Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-18T17:55:04.408Z Has data issue: false hasContentIssue false

Cognitive rehabilitation in the elderly: A randomized trial to evaluate a new protocol

Published online by Cambridge University Press:  13 December 2006

DONALD T. STUSS
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Psychology, University of Toronto, Ontario, Canada Department of Medicine (Neurology), University of Toronto, Ontario, Canada Department of Medicine (Rehabilitation Sciences), University of Toronto, Ontario, Canada
IAN H. ROBERTSON
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Psychology and Institute of Neuroscience, Trinity College, Dublin, Ireland
FERGUS I.M. CRAIK
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Psychology, University of Toronto, Ontario, Canada
BRIAN LEVINE
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Psychology, University of Toronto, Ontario, Canada Department of Medicine (Neurology), University of Toronto, Ontario, Canada
MICHAEL P. ALEXANDER
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
SANDRA BLACK
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Medicine (Neurology), University of Toronto, Ontario, Canada Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada
DEIRDRE DAWSON
Affiliation:
Department of Medicine (Rehabilitation Sciences), University of Toronto, Ontario, Canada Kunin-Lunenfeld Applied Research Unit, Baycrest, Toronto, Ontario, Canada Department of Medicine (Occupational Science & Occupational Therapy), University of Toronto, Ontario, Canada
MALCOLM A. BINNS
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
HEATHER PALMER
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
MAUREEN DOWNEY-LAMB
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
GORDON WINOCUR
Affiliation:
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada Department of Psychology, University of Toronto, Ontario, Canada Department of Medicine (Psychiatry), University of Toronto, Ontario, Canada Department of Psychology, Trent University, Peterborough, Canada

Abstract

This study provides an introduction to, and overview of, several papers that resulted from a randomized control trial that evaluated a new cognitive rehabilitation protocol. The program was designed to improve general strategic abilities in ways that would be expressed in a broad range of functional domains. The trial, which was conducted on a sample of older adults who had experienced normal age-related cognitive decline, assessed performance in the following domains: memory, goal management, and psychosocial status. The general rationale for the trial, the overall experimental design, and the approach to statistical analyses that are relevant to each paper are described here. The results for each functional domain are reported in separate papers in this series (JINS, 2007, 13, 120–131.)

Type
REHAB SERIES—INTRODUCTORY PAPER
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alexander, M.P., Stuss, D.T., & Fansabedian, N. (2003). California verbal learning test: Performance by patients with focal frontal and non-frontal lesions. Brain, 126, 14931503.Google Scholar
Anschutz, L., Camp, C.L., Markley, R.P., & Kramer, J.J. (1985). Maintenance and generalization of mnemonics for grocery shopping by older adults. Experimental Aging Research, 11, 157160.Google Scholar
Antonucci, T.C. & Akiyama, H. (1997). Social support and the maintenance of competence. In S.L. Willis, K.W. Schaie, & M. Hayward (Eds.), Societal mechanisms for maintaining competence in old age (pp. 183206). New York: Springer Publishing Company.
Bäckman, L., Almkvist, O., Andersson, J., Nordberg, A., Winblad, B., Reineck, R., & Langstrom, B. (1997). Brain activation in young and older adults during implicit and explicit retrieval. Journal of Cognitive Neuroscience, 9, 378391.Google Scholar
Ball, K., Berch, D.B., Helmers, K.F., Jobe, J.B., Leveck, J.D., Marsiske, M., Morris, J.N., Rebok, G.W., Smith, D.M., Tennstedt, S.L., Unverzagt, F.W., & Willis, S.L. (2002). Effects of cognitive training interventions with older adults: A randomized controlled trial. Journal of the American Medical Association, 233, 22712281.Google Scholar
Balota, D.A., Law, M.B., & Zevin, J.D. (2000). The attentional control of lexical processing pathways: Reversing the word frequency effect. Memory and Cognition, 28, 10811089.Google Scholar
Baltes, P.B. & Willis, S.L. (1982). Plasticity and enhancement of intellectual functioning in old age: Penn State's Adult Development and Enrichment Project (ADEPT). In F.I.M. Craik & S. Trehub (Eds.), Aging and cognitive processes (pp. 353389). New York: Plenum Press.
