REHAB SERIES—INTRODUCTORY PAPER
Cognitive rehabilitation in the elderly: A randomized
trial to evaluate a new protocol
DONALD T. STUSS,
1– 4
IAN H. ROBERTSON,
1,5
FERGUS I.M. CRAIK,
1,2
BRIAN LEVINE,
1–3
MICHAEL P. ALEXANDER,
1,6
SANDRA BLACK,
1,3,7
DEIRDRE DAWSON,
4,8,9
MALCOLM A. BINNS,
1
HEATHER PALMER,
1
MAUREEN DOWNEY-LAMB,
1
and GORDON WINOCUR
1,2,10,11
1
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
2
Department of Psychology, University of Toronto, Ontario, Canada
3
Department of Medicine (Neurology), University of Toronto, Ontario, Canada
4
Department of Medicine (Rehabilitation Sciences), University of Toronto, Ontario, Canada
5
Department of Psychology and Institute of Neuroscience, Trinity College, Dublin, Ireland
6
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
7
Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada
8
Kunin-Lunenfeld Applied Research Unit, Baycrest, Toronto, Ontario, Canada
9
Department of Medicine (Occupational Science & Occupational Therapy), University of Toronto, Ontario, Canada
10
Department of Medicine (Psychiatry), University of Toronto, Ontario, Canada
11
Department of Psychology, Trent University, Peterborough, Canada
(Received November 11, 2005; Final Revision August 18, 2006; Accepted August 18, 2006)
Abstract
This study provides an introduction to, and overview of, several papers that resulted from a randomized control trial
that evaluated a new cognitive rehabilitation protocol. The program was designed to improve general strategic
abilities in ways that would be expressed in a broad range of functional domains. The trial, which was conducted on
a sample of older adults who had experienced normal age-related cognitive decline, assessed performance in the
following domains: memory, goal management, and psychosocial status. The general rationale for the trial,
the overall experimental design, and the approach to statistical analyses that are relevant to each paper are
described here. The results for each functional domain are reported in separate papers in this series
( JINS, 2007, 13, 120–131.)
Keywords: Aging, Memory, Treatment outcome, Cognition, Frontal lobe, Neuropsychology
INTRODUCTION
With support from the JSF McDonnell Foundation, a team
of scientists at the Rotman Research Institute of Baycrest
undertook to develop an approach to cognitive rehabilita-
tion that could be effectively applied to individuals who,
for various reasons, suffer from memory and memory-
related problems. Our objective was to devise a comprehen-
sive program that incorporates scientifically based principles
of cognitive function and current thinking about rehabilita-
tion practice. In the series of papers that comprise this spe-
cial section, we report the first phase of the project—an
experimental trial that was conducted on a population of
older adults who were experiencing normal cognitive decline.
Many studies have assessed the efficacy of different
cognitive interventions in the elderly. A focus has been on
training memory and related functions, the typical result
suggesting beneficial effects in older adults (e.g., Anschutz
et al., 1985; Glisky & Glisky, 1999; Greenberg & Powers,
1987; Kliegl et al., 1989; Stigsdotter Neely & Bäckman,
1993a, 1993b; Yesavage, 1985; Yesavage & Rose, 1983;
Zarit et al., 1981). Moreover, there is evidence that benefits
from training can be maintained for a considerable period
of time beyond training (Stigsdotter Neely & Bäckman,
1993a, 1993b). As an example, Ball and colleagues (2002)
completed a large scale study in older adults comparing
Correspondence and reprint requests to: Donald T. Stuss, Ph.D.,
Rotman Research Institute, Baycrest, 3560 Bathurst Street, Toronto, ON
M6A 2E1 Canada. E-mail: dstuss@rotman-baycrest.on.ca
Journal of the International Neuropsychological Society (2007), 13, 120–131.
Copyright © 2007 INS. Published by Cambridge University Press. Printed in the USA.
DOI: 10.10170S1355617707070154
120