Skip to main content Accessibility help

Cognitive rehabilitation in the elderly: An evaluation of psychosocial factors

  • GORDON WINOCUR (a1) (a2) (a3) (a4), HEATHER PALMER (a1), DEIRDRE DAWSON (a5) (a6) (a7), MALCOLM A. BINNS (a1), KRISTEN BRIDGES (a1) and DONALD T. STUSS (a1) (a2) (a6) (a8)...


In this study, we report changes in psychosocial function in two groups of older adults that participated in the experimental trial of our cognitive rehabilitation program. The results, based on tests that measured a range of psychosocial attributes, showed that, following training, participants improved in terms of overall well-being, as well as in specific areas that included perceived happiness, coping strategies, and quality of life. An important finding was that improvements were also observed in long-term follow-up testing. Both groups benefited from training, but the effect was greater in the group that received training before undergoing a control procedure. The results, which show that the benefits of our rehabilitation program extend into the psychosocial domain, underscore the potentially important relationship between psychosocial factors and cognitive performance in older adults. (JINS, 2007, 13, 153–165.)


Corresponding author

Correspondence and reprint requests to: Gordon Winocur, Ph.D., Rotman Research Institute, Baycrest, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada. E-mail:


Hide All


Albert, M.S., Jones, K., Savage, C.R., Berkman, L., Seeman, T., Blazer, D., & Rowe, J.W. (1995). Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychology of Aging, 10, 578589.
Arbuckle, T.Y., Gold, D., & Andres, D. (1986). Cognitive functioning of older people in relation to social and personality variables. Psychology and Aging, 1, 5562.
Arbuckle, T.Y., Maag, U., Pushkar, D., & Chaikelson, J. (1998). Individual differences in trajectory of intellectual development over 45 years of adulthood. Psychology and Aging, 13, 663675.
Bailis, D.S. & Chipperfield, J.G. (2002). Compensating for losses in perceived personal control over health: A role for collective self-esteem in healthy aging. The Journals of Gerontology: Series B, Psychological Sciences and Social Science, 57B, 531539.
Baltes, P.B. & Willis, S.L. (1982). Plasticity and enhancement of intellectual functioning in old age: Penn State's Adult Development and Enrichment Project (ADEPT). In F.I.M. Craik & S.E. Trehub (Eds.), Aging and cognitive processes (pp. 353389). New York: Plenum Press.
Ben-Yishay, Y. (1996). Reflections on the evolution of the therapeutic milieu concept. Neuropsychological Rehabilitation, 6, 327343.
Brink, T.L., Yesavage, J.A., Lum, O., Heersema, P.H., Adey, M., & Rose, T.S. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 3743.
Burgess, P.W., Alderman, N., Evans, J., Emslie, H., & Wilson, B.A. (1998). The ecological validity of tests of executive function. Journal of the International Neuropsychological Society, 4, 547558.
Churchill, J.D., Galvez, R., Colcombe, S., Swain, R.A., Kramer, A.F., & Greenough, W.T. (2002). Exercise, experience and the aging brain. Neurobiology of Aging, 23, 941955.
Colcombe, S.J. & Kramer, A.F. (2003). Fitness effects on the cognitive function of older adults: A meta-analysis study. Psychological Science, 14, 125130.
Colcombe, S.J., Erickson, K.I., Raz, N., Webb, A.G., Cohen, N.J., McAuley, E., & Kramer, A.F. (2003). Aerobic fitness reduces brain tissue loss in aging humans. The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 58A, 176180.
Cope, D.N. (1995). The effectiveness of traumatic brain injury rehabilitation: A review. Brain Injury, 9, 649670.
Coulson, I., Marino, R., & Minichiello, V. (2001). Older people's knowledge and practice about lifestyle behaviors that may prevent vascular dementia. Archives of Gerontology and Geriatrics, 33, 273285.
Dawson, D., Winocur, G., & Moscovitch, M. (1999). The psychological environment and cognitive rehabilitation in the elderly. In D.T. Stuss, G. Winocur, & I.H. Robertson (Eds.), Cognitive neurorehabilitation (pp. 94108). Cambridge, UK: Cambridge University Press.
Emery, C., Huppert, F., & Schein, R. (1995). Relationships among age, exercise, health, and cognitive function in a British sample. The Gerontologist, 35, 378385.
Flanagan, J.C. (1978). A research approach to improving our quality of life. American Psychologist, 33, 138147.
Folkman, S., Lazarus, R.S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R.J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 9921003.
Greenwood, C.E. & Winocur, G. (1999). Decline in cognitive function with aging: Impact of diet. Mature Medicine Canada, 2, 205209.
Hultsch, D.F., Hertzog, C., Dixon, R.A., & Small, B.J. (1998). Memory change in the aged. New York: Cambridge University Press.
Hultsch, D.F., Hertzog, C., Small, B.J., & Dixon, R.A. (1999). Use it or lose it: Engaged lifestyle as a buffer of cognitive decline in aging? Psychology of Aging, 14, 520527.
Jennings, J.M. & Darwin, A.L. (2003). Efficacy beliefs, everyday behavior, and memory performance among older elderly adults. Educational Gerontology, 29, 7191.
Kozma, A. & Stones, M.J. (1980). The measurement of happiness: Development of the Memorial University of Newfoundland Scale of Happiness (MUNSH). Journal of Gerontology, 35, 906912.