Beck, A.T. & Steer, R.A. (1990). The Beck Anxiety Inventory. Austin, TX: The Psychological Corporation.
Benton, A.L., Varney, N.R., & Hamsher, K. (1978). Visuospatial judgment: A clinical test. Archives of Neurology, 35, 364367.Google Scholar
Ben-Yishay, Y. & Prigatano, G.P. (1990). Cognitive remediation. In M. Rosenthal, E.R. Griffith, M.R. Bond, & et al. (Eds.), Rehabilitation of the adult and child with traumatic brain injury (pp. 393409). Philadelphia: F.A. Davis.
Brink, T.L., Yesavage, J.A., Lum, O., Heersema, P.H., Adey, M., & Rose, T.S. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 3743.Google Scholar
Cahn-Weiner, D.A., Boyle, P.A., & Malloy, P.F. (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals. Applied Neuropsychology, 9, 187191.Google Scholar
Cahn-Weiner, D.A., Malloy, P.F., Boyle, P.A., Marran, M., & Salloway, S. (2000). Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. The Clinical Neuropsychologist, 14, 187195.Google Scholar
Cicerone, K.D., Dahlberg, C., Kalmar, L., Langenbahn, D., Malec, J.F., Bergquist, T.F., Felicetti, T., Giacino, J.T., Harley, J.P., Harrington, D.E., Herzog, J., Kneipp, S., Laatsch, L., & Morse, P. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation, 81, 15961615.Google Scholar
Cicerone, K.D., Dahlberg, C., Malec, J.F., Langenbahn, D.M., Felicetti, T., Kneipp, S., Ellmo, W., Kalmar, K., Giacino, J.T., Harley, J.P., Laatsch, L., Morse, P.A., & Catanese, J. (2005). Evidence-based cognitive rehabilitation: Updated review of the literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86, 16811692.Google Scholar
Cicerone, K.D., Smith, L.C., Ellmo, W., Mangel, H., Nelson, P., Chase, R.F., & Kalmar, K. (1996). Neuropsychological rehabilitation of mild traumatic brain injury. Brain Injury, 10, 277286.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
Colcombe, S.J., Erickson, K.I., Raz, N., Webb, A.G., Cohen, N.J., McAuley, E., & Kramer, A.F. (2003). Aerobic fitness reduces brain tissue loss in aging humans. Journal of Gerontology: Medical Sciences, 58A, 176180.Google Scholar
Craik, F.I.M. & Byrd, M. (1982). Aging and cognitive deficits: The role of attentional resources. In F.I.M. Craik & S.E. Trehub (Eds.), Aging and cognitive processes (pp. 191211). New York: Plenum Press.
Craik, F.I.M. & Grady, C.L. (2002). Aging, memory, and frontal lobe functioning. In D.T. Stuss & R.T. Knight (Eds.), Principles of frontal lobe function (pp. 528540). New York: Oxford University Press.
Craik, F.I.M. & Lockhart, R.S. (1972). Levels of processing: A framework for memory research. Journal of Verbal Learning and Verbal Behavior, 11, 671684.Google Scholar
Dawson, D., Winocur, G., & Moscovitch, M. (1999). The psychological environment and cognitive rehabilitation in the elderly. In D.T. Stuss, G. Winocur, & I.H. Robertson (Eds.), Cognitive neurorehabilitation (pp. 94108). Cambridge, UK: Cambridge University Press.
Doppelt, J.E. & Wallace, W.L. (1955). Standardization of the Wechsler adult intelligence scale for older persons. Journal of Abnormal Psychology, 51, 312330.CrossRefGoogle Scholar
Flynn, T.M. & Storandt, M. (1990). Supplemental group discussions in memory training for older adults. Psychology and Aging, 5, 178181.CrossRefGoogle Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Glisky, E.L. & Glisky, M.L. (1999). Memory rehabilitation in the elderly. In D.T. Stuss, G. Winocur, & I.H. Robertson (Eds.), Cognitive neurorehabilitation (pp. 347361). Cambridge: Cambridge University Press.
