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Improving Driving Skills and Brain Functioning- Interview with ACTIVE’s Jerri Edwards

Jerri Edwards- Active trialToday we are for­tu­nate to inter­view Dr. Jer­ri Edwards, an Asso­ciate Pro­fes­sor at Uni­ver­si­ty of South Flori­da’s School of Aging Stud­ies and Co-Inves­ti­ga­tor of the influ­en­cial ACTIVE study. Dr. Edwards was trained by Dr. Kar­lene K. Ball, and her research is aimed toward dis­cov­er­ing how cog­ni­tive abil­i­ties can be main­tained and even enhanced with advanc­ing age.

Main focus of research

Alvaro Fer­nan­dez: Please explain to our read­ers your main research areas

Jer­ri Edwards: I am par­tic­u­lar­ly inter­est­ed in how cog­ni­tive inter­ven­tions may help old­er adults to avoid or at least delay func­tion­al dif­fi­cul­ties and there­by main­tain their inde­pen­dence longer. Much of my work has focused on the func­tion­al abil­i­ty of dri­ving includ­ing assess­ing dri­ving fit­ness among old­er adults and reme­di­a­tion of cog­ni­tive decline that results in dri­ving dif­fi­cul­ties.

Some research ques­tions that inter­est me include, how can we main­tain health­i­er lives longer? How can train­ing improve cog­ni­tive abil­i­ties, both to improve those abil­i­ties and also to slow-down, or delay, cog­ni­tive decline? The spe­cif­ic cog­ni­tive abil­i­ty that I have stud­ied the most is pro­cess­ing speed, which is one of the cog­ni­tive skills that decline ear­ly on as we age.

ACTIVE results

Can you explain what cog­ni­tive pro­cess­ing speed is, and why it is rel­e­vant to our dai­ly lives?

Pro­cess­ing speed is men­tal quick­ness. Just like a com­put­er with a 486 proces­sor can do a lot of the same things as a com­put­er with a Pen­tium 4 proces­sor, but it takes much longer, our minds tend to slow down with age as com­pared to when we were younger. We can do the same tasks, but it takes more time. Quick speed of pro­cess­ing is impor­tant for quick deci­sion mak­ing in our dai­ly lives. When you are dri­ving, if some­thing unex­pect­ed hap­pens, how quick­ly can you notice the sit­u­a­tion and decide how to react?

Please describe how the ACTIVE tri­al used the cog­ni­tive train­ing pro­gram, and what the results were found to be when they were pub­lished in the Jour­nal of the Amer­i­can Med­ical Asso­ci­a­tion in Decem­ber 2006?

I was a co-inves­ti­ga­tor of the ACTIVE study, a mul­ti-site, con­trolled study, with thou­sands of adults over six­ty-five, to eval­u­ate the effec­tive­ness of three dif­fer­ent cog­ni­tive train­ing meth­ods with three dif­fer­ent groups:

- The first group used a mem­o­ry train­ing pro­gram includ­ing a vari­ety of tra­di­tion­al mem­o­ry tech­niques such as mnemon­ics and the method of loci.

- The sec­ond group was trained in learn induc­tive rea­son­ing skills.

- The third group was exposed to com­put­er-based pro­grams to train pro­cess­ing speed.

All 3 groups spent the same amount of time in their respec­tive train­ing pro­grams, around 2 hours a week for 5 weeks, going through exer­cis­es of increas­ing dif­fi­cul­ty. The ACTIVE study was designed to track par­tic­i­pants’ per­for­mance over a num­ber of years, so, after this ini­tial 5‑week inter­ven­tion, some groups received train­ing boost­er ses­sions, after 1 year and again after 3 years.

