Scholarly Project Award Cover Page

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1 Allaire 1 Scholarly Project Award Cover Page THIS FORM MUST BE COMPLETED AND SUBMITTED WITH THE PROPOAL Name: Jason C. Allaire Department: Psychology Campus Box #: 7650 Project Title: Examining the Efficacy of Online Video Gaming to Produce Gains in Older Adults Cognitive and Everyday Functioning Faculty Signature Date List all external proposals planned and awards pending or received related to this project: Novel Social Technologies: Applications for Cognitive Improvement in Older Adults. Grant Submitted to the National Science Foundation. Anne McLaughlin (PI) and Jason Allaire (co-pi) List all CHASS and University awards received in the past five years to support your scholarship: CHASS Faculty Research and Development Grant (This award funded a data collection that was used in a Master s Thesis and as pilot data for a subsequent RO-3 funded by the NIA).

2 Allaire 2 Scholarly Project Award Abbreviated Curriculum Vitae Page THIS FORM MUST BE COMPLETED AND SUBMITTED WITH THE PROPOAL Name: Jason C. Allaire Rank and Hire Date: Assistant Professor - August 2003 Department: Psychology Fields/Specialty Areas of Scholarship: Cognitive Aging Faculty Signature Date Publications/Papers Relevant to Project Study Area: Allaire, J.C. & Klein, K. (in preparation). Examining the Efficacy of Emotional Writing on cognitive performance. Weatherbee, S.R. & Allaire, J.C. (in press). Everyday Cognition and Mortality: Performance Differences and Predictive Utility of the Everyday Cognition Battery. Psychology and Aging. Allaire, J.C., Tamez, E., & Whitfield, K. E. (2007). Examining the Association between Lung Functioning and Cognitive Performance in African American Adults. Journal of Aging and Health, 19, Allaire, J.C., & Willis, S.L. (2006). Competence in everyday activities as a predictor of cognitive risk and mortality. Aging, Neuropsychology, and Cognition, 2, Mast, B.T. & Allaire, J.C. (2006). Verbal learning and everyday functioning in dementia: An application of latent variable growth curve modeling. Journal of Gerontology: Psychological Science, 6, P167-P173. Allaire, J. C. & Marsiske, M. (2005). Intraindividual variability may not always indicate vulnerability in elders cognitive performance. Psychology and Aging,20,

3 Allaire 3 Allaire, J.C. & Whitfield, K. E. (2004). Relationships among education, age, and cognitive functioning in older African Americans: The impact of desegregation. Aging, Neuropsychology, and Cognition, 11, Allaire, J. C. & Marsiske, M. (2002). Well- and ill-defined measures of everyday cognition: Relationship to elders intellectual ability and functional status. Psychology and Aging, 17, Allaire, J. C., & Marsiske, M. (1999). Everyday cognition: Age and intellectual ability correlates. Psychology and Aging, 14, Ellis, R. D. & Allaire, J. C. (1999). Modeling computer interest in older adults: The role of age, education, Computer knowledge, and computer anxiety. Human Factors, 41, Kurniawan, S.H., Ellis, R.D., Allaire, J.C. (2002). The impact of Age, web self-efficacy, and web experience on bookmark manipulation. Universal Access in the Information Society 3,

