潜在认知功能的影响等效”这一问题，我们进一步分析了计算机化认知训练在各单项子测试与评分项目上的效应模式。结果显示，两个年龄队列的效应模式并无显著差异。我们的研究结果表明，计算机化认知训练带来的认知获益在成人生命周期的较长阶段内，其程度与方式均较为相似。此外，通过互联网开展的计算机化认知训练，其整体效应量与实验室或临床环境中通常观测到的效应量相当，均为中小幅度。相较于传统模式，互联网交付的计算机化认知训练不仅提升了老年群体的可及性、降低了训练成本，还使得长期训练更具可行性，有望带来更大的认知获益。