International Psychogeriatrics

  • International Psychogeriatrics 01 May 2010 22 : pp 470-478
  • Copyright © International Psychogeriatric Association 2009
  • DOI: 10.1017/S1041610209991281 (About DOI)
  • Published online: 15 December 2009

Research Article

Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial

Fredric D. Wolinskya1 c1, Henry Mahnckea2, Mark W. Vander Wega3, Rene Martina4, Frederick W. Unverzagta5, Karlene K. Balla6, Richard N. Jonesa7 and Sharon L. Tennstedta8

a1 Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa, U.S.A.

a2 Posit Science Corporation, San Francisco, California, U.S.A.

a3 Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, U.S.A.

a4 Department of Adult Nursing, College of Nursing, University of Iowa, Iowa City, Iowa, U.S.A.

a5 Department of Psychiatry, College of Medicine, Indiana University, Indianapolis, Indiana, U.S.A.

a6 Department of Psychology, College of Arts and Sciences, University of Alabama, Birmingham, Alabama, U.S.A.

a7 Research Department, Hebrew Senior Life, Boston, Massachusetts, U.S.A.

a8 Aging Studies, New England Research Institutes, Boston, Massachusetts, U.S.A.


Background: We evaluated the effects of cognitive training on self-rated health at 1, 2, 3, and 5 years post-baseline.

Methods: In the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) randomized controlled trial, 2,802 older adults (≥65 years) were randomly assigned to memory, reasoning, speed of processing, or no-contact control intervention groups. Complete data were available for 1,804 (64%) of the 2,802 participants at five years. A propensity score model was adjusted for attrition bias. The self-rated health question was coded using the Diehr et al. (2001) transformation (E = 95/VG = 90/G = 80/F = 30/P = 15), and analyzed with change-score regression models.

Results: The speed of processing (vs. no-contact control) group had statistically significant improvements (or protective effects) on changes in self-rated health at the 2, 3 and 5 year follow-ups. The 5-year improvement was 2.8 points (p = 0.03). No significant differences were observed in the memory or reasoning groups at any time.

Conclusion: The speed of processing intervention significantly protected self-rated health in ACTIVE, with the average benefit equivalent to half the difference between excellent vs. very good health.

(Received June 01 2009)

(Revised August 26 2009)

(Revised September 21 2009)

(Accepted September 24 2009)

(Online publication December 15 2009)


c1 Correspondence should be addressed to: Fredric D. Wolinsky, Department of Health Management, University of Iowa, 200 Hawkins Drive, E205-GH, Iowa City, IA 52242, U.S.A. Phone: +1 319 384 5129; Fax: +1 319 384 5125. Email:

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