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The Effects of Mixed Working Memory Training on Subsequent Training Gains Among Older Adults

The Effects of Mixed Working Memory Training on Subsequent Training Gains Among Older Adults

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05672771
Acronym
MixedWM
Enrollment
90
Registered
2023-01-05
Start date
2020-08-26
Completion date
2022-01-30
Last updated
2024-03-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cognitive Aging

Brief summary

While an intellectually active and socially integrated lifestyle shows promise for promoting cognitive resilience, the mechanisms underlying any such effects are not well understood. The aim of the current project is test the implications of the mutualism hypothesis, which suggests that intellectual function emerges out of the reciprocal influence of growth in abilities as they are exercised in the ecology of everyday life. Such a view implies that improvement in one component will enhance the modifiability of a related component. An additional aim was to test the idea that mutualistic effects will be enhanced by more diverse training in related skills, such as interleaved training of multiple skills, relative to single-component training. A successive-enrichment paradigm was developed to test this with working memory (WM) as the target for training given its centrality in models of attention, intellectual function, and everyday capacities such as reasoning and language comprehension. All participants receive the same target training, but the nature of the training that precedes it is manipulated. Outcome measures include pre- to posttest gains in working memory and episodic memory, as well as the rate of gain in learning the target task. The principle of enhanced mutualism would predict that more diverse experiences related to the target skill will enhance efficiency in acquiring the target skill.

Detailed description

Within conventional assessments of transfer that examine the effects of training on measures of function at a single time point, these ideas has not been tested. In this project, a successive-enrichment paradigm was used to examine improvement in cognitive skills as a function of different conditions for earlier training. The target for training is working memory (WM) given its centrality in models of attention, intellectual function, and everyday capacities such as reasoning and language comprehension. In the successive-enrichment paradigm, all participants receive the same target training, but the nature of the training that precedes it is manipulated. Thus, in Phase 2, all participants are trained for 10 days on the reading span task (RdgS), in which the task is to verify sensibility in a set of sentences and retain in memory an alphabetic character presented after each sentence. The set size adapts to the participant's skill (in both accuracy of sensibility decisions and memory for the letter set). In Phase 1, participants are randomly assigned to one of four groups designed to test the assumption that related and diverse experiences with the target skill differentially enhance the rate of learning the new skill. In the Same Task (ST) control, participants train on the RdgS, and were expected to be at ceiling in Phase 2. In the Different Single condition (DS), participants trained on a WM task different from that in Phase 1 (the lexical decision span). In the Different Mixed (DM) condition, participants trained on two different interleaved WM tasks, the lexical decision span and the category span. In the non-WM Placebo Control (PC), participants train on a speeded lexical decision task (matched in materials and verbal decision component to the lexical decision span the but requiring no simultaneous memory. Outcome measures include pre- to posttest gains in working memory and episodic memory, as well as the rate of gain in learning the RdgS in Phase 2. The PC and ST controls define the lower and upper limits of performance, respectively. The principle of enhanced mutualism would predict that the DM group will show more efficient learning of the RdgS in Phase 2 than the DS group, which will both show more efficient learning than the PC group.

Interventions

BEHAVIORALDifferent Mixed Condition (DM)

Participants engage in home-based training on two working memory tasks, both different from those in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.

BEHAVIORALDifferent Single Condition (DS)

Participants engage in home-based training on a working memory task that is different from that in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.

BEHAVIORALSame Task (ST) Practice Control

Participants engage in home-based training on the exact same working memory tasks as that in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.

BEHAVIORALNon-WM Placebo Control (PC)

Participants engage in home-based training on speeded verbal decision, which unlike the target task training, has no memory component. Goal is 10 days of training, with 4 8-min blocks of training each day.

Sponsors

National Institute on Aging (NIA)
CollaboratorNIH
University of Illinois at Urbana-Champaign
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)

Eligibility

Sex/Gender
ALL
Age
60 Years to 90 Years
Healthy volunteers
Yes

Inclusion criteria

* Native English speakers or acquisition of English before age 6 yrs old * Self-report of hearing ability sufficient to engage with lab personnel * No stroke in the last 3 years * No current cancer treatment involving radiation or chemotherapy - No self-reported learning disability * No self-reported psychiatric disorder * Willingness to be randomly assigned to training conditions * No plans that would limit participation during the activity period * No participation in a cognitive intervention program in the last year No additional

Exclusion criteria

.

