Understanding heterogeneity in response to memory training in older adults: Results from *ACTIVE

Cognitive decline is a major concern for community-dwelling older adults. Although some amount of decline in memory is considered to be a part of the normal aging process, it has been suggested that an intervention program for memory problems in the elderly would be a valuable component of a preventative mental health program. Undoubtedly this is motivated by the fact that, whether the concern is reflective of subjective memory complaints or objective memory impairment, cognitive decline has a tremendous impact on public health due to both the increase in prevalence with age as well as the associated health care costs. Cognitive training, and in particular memory training, is one type of intervention program designed to improve memory abilities in older adults. While there is a great deal of research demonstrating the overall effectiveness of memory training in this population, to date, little work has been done to understand the variability in response to training in older adults. This is a critical area to understand if memory training is to play a larger role in public health policy. Motivated by this issue, this dissertation examines data from the memory training arm of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study in order to address the following topics. First, characterize the variability in response to memory training among ACTIVE participants. Second, determine which baseline demographic and cognitive factors are predictive of initial training response patterns. Third, establish whether initial responsiveness patterns influence the long-term outcomes of memory training. Results from this dissertation will help guide the direction of future memory training programs targeted at older adults.