Willis and col­leagues pub­lished the 5‑year results in JAMA last Decem­ber and the results were very pos­i­tive. All 3 types of cog­ni­tive pro­grams were shown to have an effect imme­di­ate­ly after the pro­gram, after 3 years, and after 5. But, the results of the group that used a com­put­er-based pro­gram to train pro­cess­ing speed showed clear short-term and long-term results. Indi­vid­u­als who expe­ri­enced improved speed of pro­cess­ing also showed bet­ter per­for­mance on tasks of instru­men­tal activ­i­ties of dai­ly liv­ing such as quick­ly find­ing an item on a crowd­ed pantry shelf and read­ing med­ica­tion bot­tles. They also react­ed to road signs more quick­ly. We found this trans­fer of train­ing in our pri­or stud­ies using the train­ing pro­to­col as well.

In short, sig­nif­i­cant per­cent­ages of the par­tic­i­pants improved their mem­o­ry, rea­son­ing and infor­ma­tion-pro­cess­ing speed across all three meth­ods. The most impres­sive result was that, when test­ed five years lat­er, the par­tic­i­pants in the com­put­er-based pro­gram had less of a decline in the skill they were trained in than did a con­trol group that received no cog­ni­tive train­ing.

Clar­i­fy­ing con­fu­sion

The results of the ACTIVE study were quite impres­sive and con­tributed in large part to the amount of media cov­er­age about brain fit­ness last year. How­ev­er, as you have prob­a­bly seen, there is a good deal of con­fu­sion about brain fit­ness among the media and the pub­lic at large. Can you help our read­ers under­stand two com­mon ques­tions: 1) Why are new pro­grams bet­ter than, say, doing cross­words puz­zles?, and 2) Can one real­ly say that these pro­grams can reverse age-relat­ed decline?

To answer the first ques­tion, I would say that a cross­word puz­zle is not a form of cog­ni­tive train­ing. It can be stim­u­lat­ing, but it is not a form of struc­tured men­tal exer­cise that has been shown to improve spe­cif­ic cog­ni­tive skills — oth­er than the skill of doing cross­word puz­zles, of course.

In terms of the sec­ond ques­tion, it is too ear­ly to say whether we can real­ly reverse decline in a per­ma­nent way. There are many skills involved and the stud­ies are not long enough to real­ly com­pare dif­fer­ent tra­jec­to­ries. What we can say is that by doing some exer­cis­es, one can improve cog­ni­tive speed of pro­cess­ing by 146–250%, and that a sig­nif­i­cant por­tion of that improve­ment stays even after 5 years. We can­not say more defin­i­tive­ly.

But I think it is note­wor­thy to be able to say that, in all of the pro­grams test­ed, the pay­off from cog­ni­tive train­ing, or what we can call “men­tal exer­cise”, seemed far greater than we are accus­tomed to get­ting from phys­i­cal exer­cise. Just imag­ine if you could say that 10 hours of work­outs at the gym every day this month was enough to help keep you fit five years from now.

Now, the pro­gram used is not ful­ly auto­mat­ed, cor­rect? It required the inter­ven­tion of a trained per­son to cal­i­brate the pro­gram at the right lev­el of dif­fi­cul­ty.

That is cor­rect.

Dri­ving-relat­ed per­for­mance

Anoth­er fas­ci­nat­ing study that you pub­lished as a co-author in Human Fac­tors (2003), applied the same com­put­er-based pro­gram to improv­ing the dri­ving-relat­ed men­tal skills of old­er adults. Can you explain that study?

Sure. Our goal was to train what is called the “use­ful field of view.” The use­ful field of view is a mea­sure of pro­cess­ing speed and visu­al atten­tion that is crit­i­cal for dri­ving per­for­mance, and one of the areas that declines with age. It has pre­vi­ous­ly been shown that this skill can be improved with train­ing, so we want­ed to see what effect it would have on the dri­ving per­for­mance of old­er adults, and whether the train­ing would be more or less effec­tive than a tra­di­tion­al dri­ving sim­u­la­tion course.

