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Working Memory Training for Older Participants: A Control Group Training Regimen and Initial Intellectual Functioning Assessment
Published on: September 20, 2020
Change in Learning and Memory Partially Mediates Effects of Compensatory Cognitive Training on Self-Reported
Maya Elin O'Neil1, David Cameron, Kate Shirley
1VA Portland Health Care System, Portland, Oregon (Drs O'Neil, Roost, Storzbach, and Huckans, Mr Cameron, and Mss Shirley and Sano); Departments of Psychiatry (Drs O'Neil, Storzbach, and Huckans), Medical Informatics and Clinical Epidemiology (Dr O'Neil), and Neurology (Dr Storzbach), Oregon Health & Science University, Portland; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California (Drs Twamley and Jak); Department of Psychiatry, University of California San Diego, La Jolla (Drs Twamley and Jak); VA Puget Sound Health Care System, Seattle, Washington (Drs Williams, Turner, and Pagulayan); and Departments of Rehabilitation Medicine (Drs Williams and Turner) and Psychiatry and Behavioral Sciences (Dr Pagulayan), University of Washington School of Medicine, Seattle.
Objective:
To examine associations among compensatory cognitive training (CCT), objective cognitive functioning, and self-reported cognitive symptoms. We examined whether change in objective cognitive functioning associated with participation in CCT at 10-week follow-up mediates change in self-reported cognitive symptoms associated with CCT at 15-week follow-up.
Setting:
Three VA outpatient mental health clinics.
Participants:
Veterans with a history of mild traumatic brain injury who reported cognitive deficits.
Design:
Randomized controlled trial post hoc causal mediation analysis.
Main Measures:
Self-reported cognitive symptoms were measured by the Prospective-Retrospective Memory Questionnaire and the Multiple Sclerosis Neuropsychological Screening Questionnaire. Objective cognitive functioning was measured using a battery of neuropsychological tests.
Results:
Improvement on the Hopkins Verbal Learning Test-Revised (HVLT-R) Delayed Recall test mediated the association between participation in CCT and decrease in the Prospective-Retrospective Memory Questionnaire total score. Improvement on the HVLT-R Total Recall and HVLT-R Delayed Recall tests both meditated the association between participation in CCT and decrease in the Multiple Sclerosis Neuropsychological Screening Questionnaire total score. No other measures of objective cognitive functioning were significant mediators.
Conclusion:
Patients' perceptions of cognitive symptom improvement due to CCT are partially mediated by learning and memory, though these subjective improvements occur regardless of other changes in objective cognitive functioning associated with CCT.
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