Grant, D.A. & Berg, E.A. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology, 38, 404411.Google Scholar
Greenberg, C. & Powers, S.M. (1987). Memory improvement among adult learners. Educational Gerontology, 12, 385394.Google Scholar
Haug, H. & Eggers, R. (1991). Morphometry of the human cortex cerebri and corpus striatum during aging. Neurobiology of Aging, 12, 352355.Google Scholar
Heaton, R.K. (1981). A manual for the Wisconsin Card Sorting Test. Odessa, FL: Psychological Assessment Resources.
Hertzog, C., Dixon, R.A., & Hultsch, D.F. (1992). Intraindividual change in text recall of the elderly. Brain and Language, 42, 248269.Google Scholar
Hultsch, D.F., Hertzog, C., Small, B.J., & Dixon, R.A. (1999). Use it or lose it: Engaged lifestyle as a buffer of cognitive decline in aging? Psychology of Aging, 14, 520527.Google Scholar
Jernigan, T.L., Archibald, S.L., Fennema-Notestine, C., Gamst, A.C., Stout, J.C., Bonner, J., & Hesselink, J.R. (2001). Effects of age on tissues and regions of the cerebrum and cerebellum. Neurobiology of Aging, 22, 581594.Google Scholar
Jobe, J.B., Smith, D.M., Ball, K., Tennstedt, S.L., Marsiske, M., Willis, S.L., Rebok, G.W., Morris, J.N., Helmers, K.F., Leveck, M.D., & Kleinman, K. (2001). ACTIVE: A cognitive intervention trial to promote independence in older adults. Controlled Clinical Trials, 22, 453479.Google Scholar
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test (2nd ed.). Philadelphia: Lea and Febiger.
Kliegl, R., Smith, J., & Baltes, P.B. (1989). Testing-the-limits and the study of adult age differences in cognitive plasticity of a mnemonic skill. Developmental Psychology, 25, 247256.Google Scholar
Kramer, A.R. & Willis, S.L. (2002). Enhancing the cognitive vitality of older adults. Current Directions in Psychological Science, 11, 173176.Google Scholar
Levine, B. & Downey-Lamb, M. (2002). Design and evaluation of intervention experiments. In P.J. Eslinger (Ed.), Neuropsychological interventions: Emerging treatment and management models for neuropsychological impairments (pp. 80104). New York: Guilford Publications.
Levine, B., Robertson, I.H., Clare, L., Carter, G., Hong, J., Wilson, B.A., Duncan, J., & Stuss, D.T. (2000). Rehabilitation of executive functioning: An experimental-clinical validation of Goal Management Training. Journal of the International Neuropsychological Society, 6, 299312.CrossRefGoogle Scholar
Mack, W.J., Freed, D.M., Williams, B.W., & Henderson, V.W. (1992). Boston Naming Test: Shortened versions for use in Alzheimer's Disease. Journal of Gerontology, 47, 154158.Google Scholar
Milner, B. (1963). Effects of different brain lesions on card sorting: The role of the frontal lobes. Archives of Neurology, 9, 100110.Google Scholar
Moscovitch, M. (1992). Memory and working-with-memory: A component process model based on modules and central systems. Journal of Cognitive Neuroscience, 4, 257267.Google Scholar
Moscovitch, M. & Winocur, G. (1992). The neuropsychology of memory and aging. In F.I.M. Craik & T. Salthouse (Eds.), The handbook of aging and cognition (pp. 315371). Hillsdale: Lawrence Erlbaum Associates.
Nelson, H. & Willison, J.R. (1991). National Adult Reading Test (NART): Test Manual (2nd ed.). Windsor: NFER-Nelson.
Park, D.C. & Hedden, T. (2002). Working memory and aging. In M. Naveh-Benjamin, M. Moscovitch, & H.L. Roediger III (Eds.), Perspectives on human memory and cognitive aging: Essays in honour of Fergus Craik (pp. 148160). East Sussex, UK: Psychology Press.
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characteristics and outcome. Archives of Neurology, 56, 303308.Google Scholar
Picton, T.W., Stuss, D.T., Champagne, S.C., & Nelson, R.F. (1984). The effects of age on human event-related potentials. Psychophysiology, 21, 312325.Google Scholar
Prigatano, G.P. (1999). Motivation and awareness in cognitive neurorehabilitation. In D.T. Stuss, G. Winocur, & I.H. Robertson (Eds.), Cognitive neurorehabilitation (pp. 240251). Cambridge, UK: Cambridge University Press.
