What is the clinical evidence from this study?

Study design: RCT. Population: Healthy older adults (n=42). Intervention: Variable priority (VARIABLE) training vs. Fixed priority (FIXED) and single-task (SINGLE) training. Primary outcome: Divided attention cost (time × emphasis × task × group interaction) (p=<0.001).

July 29, 2014Open Access

Identifying training modalities to improve multitasking in older adults

Q: What are the key findings of this study?

Variable priority training significantly improved the ability of older adults to vary their attentional priorities according to instructions compared to fixed priority or single-task training.

Key Result

Variable priority training significantly improved the ability of older adults to vary their attentional priorities according to instructions compared to fixed priority or single-task training.

Study Design

Type

RCT (n=42)

Randomization

Stratified by education and age

Multicenter

Structured PICO

Does variable or fixed priority attentional training improve divided attention and transfer to working memory tasks in healthy older adults compared to single-task training?

Population

42 healthy older adults (37 analyzed after exclusions), French-speaking, community-dwelling, living in the Montreal area, right-handed, with normal or corrected-to-normal hearing and vision. Mean age ~69 years.

Intervention

VARIABLE training condition (practicing visual detection and alphanumeric equation tasks simultaneously while varying attentional priority) or FIXED training condition (practicing both tasks simultaneously with equal attention allocated to each).

Comparator

SINGLE training condition (practicing the visual detection and alphanumeric equation tasks in isolation).

Outcome

Divided attention cost (computed by combining reaction time and accuracy for each task in the divided attention condition relative to the focused attention condition).

Attentional control capacities in older adults are plastic and can be improved with appropriate training, with variable-priority training specifically enhancing the ability to flexibly allocate attention.

Main Result

p-value: p=<0.001

Limitations

Small sample size
Potential ceiling effect in the single training group for the 1-back test

Abstract

Studies that have measured the effects of attentional training have relied on a range of training formats, which may vary in their efficacy. In particular, it is unclear whether programs that practice dual-tasking are more effective in improving divided attention than programs focusing on flexible allocation priority training. The aims of this study were as follows: (1) to compare the efficacy of different types of attentional training formats and (2) to assess transfer to distal measures. Forty-two healthy older adults were randomly assigned to one of three training groups. In the SINGLE training condition, participants practiced a visual detection and an alphanumeric equation task in isolation. In the FIXED training condition, participants practiced both tasks simultaneously with equal attention allocated to each. In the VARIABLE training condition, participants varied the attentional priority allocated to each task. After training, all participants improved their performance on the alphanumeric equation task when performed individually, including those in the SINGLE training condition. Participants in the FIXED training condition improved their divided attention, but only the participants in the VARIABLE training condition showed a greater capacity to vary their attentional priorities according to the instructions. Regarding transfer, all groups improved their performance on the 2-back condition, but only the VARIABLE and FIXED conditions resulted in better performance on the 1-back condition. Overall, the study supports the notion that attentional control capacities in older adults are plastic and can be improved with appropriate training and that the type of training determines its impact on divided attention.

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