Goal-Oriented Attention Self-Regulation (GOALS) training in older adults

Abstract

Abstract

Objectives: A common cognitive complaint of older adulthood is distractibility, or decline in ability to concentrate and maintain focus, yet few evidence-based interventions exist to address these deficits. We implemented s pilot trial of an evidence-based executive function training program, to investigate whether training in applied goal-directed attention regulation and problem solving would enhance executive control abilities in a sample of cognitively normal older adults with self-reported complaints of concentration problems.

Method: Consecutively recruited participants were placed into small groups and randomized to either Goal-Oriented Attentional Self-Regulation training (GOALS; N = 15) or a closely matched Brain Health Education program (BHE; N = 15).

Results: GOALS participants significantly improved on: neurocognitive measures of mental flexibility (p = 0.03, partial eta squared = 0.23); real-world setting functional performance measures of: task failures (p = 0.02, Cohen’s d = 0.88), task rule breaks (p = 0.02, Cohen’s d = 1.06), and execution (p = 0.04, Cohen’s d = 0.76); and in-lab functional assessment of goal-directed behaviour divergent thinking scale (p = 0.03, Cohen’s d = 0.95). All participants improved on a neurocognitive measure of planning (p = 0.01, partial eta squared = 0.031). BHE participants’ improvement over and above GOALS participants was limited to: rule adherence on the real world task (p = 0.04, Cohen’s d = 0.99), and evaluator rating (p = 0.03, Cohen’s d = 0.56), and average score (p = 0.02, Cohen’s d = 0.71) on the in-lab functional task.

Conclusion: Participation in GOALS training can enhance executive control, and lead to real-world functional improvements, for cognitively normal older adults with self-reported attention difficulties.

Keywords:

• Aging
• cognitive training
• rehabilitation
• executive function
• attention

Acknowledgements

The authors would like to acknowledge Nina Davids, Jessica Black, Michelle Murphy, Annemarie Rossi and Elaine Lageurta for their exceptional support in data collection and analyses throughout the project.

Funding

This work was supported by a grant from the National Institutes of Health (AG034642 –D’Esposito) and VA Rehabilitation Research and Development Merit Review Awards (Novakovic-Agopian & D’Esposito).