Division of General Internal Medicine & Geriatrics, University of Indiana School of Medicine, Indianapolis, IN 46202, USA.
Center for Aging Research, Regenstrief Institute, Indianapolis, IN 46202, USA.
Int J Environ Res Public Health. 2023 Mar 11;20(6):4941. doi: 10.3390/ijerph20064941.
The purpose of this study was to examine the effect of cognitive training on the risk of experiencing a fall across 10 years. The study used data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial. Older adults aged 65-94 were randomly assigned to speed of processing, memory, or reasoning training or to a no-contact control group ( = 2802). The experience of a fall in the prior two months was assessed at baseline and at 1, 2, 3, 5, and 10 years posttest. Cox proportional hazards explored group differences in the total sample, as well as group differences for participants classified as low risk ( = 2360) and high risk ( = 442) for future falls. The data were censored at the first reported fall postbaseline. After baseline, 983 (35.08%) participants across the full sample reported a fall. There were no significant effects of the training in the full sample or in the low-risk sample of participants. However, the participants at greater risk for future falls in the speed of processing training group were 31% less likely (HR = 0.69; 95% CI = 0.48, 0.998, = 0.049) to experience a subsequent fall across ten years compared to the control group. Reasoning and memory training did not reduce a future fall in the high-risk sample. The speed of processing training reduced the risk of future falls across ten years in the high-risk participants. Future work should examine moderators and mediators of training in at-risk samples.
本研究旨在探讨认知训练对 10 年内跌倒风险的影响。该研究使用了来自高级认知训练对独立和重要老年人（ACTIVE）随机对照试验的数据。65-94 岁的老年人被随机分配到速度处理、记忆或推理训练组或无接触对照组（=2802）。在基线、1、2、3、5 和 10 年随访时，评估了前两个月的跌倒经历。Cox 比例风险模型探讨了总样本中组间的差异，以及根据未来跌倒低风险（=2360）和高风险（=442）分类的参与者之间的组间差异。数据在基线后首次报告跌倒时进行了删失。基线后，2802 名参与者中有 983 名（35.08%）报告了跌倒。在全样本或低风险样本中，训练均无显著效果。然而，在速度处理训练组中，未来跌倒风险较高的参与者发生后续跌倒的可能性降低了 31%（HR=0.69；95%CI=0.48,0.998，=0.049）。推理和记忆训练并未降低高风险样本中未来跌倒的风险。速度处理训练降低了高风险参与者未来十年内跌倒的风险。未来的工作应该研究高危人群中训练的调节因素和中介因素。
