A Randomized Controlled Trial of Cognitive Training Using a Visual Speed of Processing Intervention in Middle Aged and Older Adults

Wolinsky, Fredric D.; Weg, Mark W. Vander; Howren, M. Bryant; Jones, Michael P.; Dotson, Megan M. · 2013 · OpenAlex-citations

DOI: 10.1371/journal.pone.0061624

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Summary

This randomized controlled trial, the Iowa Healthy and Active Minds Study (IHAMS), investigated whether visual speed of processing (VSP) training could prevent or reverse age-related cognitive decline in middle-aged and older adults. Motivated by the high prevalence of cognitive decline and the limitations of prior studies—specifically the Advanced Cognitive Trial for Independent and Vital Elderly (ACTIVE)—the researchers sought to determine if VSP training effects were robust against placebo effects, applicable to younger adults (ages 50–64), and feasible for widespread implementation via home computers. The study randomized 681 participants into two age bands (50–64 and ≥65 years) across four arms: three VSP training groups (10 hours on-site, 14 hours on-site with boosters, and 10 hours at-home) and an on-site attention control group using computerized crossword puzzles. The primary outcome was the Useful Field of View (UFOV) test, with secondary outcomes including Trail Making Tests A and B, Symbol Digit Modalities Test (SDMT), Stroop Test, Controlled Oral Word Association Test, and Digit Vigilance Test. Assessments occurred at baseline and one year. Anal utilized linear mixed models with Blom rank transformations to normalize data and calculate standardized effect sizes (Cohen’s d). Results from the 620 participants (91%) who completed the study showed that all three VSP intervention groups achieved statistically significant small to medium improvements compared to the control group. Effect sizes ranged from Cohen’s d = 0.204 to 0.579 across various tests. Specifically, VSP training yielded improvements on UFOV, Trails A and B, SDMT, and Stroop Word. These gains were translated into years of protection against age-related decline: 3.0 to 4.1 years for UFOV, 2.2 to 3.5 years for Trails A, 1.5 to 2.0 years for Trails B, 5.4 to 6.6 years for SDMT, and 2.3 to 2.7 years for Stroop Word. Notably, the effects were comparable across both age bands and between on-site and at-home delivery methods, despite lower adherence rates in the at-home group. The study concludes that VSP training, delivered via standard personal computers, effectively stabilizes or improves cognitive processing speed in adults aged 50 and older. By demonstrating efficacy in a younger cohort and validating home-based delivery, the findings suggest that this intervention is a feasible, scalable strategy for mitigating cognitive decline. The results support the broader potential of cognitive training to promote positive brain plasticity and maintain functional independence in aging populations.

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• cognitive aging