For the study, we divid­ed forty-eight adults over fifty-five years old into two inter­ven­tion groups of twen­ty-four peo­ple each. Each group received twen­ty hours of train­ing. One group was exposed to a tra­di­tion­al dri­ving sim­u­la­tor, where they learned spe­cif­ic dri­ving behav­iours. The oth­er one went through the cog­ni­tive train­ing pro­gram.

Both groups’ dri­ving per­for­mance improved right after their respec­tive pro­grams, but most ben­e­fits of the dri­ving sim­u­la­tor dis­ap­peared by month eigh­teen.

The speed-of-pro­cess­ing inter­ven­tion helped par­tic­i­pants not only improve “use­ful field of view,” the skill that was direct­ly trained, but it also trans­ferred into real-life dri­ving, and the results were sus­tained after 18 months. And, by the way, the eval­u­a­tion was as real as one can imag­ine: a 14-mile open road eval­u­a­tion.

Faster speed-of-pro­cess­ing seemed to enable adults to react bet­ter to unex­pect­ed events that require a fast response and to reduce by 40% the num­ber of dan­ger­ous manoeu­vres on real roads (defined as those that required the train­ing instruc­tor to inter­vene dur­ing the eval­u­a­tion).

The Future

Research like this seems to present major oppor­tu­ni­ties for soci­ety. For exam­ple, would­n’t insur­ance com­pa­nies, or the AARP, want to spon­sor more research and eval­u­ate whether to offer this type of train­ing to their mem­bers? Won’t major employ­ers see oppor­tu­ni­ties to improve the per­for­mance of old­er employ­ees by iden­ti­fy­ing the cog­ni­tive skills that may need the most improve­ment and offer­ing tai­lored train­ing? We could spec­u­late that a per­son with faster pro­cess­ing abil­i­ties will also be able to make faster deci­sions and learn faster…

That makes sense, based on what we know. Cog­ni­tive abil­i­ties evolve in dif­fer­ent ways as we age, and some typ­i­cal­ly start to decline in our thir­ties. Cog­ni­tive inter­ven­tions may help train and improve those abil­i­ties, and there is already research that strong­ly indi­cates where and how train­ing can be use­ful. More research is still required to deliv­er more pre­cise and tai­lored inter­ven­tions in a vari­ety of envi­ron­ments. I sus­pect we will see the field grow sig­nif­i­cant­ly — and not just for aging-relat­ed pri­or­i­ties. Cog­ni­tive train­ing may become use­ful for a vari­ety of health con­di­tions, such as Parkin­son’s and Alzheimer’s patients, for exam­ple. More research will help researchers refine assess­ments and train­ing pro­grams.


- Edwards, J.D., Ross, L.A., Clay, O.C., Wadley, V.G., Crowe, M., Roenker, D.L. & Ball, K.K. (2006). The Use­ful Field of View test: Nor­ma­tive data. Archives of Clin­i­cal Neu­ropsy­chol­o­gy, 21: 275–286

- Ball, K.K., Roenker, D., Wadley, V.G., Edwards, J.D., Roth, D.L., McG­win, G. M., Raleigh, R., Joyce, J., & Cis­sell, G.M. & Dube, T. (2006). Can high-risk old­er dri­vers be iden­ti­fied through per­for­mance-based mea­sures in a depart­ment of motor vehi­cles set­ting? Jour­nal of the Amer­i­can Geri­atrics Soci­ety, 54: 77–84.

- Roenker, D., Cis­sell, G., Ball, K., Wadley, V., & Edwards, J. (2003). Speed of pro­cess­ing and dri­ving sim­u­la­tor train­ing result in improved dri­ving per­for­mance. Human Fac­tors, 45: 218–233.

- Jobe, J.B., Smith, D.M., Ball, K., Tennst­edt, S. L., Mar­siske, M., Willis, S.L., Rebok, G.W., Mor­ris, J.N., Helmers, K.F., Lev­eck, M.D., Klein­man, K. ACTIVE: A cog­ni­tive inter­ven­tion trail to pro­mote inde­pen­dence in old­er adults. Con­trol Clin­i­cal Tri­als, 2001, 22(4): 453–479.