4 Allaire 4 Examining the Efficacy of Online Video Gaming to Produce Gains in Older Adults Cognitive and Everyday Functioning Description of Proposed Research This proposal is being submitted for consideration to the Faculty Research and Professional Development fund to support a pilot investigation focused on determining whether playing World of Warcraft, a Massively Multi-Player Online Role Playing Game (MMO), can produce significant improvements in the cognitive, real-world everyday functioning of older adults. World of Warcraft (WoW) and similar MMO s provide a rich, cognitively complex, and social world in which individuals play a character in a fantasy world. Previous research has shown that playing video games produces significant improvements in cognitive abilities such as reaction time, spatial ability, and attention (e.g., Green & Bavelier, 2006a, 2006b, 2007; Feng, Spence, & Pratt, 2007). It is expected that findings from this pilot study, which represents the first attempt to apply this intervention to community dwelling older adults, will serve as spring board for a larger application (RO-1or R-21) to the National Institute on Aging (NIA) which has expressed specific interest in novel approaches to cognitive intervention in older adults (e.g., Berch & Wagster, 2004). In an attempt to develop, fine tune, and establish the efficacy of the intervention that will ultimately be proposed in this larger application, the current proposal is driven by four specific aims: Specific Aim 1: Assess old adults experience with and perceptions of video games before and after the intervention. Specific Aim 2: Conduct a task analysis of WoW game play in order to determine what in-game tasks are particularly associated with specific cognitive ability. Specific Aim 3: Use the results of the task analysis to determine what activities each participant must engage in while playing WoW. Specific Aim 4: Determine the efficacy of playing WoW to improve older cognitive, realworld, and emotional functioning.

5 Allaire 5 Relevance and Novelty of Proposed Research Previous Training Research Perhaps one of the most ubiquitous findings in the cognitive aging literature is that as individuals age many abilities such as memory and thinking speed tend to decline (Lövdén, Ghisletta, & Lindenberger, 2004; Schaie, 2004). Over the past 25 years the primary focus of intervention research has been on the development the skills to perform these cognitive tasks. Though ability-training studies differ with respect to the focus of intervention (i.e., cognitive ability being trained), they share a common approach to training. Across most of these intervention studies, training occurs in a group setting, led by a trained tutor/teacher, and over the course of a number of sessions, the tutor instructs participants in the knowledge, skills, rules, and techniques associated with the cognitive ability under investigation. The results from this work have been impressive; training in an ability produces significant gains for that ability. However, previous interventions have not found reliable transfer from their trained tasks to other areas of function (Salthouse, 2006, 2007; Schooler, 2007). Thus, although performance in the task may improve, performance in other tasks, situations, or abilities does not (Willis, Cornelius, Blow, & Baltes, 1983). This lack of transfer is troubling; in a sense they may have been trained for the test in the same way some high schools are accused of training students for the SAT rather than improving their general intellect and ability. The most well-known of current cognitive training interventions is the ACTIVE study (Willis, Tennstedt, Marsiske, Ball, Elias, Koepke, Morris, Rebok, Unverzagt, Stoddard, & Wright, 2006), which provided over 3000 elders cognitive training in one of three domains: reasoning, memory, and processing speed. The results indicated that participants saw significant improvements on measures of their targeted ability (Ball, Berch, Helmers, Jobe, Leveck, Marsiske, Morris, Rebok, Smith, Tennstedt, Unverzagt, & Willis, 2002; Boron, Turiano, Willis, & Schaie, 2007; Willis et al., 2006). However, there was little evidence that the effects of training in one

6 Allaire 6 cognitive domain transferred to other cognitive domains or to real-world indices of functioning. The one exception was the processing speed training, which focused on increasing visual attention and useful field of view (Karlene Ball et al., 2002). Lack of transfer to real-world outcomes in the ACTIVE study have made many doubt the ultimate efficacy of ability-focused interventions. Instead, there is a need for interventions with the potential to broadly impact elders cognitive abilities as well their everyday competence (e.g., Berch & Wagster, 2004). Non-Traditional Approaches to Cognitive Intervention Given the narrow effect of previous training studies, there is currently an emphasis by the NIA to encourage interventions targeted at more global processes rather than specific cognitive abilities. The current proposal is designed in response to this request and will test the efficacy of an intervention (i.e., video games) that has proven successful in samples of adults from the early and middle portion of the life span. A recent study investigated reduction of gender differences in spatial ability through experience in a video game with spatial requirements (Feng, Spence, & Pratt, 2007). After 10 hours of merely playing the game, all participants showed improved spatial ability. Although females in the study started with lower spatial ability scores, they improved significantly more than the. The near lack of gender differences by the end of the intervention indicated that spatial ability is at least partly learned (Feng et al., 2007). A recent series of studies investigated differences in visual short-term memory between video game players and non-video game players. Playing games increased short-term visual memory, spatial resolution, viseospatial attention, and attentional control (Green & Bavelier, 2006a, 2006b, 2007; Klingberg, Fernell, Olesen, Johnson, Gustafsson, Dahlström, Gillberg, Forssberg, & Westerberg, 2005). Last, in older adults, games successfully increased working memory capacity following a stroke (Westerberg, Jacobaeus, Hirvikoski, Clevberger, Östensson, Bartfai, & Klingberg, 2007). It is important to note these empirical studies establish a cause and effect relationship of gaming to improvements in these skills.

