ACTIVE: a cognitive intervention trial to promote independence in older adults.

The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial is a randomized, controlled, single-masked trial designed to determine whether cognitive training interventions (memory, reasoning, and speed of information processing), which have previously been found to be successful at improving mental abilities under laboratory or small-scale field conditions, can affect cognitively based measures of daily functioning. Enrollment began during 1998; 2-year follow-up will be completed by January 2002. Primary outcomes focus on measures of cognitively demanding everyday functioning, including financial management, food preparation, medication use, and driving. Secondary outcomes include health-related quality of life, mobility, and health-service utilization. Trial participants (n = 2832) are aged 65 and over, and at entry into the trial, did not have significant cognitive, physical, or functional decline. Because of its size and the carefully developed rigor, ACTIVE may serve as a guide for future behavioral medicine trials of this nature.

[1]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[2]  G. Jay,et al.  Longitudinal Change and Prediction of Everyday Task Competence in the Elderly , 1992, Research on aging.

[3]  Strahan Gw.  An overview of nursing homes and their current residents: data from the 1995 National Nursing Home Survey. , 1997 .

[4]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[5]  K. Ball,et al.  Visual/cognitive correlates of vehicle accidents in older drivers. , 1991, Psychology and aging.

[6]  Yaakov Stern,et al.  A study of the efficacy of a comprehensive memory enhancement program in healthy elderly persons , 1998, Psychiatry Research.

[7]  L. Bäckman,et al.  Effects of multifactorial memory training in old age: generalizability across tasks and individuals. , 1995, The journals of gerontology. Series B, Psychological sciences and social sciences.

[8]  S. Willis,et al.  Everyday cognitive competence in elderly persons: conceptual issues and empirical findings. , 1996, The Gerontologist.

[9]  J. Brandt,et al.  Effects of Three Types of Memory Training in Normal Elderly , 1999 .

[10]  K. Levit,et al.  National Health Expenditures, 1996 , 1997, Health care financing review.

[11]  D. Rubin.  Multiple imputation for nonresponse in surveys , 1989 .

[12]  E. Steinhagen-Thiessen,et al.  Morbidity, medication, and functional limitations in very old age , 1999 .

[13]  D. Morrow,et al.  Elders' Nonadherence, Its Assessment, and Computer Assisted Instruction for Medication Recall Training , 1988, Journal of the American Geriatrics Society.

[14]  M. G. Kovar,et al.  The Supplement on Aging to the 1984 National Health Interview Survey. , 1987, Vital and health statistics. Ser. 1, Programs and collection procedures.

[15]  M. Lachman,et al.  Improving memory and control beliefs through cognitive restructuring and self-generated strategies. , 1992, Journal of gerontology.

[16]  G. McDougall.  Cognitive Interventions Among Older Adults , 1999, Annual Review of Nursing Research.

[17]  M. Lawton,et al.  Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living , 1969 .

[18]  K. Schaie,et al.  Training the elderly on the ability factors of spatial orientation and inductive reasoning. , 1986, Psychology and aging.

[19]  J. Ware,et al.  Random-effects models for longitudinal data. , 1982, Biometrics.

[20]  J. Yesavage.  Nonpharmacologic treatments for memory losses with normal aging. , 1985, The American journal of psychiatry.

[21]  M. Sloane,et al.  Visual processing impairment and risk of motor vehicle crash among older adults. , 1998, JAMA.

[22]  A. Myers.  The clinical Swiss army knife. Empirical evidence on the validity of IADL functional status measures. , 1992, Medical care.

[23]  D. Carmelli,et al.  Performance on the digit symbol substitution test and 5-year mortality in the Western Collaborative Group Study. , 1995, American journal of epidemiology.

[24]  K. Ball,et al.  Vision impairment, eye disease, and injurious motor vehicle crashes in the elderly. , 1998, Ophthalmic epidemiology.

[25]  R. Rupprecht,et al.  The SIMA-project: effects of 1 year cognitive and psychomotor training on cognitive abilities of the elderly , 1996, Behavioural Brain Research.

[26]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[27]  A M Jette,et al.  A prospective study of long-term care institutionalization among the aged. , 1982, American journal of public health.