- Edwards, J., Wadley, V., Myers, R., Ball, K., Roenker, D., & Cis­sell, G. (2002). Trans­fer of a speed of pro­cess­ing inter­ven­tion to near and far cog­ni­tive func­tions. Geron­tol­ogy, 48: 329–340.

- Edwards, J.D., Wadley, V.G., Vance, D.E., Wood, K.M., Roenker, D.L., & Ball, K.K. (2005). The impact of speed of pro­cess­ing train­ing on cog­ni­tive and every­day per­for­mance. Aging & Men­tal Health, 9: 262–271.

Cred­it for pic: Den­nis Keim dk-stu­dio

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13 Responses

  1. George says:

    Are there any com­mer­cial­ly avail­able pro­grams avail­able to train cog­ni­tive pro­cess­ing speed?

  2. Michael Cole says:

    Great inter­view!

    George, there are a lot of pro­grams that work on pro­cess­ing speed with­in a larg­er frame­work

  3. Mike Scanlon says:

    Jer­ri, I’ve read sev­er­al of your papers on train­ing visu­al atten­tion and pro­cess­ing speed — thanks for your impor­tant con­tri­bu­tions to the field.

    George, I work on an online train­ing pro­gram designed to improve pro­cess­ing speed, as well as mem­o­ry and atten­tion. There’s a free tri­al at

  4. Roy Israely says:

    If you are look­ing for a great soft­ware that improves pro­cess­ing speed, as well as oth­er dri­ving- relat­ed cog­ni­tive abil­i­ties, I would sug­gest Dri­ve­Fit. You can read some details at:

  5. Laura Fay says:

    George — Hap­py Neu­ron offers cog­ni­tive train­ing pro­grams for atten­tion and visu­al-spa­tial skills, the key brain func­tions that impor­tant in Dri­ving — pro­cess­ing speed (aka reac­tion time), land­mark iden­ti­fi­ca­tion & nav­i­ga­tion, etc.
    Train­ing pro­grams have been pro­vid­ed to cor­po­ra­tions specif­i­cal­ly for dri­ver fleet train­ing. Vis­it to expe­ri­ence these cog­ni­tive train­ing tools.

  6. Jason says:

    For the last few years I have been doing lots of “fact find­ing” with regards to brain fitness/health. One piece I recent­ly came across, with regards to Dr. Ball , was this:

    This “team up” if you will, could be a great thing for peo­ple who want pro­grams with real sci­ence behind them.

    Keep up the great inter­views Alvaro.

  7. Alvaro says:

    Thank you all for your con­tri­bu­tions.

    George, you could try a few of the pro­grams men­tioned here. Anoth­er one, focused on audi­to­ry pro­cess­ing, is Posit Sci­ence. Phys­i­cal exer­cise has also been shown to improve reac­tion time, as well as med­i­ta­tion. There are no uni­ver­sal “pre­scrip­tions” yet, but dif­fer­ent tools most appro­pri­ate to our spe­cif­ic con­texts. That’s why we rec­om­mend you use our check­list

    Jason, thanks for the encour­age­ment. I am sure your “fact find­ing” has been more in-depth than the one reflect­ed in the press release you link to…(a very inter­est­ing devel­op­ment indeed, that in fact we blogged about last month), but it los­es cred­i­bil­i­ty when it opens with the fac­tu­al­ly incor­rect “Only com­pa­nies with sci­en­tif­i­cal­ly proven train­ing pro­grams that improve men­tal func­tion…”

    Please take a look at my inter­views with Torkel Kling­berg and Daniel Gopher, for exam­ple. And please let us know of inter­est­ing devel­op­ments you see in the field! What is your moti­va­tion to fol­low Dr. Bal­l’s research/ what do you work on?

