Mediators and Moderators of Executive Function Training in Older Adults

PROJECT SUMMARY This proposal aims to improve the rigor and reproducibility of research on plasticity in human executive functions (EFs) in older adults, many of which are at risk for developing Alzheimer’s Disease and Related Dementias (ADRD). We address a critical gap between research and practice that is characterized by a growing commercial space marketing “brain training” approaches (with EFs being one of the most common targets), many of which are particularly catering to older adult populations promising to mitigate age-related cognitive decline or even prevent ADRD. However, despite the growing literature, the current evidence is mixed, with both methods and findings varying vastly across studies. Here, we address these significant gaps that pose obstacles to understanding interventions’ reliability and validity by collecting a large-scale open dataset that compares different training approaches on a common set of outcome measures. This is addressed through 4 independent aims, all based upon a large-scale study involving new data collection from 1,250 older adults (aged 60+). Aim 1 focuses on determining ingredients that promote adherence and effective engagement with EF training by examining a set of commonly used ingredients in EF training studies (single vs multicomponent training, standard vs gamified training, and standard vs. added coaching). We will examine how these ingredients differentially impact various dimensions of adherence including initiation, implementation, persistence, and effective engagement. Aim 2 investigates how those ingredients mediate training outcomes, specifically, we test the differential impact of training conditions on EFs, broader cognition, everyday functions, quality of life, and belief structures. Aim 3 seeks to uncover individual characteristics that moderate training outcomes. Here, we examine how adherence and cognitive training outcomes may differ across individuals, and the extent to which this variability may explain differential outcomes across studies. Aim 4 highlights our goal of promoting open science through sharing of software tools and data. We will freely share the cross-platform training and assessment app, research portal, and dataset, that together will promote replication and provide access to other groups using common outcomes and individual difference variables. Our project goals extend our systematic and programmatic approach that builds upon successful work in younger adult populations using a citizen science approach involving thousands of participants, as well as an R21 that has focused on testing the impact of gamification and the extent to which participant characteristics (i.e., inhibitory control skills) interact with the implementation of such motivational structures. Our unique and novel large-scale dataset will lead to a robust and representative understanding of factors that mediate and moderate EF training that will be impactful whether or not one hypothesizes benefits from EF training. Project outcomes will advance our scientific understanding of factors impacting effectiveness of cognitive training and help empower older adults with evidence-based and freely available tools that are effective and genuinely enhance their cognitive resilience and quality of life.