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Psychologist Karlene Ball's older-driver intervention is part of a major applied gerontology study funded by the National Institutes of Health, and she is one of the principal investigators. Called ACTIVE—Advanced Cognitive Training for Independent and Vital Elderly—it aims to improve older people's functioning by training them on cognitive tasks.

ACTIVE started in the late 1990s with 2,802 participants 65 and older. Across six different sites, ACTIVE is testing three interventions that hone adults' memory, reasoning and speed of processing, the intervention developed by Ball.

Initial results were not that encouraging. Two years into the study, participants improved in their cognitive skills but reported no transfer to their ability to perform daily tasks, such as preparing meals, doing housework, managing money and reacting to road signs—perhaps because most participants at this stage were quite healthy, Ball says.

Five years into the study, the speed-of-processing group showed statistically significant gains in everyday activities for those who received the training, according to a 2006 study in the Journal of the American Medical Association (Vol. 296, No. 23).

Speed-of-processing training also appears to reduce aging adults' depression and improve their quality of life, notes University of Iowa sociologist Fredric D. Wolinsky, PhD, who has conducted several secondary analyses of the ACTIVE data.

In a study in press at the Journal of Gerontology: Medical Sciences, participants who took the speed-of-processing intervention were 30 percent less likely than no-intervention controls or the other intervention groups to have depressive symptoms both at year one and year five, Wolinksy's team found. In other studies, the team also found that members of the processing speed group were less likely to experience declines in their quality of life.

The intervention may stem depression in one of two ways, Wolinsky suggests. One is via indirect mechanisms, where a person's mood improves because he or she is better able to function in a variety of life domains, including driving. The other is through direct brain mechanisms, where the intervention activates aspects of the brain's reward and attentional systems in new ways.

Either way such approaches present an important and safe alternative to helping older adults improve their lives, he believes.

"Given the importance of depressive symptoms and the risks of overmedication in older adults, nonpharmacological approaches, like the speed-of-processing intervention, have considerable promise in gerontology and geriatrics," he says.

—T. DeAngelis

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