The ‘Brain Gym’ Approach: Testing a Community-based Brain Training Model for Older Adults

Computerized brain training programs represent an area of increasing interest because of the protective and restorative effects of regular, targeted cognitive training. As we consider the increasing number of older Canadians (Statistics Canada, 2011) these programs take on particular significance as potential interventions to protect against age-related cognitive declines (Kueider et al., 2012) In a large-scale RCT study, Smith et al. (2009) investigated the efficacy of the commercially available Brain Fitness Program software (BFP) from Posit Science. Older adult participants completed the training program in their homes and showed improvements on generalized measures of memory and attention (Smith et al., 2009). Despite positive results, both the efficacy and transferability of these effects may be limited (Buitenweg, Murre & Ridderinkhof, 2012). Nevertheless, some authors speculate that such interventions might still be practically useful for the user (Rabipour & Raz, 2012). In view of this hypothesis, we sought to evaluate the effects and implementation of a community-based brain training program specifically for older adults. Using a novel community-based brain training model (the ‘brain gym’ model), we established ‘brain gyms’ (BGs) in several community locations attended regularly by older adults, including a senior’s recreation centre, a public library and a retirement residence. Participants were required to complete 40 hours of training using the Posit Science BFP software (1 hour per day, 5 days per week) at their BG location. Standardized measurements of memory, attention and activities of daily living (ADLs) were collected pre- and post-training, and qualitative data relating to the enjoyment and usefulness of the training and the BG location were also collected. Eleven older adults aged 68-75 completed the training across four community locations. Cognitively, participants showed slight, non-significant improvements in memory and attention; there was no significant effect of training on their ADLs. Subjectively they reported greater alertness, improved concentration and memory, and decreased distractibility. Most participants also reported enjoying the challenge of the program, the opportunities for socialization at the BG locations, and were motivated to continue brain training activities independently. Most participants felt that it was moderately easy to incorporate training at the BG into their daily schedule, suggesting that the BG model may be an effective and innovative approach to encourage cognitive training at the community level. Challenges inherent in community-based delivery, as well as recommendations for implementation (including online and at-home options) will be discussed

The Driving Cognitive Training Centre (DCTC): Testing a Community-based Brain Training Model for Older Drivers

Driving allows older adults to remain independent. However, age-related changes in visual and cognitive processes can have an adverse impact on driving skills. Research has shown improvements in driving abilities following 10 hours of targeted brain training using Posit Science’s DriveSharp computer program. We sought to determine if i) making this brain training program available in a community setting (the Driving Cognitive Training Centre, DCTC) is an effective means of engaging older drivers in structured cognitive training, and ii) if there are differences in outcomes for those who participate from home instead of at the DCTC. Over a 2-week period, 10 participants aged 64-85 completed 10 hours (1 hour/day; 5 days/week) of driving-specific brain training (provided by DynamicBrain, the Canadian partner of Posit Science) at home or at the DCTC. Pre and post-training measures were collected including assessments of self-reported driving, objective and self-reported cognition and training-related motivation. Subjectively reported positive changes following training for both groups included better peripheral vision, increased awareness and focus level. Participants attending the DCTC felt that the commitment they made to a community centre motivated them to complete their daily training; they also appreciated having better equipment, fewer distractions, and staff assistance on-hand. Those who participated from home primarily cited the benefit of convenience. The DCTC was an effective community model, particularly for those individuals who did not have access to appropriate equipment and assistance at home, and may also encourage program adherence. Future directions to engage individuals in community-based programming will be discussed