July 9, 2009
Cognitive training reduces older adults' health care costs
Older adults' predicted annual medical care expenditures can be reduced significantly through the use of cognitive training, according to a research team led by Fredric Wolinsky, Ph.D., who holds the John W. Colloton Chair in Health Management and Policy in the University of Iowa College of Public Health.
The team evaluated the effects of three cognitive training interventions (memory, reasoning, or speed of processing) on changes in predicted medical care expenditures. Five-year follow-up data were available for 1,804 of the 2,802 original study participants.
The researchers found that at one and five years post-training, annual predicted expenditures declined by $223 and $128, respectively, in the speed-of-processing treatment group. There were no statistically significant changes in the memory or reasoning treatment groups.
"Our results have important health policy relevance," Wolinsky said. "The speed-of-processing intervention was able to reduce predicted medical expenditures by 3.2 percent between baseline and the first annual follow-up. This translates into significant potential savings for the Medicare population."
The study, part of a National Institutes of Health-funded multi-site trial known as Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE), was published June 29 online in the journal BMC Health Services Research.
The speed-of-processing training is a computer-based program designed to improve users' ability to identify and locate visual information quickly. The easy-to-use program has the potential to be widely disseminated and installed on home computers, increasing the public health impact, Wolinsky said.
As to how the cognitive training reduced predicted expenditures, the investigators noted that speed of processing operates through sensory-motor elaboration and repetition, and procedural tasks have a broader pattern of regional brain activation than explicit memory tasks.
"The onset of cognitive limitations in older adults is associated with increased health services use and medical expenditures," Wolinsky said. "We believe that the resulting improvements in brain activation and/or structure delayed the onset or reduced the risk of cognitive slowing, which has been argued to be among the most significant contributors to overall cognitive decline."
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