7 Allaire 7 In addition to testing the efficacy of the intervention, a number of additional aims will be addressed the results of which will be used to develop a larger federal funding application. First, data concerning elders experience with and perception of video games before and after the intervention will be assessed. This data is imperative to establish older adult interest in the intervention. Second, a task analysis of WoW will identify what cognitive abilities are required for specific in-game tasks. This information will be used to develop specific goals and requirements participants must satisfy with in the virtual world of WoW. Research Methods Participants. The sample for the proposed study will initially consist of 50 ethnically heterogeneous independently living older adults aged 65 and older. Given that this study is a pilot and funds are limited, we will only recruit individuals who have a relatively new (purchased in three last 3 years) home computer. Participants will be recruited either from our extensive participant database (n = 500) or the SeniorNet computer club housed at the Cary Senior Center (CSC). The CSC has been a partner in our ongoing aging research program for the past 4 years Design and Procedure. A pretest-posttest experimental control group design will be used in the proposed study, which is organized into three phases. During Phases 1 (Pretest) and 3 (Posttest), all participants complete a two hour multidimensional psychological measurement battery. Following the pretest, participants will be randomly assigned into the experimental (n = 25) or control (n = 25) group. Participants in the experimental group will be asked to play WoW for at least 1 hour a day for 2 weeks. The control group will participate in computer-related activities (surf the internet, , etc) for at least 1 hour a day for 2 weeks. Participants assigned to the intervention condition will be given a 2 hour orientation on the basics of game play. World of Warcraft Intervention. While WoW offers a virtual world for individuals to explore, it is important that each participant completes cognitively complex tasks. Results from the task analysis will inform what tasks and actions each participant must complete in order to insure

8 Allaire 8 that each participant engages in roughly the same game play experience and has similar cognitive abilities exercised. For instance, one of the main activities in WoW is the completion of Quests given by computer-generated characters. Quests require participants to do different tasks each of which exercises one or more cognitive abilities such as: locate another NPC or geographic location (spatial ability, memory), find certain plants (visual search), figure out what plagues a near-by town (reasoning, problem solving). Each quest rewards the player for successful completion. The research team will log into participants accounts to see the obtained reward and verify the assigned task was completed. This method will fashion a uniform intervention protocol. Measures. The proposed study includes a large multidimensional battery of well established measures taping a number of psychological domains. Specifically, it includes measures of four cognitive abilities (Memory, Working Memory, Processing Speed, and Problem Solving), an assessment of everyday cognitive functioning (Allaire & Marsiske, 1999), measures of everyday functioning, as well as assessments of well-being and social relationships. Proposed Analysis. The overarching goal is to determine if a video game intervention increases cognitive, everyday functioning. To examine these aims, an Occasion (pretest and immediate posttest) x Condition (experimental and control) repeated measures analyses of variance (RMANOVA) framework will be used. Of particular interest is the Occasion x Condition interaction, where it is expected that participants in the experimental condition will show greater pretest-to-posttest differences than the control group on the set of cognitive tests, everyday functioning, and well-being measures.