[28]  D. Rubin,et al.  Statistical Analysis with Missing Data. , 1989 .

[29]  C. Hertzog,et al.  Effects of cognitive training on primary mental ability structure. , 1987, Psychology and aging.

[30]  Beth T. Stalvey,et al.  Older drivers and cataract: driving habits and crash risk. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[31]  B. Black,et al.  Age-Related Variation in Roles Performed by Hospice Volunteers , 1999 .

[32]  Reinhold Kliegl,et al.  On the locus and process of magnification of age differences during mnemonic training. , 1990 .

[33]  A. Rey.  Lexamen psychologique : Dans les cas d'encephalopathie traumatique (Les problemes) , 1941 .

[34]  John R. Nesselroade,et al.  Examination of personality-ability relationships in the elderly: The role of the contextual (interface) assessment mode , 1982 .

[35]  G. Rebok,et al.  Memory self-efficacy and performance differences in young and old adults: The effect of mnemonic training. , 1989 .

[36]  F. I. Mahonery.  Functional evaluation : Barthel index , 1965 .

[37]  J. Brandt.  The Hopkins Verbal Learning Test: Development of a new memory test with six equivalent forms. , 1991 .

[38]  R. J. Johnson,et al.  The use of health services by older adults. , 1991, Journal of gerontology.

[39]  Cynthia Owsley,et al.  The Life Space Questionnaire: A Measure of the Extent of Mobility of Older Adults , 1999 .

[40]  D. Roenker,et al.  Age and visual search: expanding the useful field of view. , 1988, Journal of the Optical Society of America. A, Optics and image science.

[41]  K. Schaie,et al.  Everyday problem solving in older adults: observational assessment and cognitive correlates. , 1995, Psychology and aging.

[42]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .

[43]  Sandra M. Powers,et al.  MEMORY IMPROVEMENT AMONG ADULT LEARNERS , 1987 .

[44]  S. Willis,et al.  Long-term effects of fluid ability training in old-old age , 1990 .

[45]  G. Kennedy,et al.  Cognitive impairment and mortality in older community residents. , 1994, American journal of public health.

[46]  R Zemke,et al.  Occupational therapy for independent-living older adults. A randomized controlled trial. , 1997, JAMA.

[47]  Juster Ft,et al.  Asset and Health Dynamics Among the Oldest Old (AHEAD): initial results from the longitudinal study. Introduction. , 1997 .

[48]  N. Ikegami,et al.  Comprehensive Clinical Assessment in Community Setting: Applicability of the MDS‐HC , 1997, Journal of the American Geriatrics Society.

[49]  J. Cavanaugh,et al.  PERSONALITY AND METAMEMORY CORRELATES OF MEMORY PERFORMANCE IN YOUNGER AND OLDER ADULTS , 1986 .

[50]  L. Radloff.  The CES-D Scale , 1977 .

[51]  B E Fries,et al.  Scaling ADLs within the MDS. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[52]  E F Cook,et al.  Development of the Activities of Daily Vision Scale: A Measure of Visual Functional Status , 1992, Medical care.

[53]  K. Ball,et al.  Visual attention problems as a predictor of vehicle crashes in older drivers. , 1993, Investigative ophthalmology & visual science.

[54]  Beth T. Stalvey,et al.  Timed Instrumental Activities of Daily Living Tasks: Relationship to Visual Function in Older Adults , 2001, Optometry and vision science : official publication of the American Academy of Optometry.

[55]  P. Baltes,et al.  Training research in aging: Attentional processes , 1983 .

[56]  Beth T. Stalvey,et al.  Driving avoidance and functional impairment in older drivers. , 1998, Accident; analysis and prevention.

[57]  Graves Ej,et al.  National Hospital Discharge Survey: annual summary, 1992. , 1994, Vital and health statistics. Series 13, Data from the National Health Survey.

[58]  S. Willis,et al.  Cognitive Training and Everyday Competence , 1987, Annual Review of Gerontology and Geriatrics.

[59]  Sherry L. Willis,et al.  9 Current Issues in Cognitive Training Research , 1990 .