Does age matter? Effects of cognitive rehabilitation across the age span

Cognitive remediation (CR) therapy in its various disguises can be helpful for people with schizophrenia but it is not clear if patient characteristics are likely to interfere with its effectiveness.

This paper describes the assessment of one putative moderating variable, age, on the outcome of CRT in a rigorous randomised control trial with memory, cognitive flexibility and planning as primary outcomes and social behaviour, symptoms and self-esteem as secondary outcomes. Calendar age was divided into younger (< 40; N55) and older (40 or more years; N30). There were no differences between the groups at baseline in their cognitive, social or demographic data except on predicted variables.

Younger people benefited more from cognitive remediation in two of the three cognitive domains tested. In the memory domain both groups benefited. Only negative symptoms showed a moderating effect of age on CRT, where again the younger group showed improvements in the context of CRT but the older group did not. When older people did show a cognitive advantage in memory following therapy this cognitive improvement benefited social behaviour.

CRT needs some modification to increase the benefits to older participants. However, any cognitive improvements do still seem to have a beneficial effect.