Rabbitt, P., Lowe, C., & Shilling, V. (2001). Frontal tests and models for cognitive ageing. European Journal of Cognitive Psychology, 13, 528.CrossRefGoogle Scholar
Rasmusson, D.X., Rebok, G.W., Bylsma, F.W., & Brandt, J. (1999). Effects of three types of memory training in normal elderly. Aging, Neuropsychology, and Cognition, 6, 5666.CrossRefGoogle Scholar
Raz, N. (2000). Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings. In F.I.M. Craik & T. Salthouse (Eds.), The handbook of aging and cognition (pp. 190). Mahwah, NJ: Lawrence Erlbaum Associates.
Regnier, V. (1997). The physical environment and maintenance of competence. In S.L. Willis, K.W. Schaie, & M. Hayward (Eds.), Societal mechanisms for maintaining competence in old age (pp. 233250). New York: Springer Publishing Company.
Robertson, I.H. (1996). Goal management training. Cambridge: MRC Cognition and Brain Sciences Unit.
Rypma, B., Prabhakaran, V., Desmond, J.E., & Gabrieli, J.D.E. (2001). Age differences in prefrontal cortical activity in working memory. Psychology and Aging, 16, 371384.Google Scholar
Salthouse, T.A. (1988). The role of processing resources in cognitive aging. In M.L. Howe & C. Brainerd (Eds.), Cognitive development in adulthood (pp. 185239). New York: Springer-Verlag.
Salthouse, T.A. (1991). Mediation of adult age differences in cognition by reductions in working memory and speed of processing. Psychological Science, 2, 179183.Google Scholar
Salthouse, T.A. (1992). What do adult age differences in the Digit Symbol Substitution Test reflect? Journal of Gerontology 47, 121128.Google Scholar
Salthouse, T.A. (1993). Attentional blocks are not responsible for age-related slowing. Journal of Gerontology, 48, 263270.Google Scholar
Schacter, D.L. (1994). Priming and multiple memory systems: Perceptual mechanisms of implicit memory. In D.L. Schacter & E. Tulving (Eds.), Memory systems (pp. 244256). Cambridge, MA: MIT Press.
Shallice, T. (2002). Fractionation of the supervisory system. In D.T. Stuss & R. Knight (Eds.), Principles of frontal lobe function (pp. 261277). New York: Oxford University Press.
Shammi, P., Bosman, E., & Stuss, D.T. (1998). Aging and variability in performance. Aging, Neuropsychology, and Cognition, 5, 113.Google Scholar
Spreen, O. & Strauss, E. (1998). A compendium of neuropsychological tests: Administration, norms & commentary (2nd ed.). New York: Oxford University Press.
Stigsdotter Neely, A. & Bäckman, L. (1993a). Long-term maintenance of gains from memory training in older adults: Two 3 1/2 year follow-up studies. Journal of Gerontology: Psychological Sciences, 48, 233237.Google Scholar
Stigsdotter Neely, A. & Bäckman, L. (1993b). Maintenance of gains following multifactorial and unifactorial memory training in late adulthood. Educational Gerontology, 19, 105117.Google Scholar
Stigsdotter Neely, A. & Bäckman, L. (1995). Effects of multifactorial memory training in old age: Generalizability across tasks and individuals. Journal of Gerontology: Psychological Sciences, 50, 134140.Google Scholar
Storandt, M. (1992). Memory-skills training for older adults. In T.B. Sonderigger (Ed.), Nebraska symposium on motivation, 1991: Vol. 39, Psychology and aging (pp. 3962). Lincoln, NE: University of Nebraska Press.