  8. Hi folks,

    The speed of pro­cess­ing train­ing pro­gram Dr. Edwards refers to is a very spe­cif­ic train­ing pro­gram with a num­ber of detailed tech­ni­cal require­ments. The design is cov­ered by sev­er­al issued US patents.

    With all due respect to the com­ments men­tion­ing Lumos­i­ty, Cog­nifit, and Hap­py Neu­ron, only the spe­cif­ic speed of pro­cess­ing train­ing pro­gram described by Dr. Edwards has been demon­strat­ed to improve instru­men­tal activ­i­ties of dai­ly liv­ing and reduce risks of func­tion­al decline over time. The train­ing pro­grams from Lumos­i­ty, Cog­nit­fit, and Hap­py Neu­ron have not been shown to have those effects; and in fact Dr. Edwards’ and Dr. Bal­l’s research shows that their pos­i­tive results are quite spe­cif­ic to that speed of pro­cess­ing train­ing pro­gram. There’s no par­tic­u­lar rea­son to think that those var­i­ous oth­er train­ing pro­grams will have those ben­e­fi­cial effects; and if their devel­op­ers think they might they should invest the time and hard work in doc­u­ment­ing those effects as Dr. Edwards and Dr. Ball have.

    The speed of pro­cess­ing train­ing pro­gram described by Dr. Edwards was acquired by Posit Sci­ence, and a ful­ly-updat­ed ver­sion includ­ing a num­ber of addi­tion­al visu­al train­ing exer­cis­es will be launched in March.

    Best regards,

    Vice Pres­i­dent of Research & Out­comes
    Posit Sci­ence

  9. Alvaro says:

    Hen­ry, thank you for your com­ment. It adds good con­text, and does well in encour­ag­ing more com­pa­nies invest in good research. It also rais­es sev­er­al ques­tions that I’d love you to address:

    1- Com­put­er­ized cog­ni­tive train­ing has been around for a while, with a vari­ety of approach­es. You may also have read my inter­views with Daniel Gopher and Torkel Kling­berg, for exam­ple. It would be high­ly sur­pris­ing to learn that some of the require­ments to make it work have been patent­ed, as you seem to imply.

    2- It is pub­lic infor­ma­tion that Posit Sci­ence has been work­ing on a visu­al pro­cess­ing pro­gram for over a year. And this acqui­si­tion just hap­pened. So the obvi­ous ques­tions are a) how are you going to inte­grate 2 dif­fer­ent prod­ucts and approach­es, b) and in such a short time­frame, by March?

    3- In fact, more research will be need­ed to show the effi­ca­cy of what­ev­er you launch in March, which is not the same that has been used in the ACTIVE and oth­er tri­als.

    4- May I sug­gest, to you and all oth­er devel­op­ers, that we need to see more sol­id con­trols? watch­ing some edu­ca­tion­al DVDs is not the best high-qual­i­ty con­trol that will allow you to claim your cog­ni­tive train­ing has been shown to be bet­ter than oth­er cog­ni­tive train­ing prod­ucts, sim­ply that cog­ni­tive train­ing itself works.

    Thank you

  10. ddriving says:

    From Michael: Learn­ing-to-process games could be fun I sup­pose but are spec­u­la­tors going any far­ther? Is any one design­ing real world brain input learn­ing in dri­ving, e.g., or oth­er fields? Thanks

  11. The only cog­ni­tive train­ing pro­gram that I know of which has been proven effec­tive through research to enhance both cog­ni­tion and every­day func­tion­ing, includ­ing dri­ving is now owned and marked by Posit Sci­ence as InSight. I would love to receive pub­lished research on the effec­tive­ness of any of the oth­er pro­grams men­tioned. The evi­dence that this pro­gram enhances dri­ving is increas­ing and was recent­ly pre­sent­ed at the Trans­porta­tion Research Board meet­ing in 2009.

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