A theoretical framework for cognitive and non-cognitive interventions for older adults: stimulation versus compensation

Background: Recently, interest in cognitive training for older adults has grown significantly, reflecting a need for preserving the quality of life into late adulthood. In spite of increasing interest in cognitive rehabilitation, recent meta-analyses have questioned reported training gains and determined that cognitive gain from cognitive training might be no larger than the gain observed from active controls such as unspecific, non-cognitive activities.

Aims: This paper presents a theoretical framework for clarifying specificity of cognitive training by exploring mechanisms of current cognitive and non-cognitive interventions for older adults. By differentiating compensatory aspects from the components of specific and non-specific stimulation in current training, two related strategies of interventions for age-related cognitive decline, i.e., stimulation versus compensation, are proposed.

Overview: Current interventions for age-related cognitive decline are reviewed in terms of stimulation- and compensation-focused interventions. Stimulation-focused, cognitive and non-cognitive training, with or without specific targets, tend to result in general improvement in attention and sensory or other cognitive functions. Meanwhile, compensation-focused training is likely to be the most effective when the intervention specifically supports the frontally mediating activity in accordance with the direction of indigenous adjustments in the aging brain.

Conclusions: It can be inferred that stimulation-focused training is to ameliorate the adverse effects of neurological aging, whereas compensation-focused cognitive training is primarily to facilitate compensatory adaptation in the brain.