Design outcomes

Primary

MeasureTime frameDescription
Change in Overall Working MemoryChange from baseline to 5-6 wks after pretestAverage change in working memory from pre- to posttest in z-score units (standard unit change). For each working memory measure (Reading Span, Lexical Decision Span, Category Span, Operation Span, and Count Span), the change in z-score units was calculated \[(posttest score - pretest score) / standard deviation of the scores at pretest)\]. The score reported is the mean of these 5 values. A z-score of 0 represents no change from pretest to posttest; the unit is the standard deviations of the sample at pretest (e.g., a score 0.5 would indicate a half standard deviation improvement in overall working memory). There is no agreed upon standard of clinical significance for improvement in working memory
Change in Reading SpanChange from Baseline to 5-6 weeks after pretestChange in Reading Span score from pre- to posttest in z-score units (standard unit change). The change in z-score units was calculated \[(posttest score - pretest score) / standard deviation of the scores at pretest)\]. A z-score of 0 represents no change from pretest to posttest; the unit is the standard deviations of the sample at pretest (e.g., a score 0.5 would indicate a half standard deviation improvement in overall working memory). There is no agreed upon standard of clinical significance for improvement in working memory

Secondary

MeasureTime frameDescription
Training Gains on the Reading Span Task in Phase 22 weeksIn Phase 2, training data on the target task (Reading Span) is collected over 10 days. Training gains are estimated by the coefficients for the condition contrast by training interaction in a linear mixed effects model, in which mean working memory score across training days was modeled as a function of the Phase 1 training condition. Using the lme4 and lmerTest packages for R version 4.2.2, a mixed-effects linear regression model was employed to model the mean daily span score with condition and training day as the fixed factors, and a by-subject random intercept, using the restricted maximum likelihood (REML) method of estimation.

Countries

United States

Participant flow

Participants by arm

ArmCount
Different Mixed Condition (DM)
Training in both Lexical Decision Span and Category Span in Phase 1 (which are both different from the target task Reading Span in Phase 2). Different Mixed Condition (DM): Participants engage in home-based training on two working memory tasks, both different from those in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.
21
Different Single Condition (DS)
Training in the Lexical Decision Span in Phase 1 (which is different from the target task Reading Span in Phase 2). Different Single Condition (DS): Participants engage in home-based training on a working memory task that is different from that in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.
25
Same Task (ST) Practice Control
Training in Reading Span task in Phase 1 (which is the same as target task in Phase 2). Same Task (ST) Practice Control: Participants engage in home-based training on the exact same working memory tasks as that in the target task training. Goal is 10 days of training, with 4 8-min blocks of training each day.
22
Non-WM Placebo Control (PC)
Training in a speeded Lexical Decision task only (which has no memory component) in Phase 1 prior to Phase 2 training in WM. Non-WM Placebo Control (PC): Participants engage in home-based training on speeded verbal decision, which unlike the target task training, has no memory component. Goal is 10 days of training, with 4 8-min blocks of training each day.
22
Total90

Baseline characteristics

CharacteristicDifferent Mixed Condition (DM)Different Single Condition (DS)Same Task (ST) Practice ControlNon-WM Placebo Control (PC)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
20 Participants24 Participants16 Participants18 Participants78 Participants
Age, Categorical
Between 18 and 65 years
1 Participants1 Participants6 Participants4 Participants12 Participants
Age, Continuous72.95 years
STANDARD_DEVIATION 6.34
72.56 years
STANDARD_DEVIATION 6.32
71.36 years
STANDARD_DEVIATION 7.82
70.77 years
STANDARD_DEVIATION 6.76
71.92 years
STANDARD_DEVIATION 6.77
Education Level16.29 years
STANDARD_DEVIATION 2.1
16.84 years
STANDARD_DEVIATION 2.21
16.46 years
STANDARD_DEVIATION 1.84
15.93 years
STANDARD_DEVIATION 2.17
16.39 years
STANDARD_DEVIATION 2.08
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants1 Participants1 Participants0 Participants3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
20 Participants24 Participants21 Participants22 Participants87 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
00 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
1 Participants1 Participants1 Participants0 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants1 Participants1 Participants0 Participants2 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
20 Participants22 Participants20 Participants22 Participants84 Participants
Region of Enrollment
United States
21 Participants25 Participants22 Participants22 Participants90 Participants
Sex: Female, Male
Female
16 Participants20 Participants14 Participants18 Participants68 Participants
Sex: Female, Male
Male
5 Participants5 Participants8 Participants4 Participants22 Participants
Working Memory Composite0.10 z-score
STANDARD_DEVIATION 0.86
-0.05 z-score
STANDARD_DEVIATION 0.77
-0.01 z-score
STANDARD_DEVIATION 0.91
-0.12 z-score
STANDARD_DEVIATION 0.55
-0.02 z-score
STANDARD_DEVIATION 0.77

