Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Department

Social Work

First Advisor's Name

Barbara Thomlison

First Advisor's Committee Title

Committee chair

Second Advisor's Name

Mark Macgowan

Second Advisor's Committee Title

Committee member

Third Advisor's Name

Nicole Ruggiano

Third Advisor's Committee Title

Committee member

Fourth Advisor's Name

Raul Gonzalez

Fourth Advisor's Committee Title

Committee member

Keywords

cognitive training, cognitive decline, older adults, intervention

Date of Defense

6-28-2016

Abstract

The negative effects of cognitive decline and impairment can be devastating for older adults and their families, and extremely costly for the healthcare system and the society. Cognitive training aims to maintain or improve cognition by utilizing repetitive tasks that target specific cognitive skills. The majority of cognitive training studies in healthy older adults involved home-based, individual, computerized approach or onsite, group, paper-and-pencil format. These approaches may not be suitable for individuals with serious health or mobility issues, caregiving responsibilities, limited transportation, or limited computer or internet access. A novel, home-based, self-administered cognitive training intervention was developed to address these barriers. It involves two older adults taking turns to administer paper-and-pencil tasks to one another. The purpose of the study was to evaluate feasibility and participant acceptability of this novel approach to cognitive training. Eighteen participants (9 dyads) 65-91 years (M = 75.94, SD = 7.66) underwent assessment and began intervention. Assessment included measures of cognitive skills and self-reported quality of life, health status, and daily functioning. Four dyads were married couples who had sessions at home. Other dyads met at various public locations and included friends, neighbors, or unfamiliar older adults connected by the researcher. Fourteen participants (7 dyads) completed cognitive training intervention that included 9-24 sessions (M = 15.14, SD = 5.30) over 4-21 weeks (M = 12.21, SD = 5.44), post-intervention assessment, and detailed interviews. Quantitative data demonstrated that the sample did not decline on any cognitive measures and exhibited improvement on visuospatial skills and delayed visual memory (Cohen’s d = .67 & -1.10). Additional analyses revealed that the results were mainly attributable to improvement in females (Cohen’s d = -1.84 & -1.35), who demonstrated weaknesses in these cognitive skills at baseline. The participants reported that the dyadic approach was flexible, convenient, and enjoyable. They also provided valuable feedback and suggestions for modifying the content and other aspects of the intervention. The findings suggest that dyadic cognitive training is feasible and well-received by older adults. Those with weaknesses in cognitive domains may show larger gains in respective domains and benefit most from cognitive training.

Identifier

FIDC000718

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