Stuss, D.T., Alexander, M.P., Palumbo, C.L., Buckle, L., Sayer, L., & Pogue, J. (1994). Organizational strategies of patients with unilateral or bilateral frontal lobe injury in word list learning tasks. Neuropsychology, 8, 355373.Google Scholar
Stuss, D.T., Binns, M.A., Carruth, F.G., Levine, B., Brandys, C.F., Moulton, R.J., Snow, W.G., & Schwartz, M.L. (2000a). Prediction of recovery of continuous memory after traumatic brain injury. Neurology, 54, 13371344.Google Scholar
Stuss, D.T., Craik, F.I.M., Sayer, L., Franchi, D., & Alexander, M.P. (1996). Comparison of older people and patients with frontal lesions: Evidence from word list learning. Psychology and Aging, 11, 387395.Google Scholar
Stuss, D.T. & Levine, B. (2002). Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual Review of Psychology, 53, 401433.Google Scholar
Stuss, D.T., Levine, B., Alexander, M.P., Hong, J., Palumbo, C., Hamer, L., Murphy, K.J., & Izukawa, D. (2000b). Wisconsin Card Sorting Test performance in patients with focal frontal and posterior brain damage: Effects of lesion location and test structure on separable cognitive processes. Neuropsychologia, 38, 388402.Google Scholar
Tulving, E. (1983). Elements of episodic memory. New York: Oxford University Press.
Tulving, E., Markowitsch, H.J., Craik, F.I.M., Habib, R., & Houle, S. (1996). Novelty and familiarity activations in PET studies of memory encoding and retrieval. Cerebral Cortex, 6, 7179.Google Scholar
Turner, G. & Levine, B. (2004). Disorders of executive function and self-awareness. In J. Ponsford (Ed.), Rehabilitation of neurobehavioral disorders. New York: Guilford Publications.
Verhaeghen, P., Marcoen, A., & Goosens, L. (1992). Improving memory performance in the aged through mnemonic training: A meta-analytic study. Psychology and Aging, 7, 242251.CrossRefGoogle Scholar
Verhaeghen, P. & Salthouse, T.A. (1997). Meta-analyses of age-cognition relations in adulthood: Estimates of linear and nonlinear age effects and structural models. Psychological Bulletin, 122, 231249.Google Scholar
Wechsler, D. (1987). WMS-R: Wechsler Memory Scale-Revised, Manual. San Diego: The Psychological Corporation.
West, R. (1996). An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin, 120, 272292.CrossRefGoogle Scholar
West, R., Murphy, K.J., Armilio, M.L., Craik, F.I.M., & Stuss, D.T. (2002). Lapses of intention and performance variability reveal age-related increases in fluctuations of executive control. Brain and Cognition, 49, 402419.Google Scholar
Wilson, R.S., Mendes de Leon, C.F., Barnes, L.L., Schneider, J.A., Bienias, J.L., Evans, D.A., & Bennett, D.A. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. Journal of the American Medical Association, 287, 742748.Google Scholar
Winocur, G., Craik, F.I.M., Levine, B., Robertson, I.H., Binns, M.A., Alexander, M.P., Black, S., Dawson, D., Palmer, H., Downey-Lamb, M., & Stuss, D.T. (2007a, this issue). Cognitive rehabilitation in the elderly: Overview and future directions. Journal of the International Neuropsychological Society, 13, 166171.Google Scholar
Winocur, G., Palmer, H., Dawson, D., Binns, M.A., Bridges, K., & Stuss, D.T. (2007b, this issue). Cognitive rehabilitation in the elderly: An evaluation of psychosocial factors. Journal of the International Neuropsychological Society, 13, 153165.Google Scholar
Winocur, G., Moscovitch, M., & Stuss, D.T. (1996). Explicit and implicit memory in the elderly: Evidence for double dissociation involving medial temporal- and frontal-lobe functions. Neuropsychology, 10, 5765.Google Scholar
Yesavage, J.A. (1985). Nonpharmacologic treatments for memory losses with normal aging. American Journal of Psychiatry, 142, 600605.Google Scholar
Yesavage, J.A. & Rose, T.L. (1983). Concentration and mnemonic training in elderly with memory complaints: A study of combined therapy and order effects. Psychiatry Research, 9, 157167.CrossRefGoogle Scholar
Zarit, S.H., Cole, K.D., & Guider. R.L. (1981). Memory training strategies and subjective complaints of memory in the aged. The Gerontologist, 21, 158162.CrossRefGoogle Scholar