Kramer, A.F., Bherer, L., Colcombe, S.J., Dong, W., & Greenough, W.T. (2004). Environmental influences on cognitive and brain plasticity during aging. Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 59A, 940957.
Krpan, K.K., Levine, B., Stuss, D.T., & Dawson, D.R., (in press). Executive function and coping at one-year post traumatic brain injury. Journal of the International Neuropsychological Society.
Laurin, D., Verreault, R., Lindsay, J., MacPherson, K., & Rockwood, K. (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology, 58, 498504.
Levine, B., Stuss, D.T., Winocur, G., Binns, M.A., Fahy, L., Mandic, M., Bridges, K., & Robertson, I.H. (2007, this issue). Cognitive rehabilitation in the elderly: Effects on strategic behavior in relation to goal management. Journal of the International Neuropsychological Society, 13, 143152.
Menec, V.H. & Chipperfield, J.G. (1997). Remaining active in later life. The role of locus of control in seniors' leisure activity participation, health, and life satisfaction. Journal of Aging and Health, 9, 105125.
Morton, M.V. & Wehman, P. (1995). Psychosocial and emotional sequelae of individuals with traumatic brain injury: A literature review and recommendations. Brain Injury, 9, 8192.
Nosek, M.A., Fuhrer, M.J., & Howland, C.A. (1992). Independence among people with disabilities: II. The Personal Independence Profile. Rehabilitation Counseling Bulletin, 36, 2136.
Prigatano, G.P. (1986). Personality and psychosocial consequences of brain injury. In G.P. Prigatano, D.J. Fordyce, H.K. Zeiner, J.R. Roueche, M. Pepping, & B.C. Woods (Eds.), Neuropsychological rehabilitation after brain injury (pp. 2950). Baltimore: Johns Hopkins University Press.
Pushkar, D., Arbuckle, T., Conway, M., Chaikelson, J., & Maag, U. (1997). Everyday activity parameters and competence in older adults. Psychology of Aging, 12, 600609.
Rath, J., Simon, D., Langenbahn, R., & Diller, L. (2003). Group treatment of problem-solving deficits with traumatic brain injury: A randomised outcome study. Neuropsychological Rehabilitation, 13, 461488.
Rattock, J., Ben-Yishay, Y., Ezrachi, O., Lakin, P., Piasetsky, E., Ross, B., Silver, S., Vakil, E., Zide, E., & Diller, L. (1992). Outcome of different treatment mixes in a multidimensional neuropsychological rehabilitation program. Neuropsychology, 6, 395416.
Rejeski, W.J. & Mihalko, S.L. (2001). Physical activity and quality of life in older adults. The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 56A, 2335.
Rodin, J. & McAvay, G. (1992). Determinants of change in perceived health in a longitudinal study of older adults. Journal of Gerontology, 47, 373384.
Rodin, J., Timko, C., & Harris, S. (1985). The construct of control: Biological and psychosocial correlates. In C. Eisdorfer, M.P. Lawton, & G.L. Maddox (Eds.), Annual review of gerontology and geriatrics (Vol. 5, pp. 355). New York: Springer.
Ruff, R.M. (1999). Discipline-specific approach versus individual care. In N.R. Varney & R.J. Roberts (Eds.), The evaluation and treatment of mild traumatic brain injury (pp. 99113). Mahwah, NY: Lawrence Erlbaum Associates, Publishers.
Ruff, R.M. & Niemann, H. (1990). Cognitive rehabilitation versus day treatment in head-injured adults: Is there an impact on emotional and psychosocial adjustment? Brain Injury, 4, 339347.
Scarmeas, N., Levy, G., Tang, M.-X., Manly, J., & Stern, Y. (2001). Influence of leisure activity on the incidence of Alzheimer's disease. Neurology, 57, 22362242.
Scheier, M.F. & Carver, C.S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219247.
Stuss, D.T. & Benson, D.F. (1984). Neuropsychological studies of the frontal lobe. Psychological Bulletin, 95, 328.
Stuss, D.T., Robertson, I.H., Craik, F.I.M., Levine, B., Alexander, M.P., Black, S., Dawson, D., Binns, M.A., Palmer, H., Downey-Lamb, M., & Winocur G. (2007, this issue). Cognitive rehabilitation in the elderly: A randomized trial to evaluate a new protocol. Journal of the International Neuropsychological Society, 13, 120131.
Wilson, R.S. (1987). Rehabilitation of memory. New York: Guilford Press.
Wilson, R.S. & Bennett, D.A. (2003). Cognitive activity and risk of Alzheimer's disease. Psychological Science, 12, 8791.
Wilson, R.S., Mendes de Leon, C.F., Barnes, L.L., Schneider, J.A., Bienias, J.L., Evans, D.A., & Bennett, D.A. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. Journal of the American Medical Association, 287, 742748.
Winocur, G. & Moscovitch, M. (1990). A comparison of cognitive function in institutionalized and community dwelling old people of normal intelligence. Canadian Journal of Psychology, 44, 435444.
Winocur, G., Moscovitch, M., & Freedman, J. (1987). An investigation of cognitive function in relation to psychosocial variables in institutionalized old people. Canadian Journal of Psychology, 41, 257269.
Winocur, G., Craik, F.I.M., Levine, B., Robertson, I.H., Binns, M.A., Alexander, M., Black, S., Dawson, D., Palmer, H., Downey-Lamb, M., & Stuss, D.T. (2007, this issue). Cognitive rehabilitation in the elderly: Overview and future directions. Journal of the International Neuropsychological Society, 13, 166171.


Related content

Powered by UNSILO

Cognitive rehabilitation in the elderly: An evaluation of psychosocial factors

  • GORDON WINOCUR (a1) (a2) (a3) (a4), HEATHER PALMER (a1), DEIRDRE DAWSON (a5) (a6) (a7), MALCOLM A. BINNS (a1), KRISTEN BRIDGES (a1) and DONALD T. STUSS (a1) (a2) (a6) (a8)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.