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 210 / 250 / 220 / 22
other
Total, other adverse events
0 / 210 / 250 / 220 / 22
serious
Total, serious adverse events
0 / 210 / 250 / 220 / 22

Outcome results

Primary

Change in Overall Working Memory

Average change in working memory from pre- to posttest in z-score units (standard unit change). For each working memory measure (Reading Span, Lexical Decision Span, Category Span, Operation Span, and Count Span), the change in z-score units was calculated \[(posttest score - pretest score) / standard deviation of the scores at pretest)\]. The score reported is the mean of these 5 values. A z-score of 0 represents no change from pretest to posttest; the unit is the standard deviations of the sample at pretest (e.g., a score 0.5 would indicate a half standard deviation improvement in overall working memory). There is no agreed upon standard of clinical significance for improvement in working memory

Time frame: Change from baseline to 5-6 wks after pretest

Population: Numbers of participants (N=80) differ from baseline (N=90) because 10 participants declined to continue the research activities.

ArmMeasureValue (MEAN)Dispersion
Different Mixed Condition (DM)Change in Overall Working Memory0.42 Standard unit changeStandard Deviation 1.4
Different Single Condition (DS)Change in Overall Working Memory0.26 Standard unit changeStandard Deviation 0.66
Same Task (ST) Practice ControlChange in Overall Working Memory-0.01 Standard unit changeStandard Deviation 0.57
Non-WM Placebo Control (PC)Change in Overall Working Memory0.04 Standard unit changeStandard Deviation 0.38
p-value: 0.355ANOVA
Primary

Change in Reading Span

Change in Reading Span score from pre- to posttest in z-score units (standard unit change). The change in z-score units was calculated \[(posttest score - pretest score) / standard deviation of the scores at pretest)\]. A z-score of 0 represents no change from pretest to posttest; the unit is the standard deviations of the sample at pretest (e.g., a score 0.5 would indicate a half standard deviation improvement in overall working memory). There is no agreed upon standard of clinical significance for improvement in working memory

Time frame: Change from Baseline to 5-6 weeks after pretest

Population: Numbers of participants (N=80) differ from baseline (N=90) because 10 participants declined to continue the research activities.

ArmMeasureValue (MEAN)Dispersion
Different Mixed Condition (DM)Change in Reading Span0.70 standard unit changeStandard Deviation 0.66
Different Single Condition (DS)Change in Reading Span0.06 standard unit changeStandard Deviation 0.85
Same Task (ST) Practice ControlChange in Reading Span-0.03 standard unit changeStandard Deviation 0.77
Non-WM Placebo Control (PC)Change in Reading Span0.14 standard unit changeStandard Deviation 0.66
p-value: <0.02ANOVA
Secondary

Training Gains on the Reading Span Task in Phase 2

In Phase 2, training data on the target task (Reading Span) is collected over 10 days. Training gains are estimated by the coefficients for the condition contrast by training interaction in a linear mixed effects model, in which mean working memory score across training days was modeled as a function of the Phase 1 training condition. Using the lme4 and lmerTest packages for R version 4.2.2, a mixed-effects linear regression model was employed to model the mean daily span score with condition and training day as the fixed factors, and a by-subject random intercept, using the restricted maximum likelihood (REML) method of estimation.

Time frame: 2 weeks

Population: Numbers of participants (N=80) differ from baseline (N=90) because 10 participants declined to continue the research activities.

ArmMeasureValue (MEAN)Dispersion
Different Mixed Condition (DM)Training Gains on the Reading Span Task in Phase 2.021 coefficientStandard Error 0.011
Different Single Condition (DS)Training Gains on the Reading Span Task in Phase 2.034 coefficientStandard Error 0.01
Same Task (ST) Practice ControlTraining Gains on the Reading Span Task in Phase 2.021 coefficientStandard Error 0.01
Non-WM Placebo Control (PC)Training Gains on the Reading Span Task in Phase 20 coefficientStandard Error 0
p-value: <0.05Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026