Lesley A. Ross - US grants

Loss of independence, cognitive decline, and difficulties in everyday function are areas of great concern for older adults and their families. From a public health perspective, successful efforts that enable older adults to age within their homes, as compared to nursing homes, will save an estimated $80 billion dollars per year. Useful Field of View training (UFOVt) is one low cost, noninvasive cognitive training intervention that has repeatedly demonstrated reliable transfer effects to maintained cognition, everyday function, health, and most recently, a 29% reduction in incident dementia. Importantly, many of these everyday function effects are maintained across five to ten years including: maintained driving mobility, 50% reduction in at-fault vehicle crashes, and maintained Instrumental Activities of Daily Living (IADL). Although clearly an important and effective intervention, the mediators, or mechanisms, underlying this program are unknown. Our overall objective is to assess the cognitive and psychosocial factors within daily life that account for the transfer of UFOVt to everyday function. This exploratory double-blind trial will randomize older adults to 20 hours of UFOVt or 20 hours of an active control group. We will assess cognitive and psychosocial factors before, during, and after training within daily life. We will then compare such factors and assess how they impact the transfer of UFOVt to everyday functioning. Our central hypothesis is that improvements in daily processing speed and attention, key components of higher order cognitive functions, will have the strongest relationship with everyday function changes. This exploratory study is the first of its kind and will be used to provide important data relevant to a future larger randomized controlled trial examining mediators of cognitive training in a representative sample of adults. This information will assist in the future development of more effective home- and community-based interventions that maintain everyday function.

Loss of independence, difficulties in everyday function, cognitive decline, Mild Cognitive Impairment (MCI), Alzheimer?s Disease (AD) and Alzheimer?s Disease Related Dementias (ADRD) are areas of great concern for older adults and their families. From a public health perspective, successful efforts that enable older adults to age within their homes, as compared to nursing homes, will save an estimated $80 billion dollars per year. Cognitive training is a low cost, noninvasive intervention that has repeatedly demonstrated reliable transfer effects to maintained cognition, everyday function, health, and most recently, a 29% reduction in incident ADRD. Importantly, many of these everyday function effects are maintained across five to ten years including: maintained driving mobility, 50% reduction in at-fault vehicle crashes, and maintained Instrumental Activities of Daily Living (IADL). Despite this promising evidence, the moderators and mechanisms underlying this program are unknown. Our overall objective in this planning grant is to lay the conceptual and methodological foundation to identify cognitive, psychosocial, lifestyle behaviors, biomarker, and neural mechanisms of two forms of conceptually driven cognitive training. Additionally, we will examine how cognitive and psychosocial factors within daily life account for the transfer of cognitive training to everyday function. We will use a factorial design to randomize adults ages 45-90 to 10, 20, 30, or 40 hours of two forms of cognitive training, a combined training, or an active control condition. This study will allow us to test the feasibility of our enrollment, assessment and training protocols for a future multisite clinical trial. This exploratory study is the first of its kind and will be used to provide important data relevant to a future larger randomized controlled trial examining mediators of cognitive training in a representative sample of adults. This information will guide future development and evaluation of affordable and more effective home- and community-based interventions that maintain everyday function and reduce the risk of Mild Cognitive Impairment (MCI), Alzheimer?s Disease (AD) and Alzheimer?s Disease Related Dementias (ADRD).