Biomedical subjects

Michael Marsiske

Publications and source records attributed to Michael Marsiske.

6 recordsLinked to original sources

PubMed2006

Long-term effects of cognitive training on everyday functional outcomes in older adults.

CONTEXT: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. OBJECTIVE: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. INTERVENTIONS: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. MAIN OUTCOME MEASURES: Self-reported and performance-based measures of daily function and cognitive abilities. RESULTS: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). CONCLUSIONS: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00298558.

Activities of Daily Living↗

PubMed2006

Subjective cognitive function and decline among older adults with psychometrically defined amnestic MCI.

OBJECTIVE: To examine the relationship between subjective cognitive function and subsequent cognitive decline among individuals with psychometrically defined amnestic mild cognitive impairment (MCI), and to determine whether the presence of depressive symptoms modifies this relationship. METHOD: Fifty-five individuals met psychometric criteria for amnestic mild cognitive impairment (MCI). Cognitive decline was measured using the Mini-Mental State Examination (MMSE), which was administered at baseline and at follow-up two years later. Subjective cognitive function was examined using two different one-item memory complaints, as well as a scale focused on current level of cognitive function relative to past function and a scale focused on forgetting in specific everyday situations. RESULTS: In multiple regression analyses, the one-item complaint of change in memory at baseline predicted future cognitive decline. There was a significant interaction effect whereby this association was stronger in participants who endorsed fewer symptoms of depression. CONCLUSION: Individuals showing memory deficits consistent with amnestic MCI have at least some insight regarding cognitive decline and the extent to which subjective cognitive function is useful in predicting future decline may depend on what particular questions are asked as well as presence of depressive symptoms.

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PubMed2005

Intraindividual variability may not always indicate vulnerability in elders' cognitive performance.

This study examined consistency of performance, or intraindividual variability, in older adults' performance on 3 measures of cognitive functioning: inductive reasoning, memory, and perceptual speed. Theoretical speculation has suggested that such intraindividual variability may signal underlying vulnerability or neurologic compromise. Thirty-six participants aged 60 and older completed self-administered cognitive assessments twice a day for 60 consecutive days. Intraindividual variability was not strongly correlated among the 3 cognitive measures, but, over the course of the study, intraindividual variability was strongly intercorrelated within a task. Higher average performance on a measure was associated with greater performance variability, and follow-up analyses revealed that a higher level of intraindividual variability is positively associated with the magnitude of a person's practice-related gain on a particular measure. The authors argue that both adaptive (practice-related) and maladaptive (inconsistency-related) intraindividual variability may exist within the same individuals over time.

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PubMed2002

Effects of cognitive training interventions with older adults: a randomized controlled trial.

CONTEXT: Cognitive function in older adults is related to independent living and need for care. However, few studies have addressed whether improving cognitive functions might have short- or long-term effects on activities related to living independently. OBJECTIVE: To evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older, independent-living adults. DESIGN: Randomized, controlled, single-blind trial with recruitment conducted from March 1998 to October 1999 and 2-year follow-up through December 2001. SETTING AND PARTICIPANTS: Volunteer sample of 2832 persons aged 65 to 94 years recruited from senior housing, community centers, and hospital/clinics in 6 metropolitan areas in the United States. INTERVENTIONS: Participants were randomly assigned to 1 of 4 groups: 10-session group training for memory (verbal episodic memory; n = 711), or reasoning (ability to solve problems that follow a serial pattern; n = 705), or speed of processing (visual search and identification; n = 712); or a no-contact control group (n = 704). For the 3 treatment groups, 4-session booster training was offered to a 60% random sample 11 months later. MAIN OUTCOME MEASURES: Cognitive function and cognitively demanding everyday functioning. RESULTS: Thirty participants were incorrectly randomized and were excluded from the analysis. Each intervention improved the targeted cognitive ability compared with baseline, durable to 2 years (P<.001 for all). Eighty-seven percent of speed-, 74% of reasoning-, and 26% of memory-trained participants demonstrated reliable cognitive improvement immediately after the intervention period. Booster training enhanced training gains in speed (P<.001) and reasoning (P<.001) interventions (speed booster, 92%; no booster, 68%; reasoning booster, 72%; no booster, 49%), which were maintained at 2-year follow-up (P<.001 for both). No training effects on everyday functioning were detected at 2 years. CONCLUSIONS: Results support the effectiveness and durability of the cognitive training interventions in improving targeted cognitive abilities. Training effects were of a magnitude equivalent to the amount of decline expected in elderly persons without dementia over 7- to 14-year intervals. Because of minimal functional decline across all groups, longer follow-up is likely required to observe training effects on everyday function.

Activities of Daily Living↗

PubMed2002

Well- and ill-defined measures of everyday cognition: relationship to older adults' intellectual ability and functional status.

The present study examined 2 approaches to the measurement of everyday cognition in older adults. Measures differing in the degree of structure offered for solving problems in the domains of medication use, financial management, and food preparation and nutrition were administered to a sample of 130 community-dwelling older adults ranging in age from 60 to 90 (M = 73 years, SD = 7.02 years). Well-defined and ill-defined everyday problem-solving measures, which varied in the amount of means-end-related information provided to participants, were used. The study found that (a) well- and ill-defined measures were moderately interrelated, (b) the 2 approaches were differentially related to basic cognitive abilities, and (c) together the 2 approaches explained over half of the variance in older adults' everyday instrumental functioning and were in fact better predictors of everyday functioning than traditional psychometric cognitive measures. Discussion focuses on the differential importance of both methods for assessing older adults' everyday cognitive functioning.

Activities of Daily Living↗

PubMedDate not supplied

A growth curve model of learning acquisition among cognitively normal older adults.

The objective of this study was to model recall and learning on the Auditory Verbal Learning Test using latent growth curve techniques. Participants were older adults recruited for the ACTIVE cognitive intervention pilot. A series of nested models revealed that an approximately logarithmic growth curve model provided optimal fit to the data. Although recall and learning factors were statistically uncorrelated, a fitted multivariate model suggested that initial recall was significantly associated with demographic characteristics but unrelated to health factors and cognitive abilities. Individual differences in learning were related to race/ethnicity, speed of processing, verbal knowledge, and global cognitive function level. These results suggest that failing to recognize initial recall and learning as distinct constructs clouds the interpretation of supraspan memory tasks.

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