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

  • Fredric D. Wolinsky (a1), Henry Mahncke (a2), Mark W. Vander Weg (a3), Rene Martin (a4), Frederick W. Unverzagt (a5), Karlene K. Ball (a6), Richard N. Jones (a7) and Sharon L. Tennstedt (a8)...


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.


Corresponding author

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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