9 Allaire 9 References Allaire, J. C., & Marsiske, M. (1999). Everyday cognition: Age and intellectual ability correlates. Psychology and Aging, 14, Allaire, J.C. & Marsiske, M. (2002). Well- and ill-defined measures of everyday cognition: Relationship to older adults intellectual ability and functional status. Psychology and Aging, 17, Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., Marsiske, M., et al. (2002). Effects of cognitive training interventions with older adults: A randomized controlled trial. JAMA: Journal of the American Medical Association, 288(18), Berch, D.B., & Wagster, M.V. (2004). Future directions in cognitive aging research: Perspectives from the National Institute on Aging. In R.A. Dixon & L. Backman (eds.) New Frontiers in Cognitive Aging (pp ). New York: Oxford University Press. Boron, J. B., Turiano, N. A., Willis, S. L., & Schaie, K. W. (2007). Effects of cognitive training on change in accuracy in inductive reasoning ability. Journals of Gerontology, 62(3), Feng, J., Spence, I., & Pratt, J. (2007). Playing an action video game reduces gender differences in spatial cognition. Psychological Science, 18(10), Green, C. S., & Bavelier, D. (2006a). Effect of action video games on the spatial distribution of visuospatial attention. Journal of Experimental Psychology: Human Perception and Performance, 32(6), Green, C. S., & Bavelier, D. (2006b). Enumeration versus multiple object tracking: the case of action video game players. Cognition 101, Green, C. S., & Bavelier, D. (2007). Action-video-game experience alters the spatial resolution of vision. Psychological Science, 18(1), Klingberg, T., Fernell, E., Olesen, P., Johnson, M., Gustafsson, P., Dahlström, K., et al. (2005). Computerized training of working memory in children with ADHD a randomized, controlled, trial. Journal of the American Academy of Child and Adolescent Psychiatry 44 (2), Lövdén, M., Ghisletta, P., & Lindenberger, U. (2004). Cognition in the Berlin Aging Study (BASE): The first 10 years. Aging, Nueropsychology, and Cognition, 11, Schaie, K.W. (2004). Developmental influences on cognitive development: The Seattle Longitudinal Study. New York: Oxford University Press. Westerberg, H., Jacobaeus, H., Hirvikoski, T., Clevberger, P., Östensson, M. L., Bartfai, A., et al. (2007). Computerized working memory training after stroke A pilot study. Brain Injury, 21(1), Willis, S. L. (1989). Improvement with cognitive training: Which old dogs learn new tricks? In L. W. Poon, D. C. Rubin, & B. A. Wilson (Eds.). Everyday cognition in adulthood and late life. Cambridge, England: Cambridge University Press. Willis, S. L., Tennstedt, S. L., Marsiske, M., Ball, K., Elias, J., Koepke, K. M., et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 296(23), Zacks, R.T., Hasher, L., & Li, K.Z.H. (2000). Human memory. In F.I.M. Craik & T.A. Salthouse (Eds.), The handbook of aging and cognition (2 nd edition) (pp ). Mahwah, NJ: Lawrence Erlbaum.

10 Allaire 10 Budget Item Cost and Amount Total (1) World of Warcraft Game $30.00 x 28 copies $840 (2) World of Warcraft Monthly Subscription $15 a month x 28 copies $420 (3)Participant honorarium $50 x 50 participants $2500 (4) Copying $375 $375 (5) Testing Software $365 $4000 Budget Justification (1) Copies of World of Warcraft are needed for each participant in the intervention group as well for 2 research assistants and the PI. (2) A monthly fee is charged for each World of Warcraft account. The intervention only last 2 weeks so only a 1-month subscription is needed. (3) In order to reimburse participants for their time a 50$ honorarium will be given to each. (4) Monies are requested to cover the cost of copying pre and posttest as well as intervention related materials. (5) A subset of the pre and posttests will have to be administered via computer (to capture reaction time). Money is requested to cover the cost of the specialized software needed to administer the tests.

Online Cognitive Training Improves Cognitive Performance.

Online Cognitive Training Improves Cognitive Performance. Bernard Croisile (1), Diana Miner (2), Sandrine Bélier (2), Michel Noir (2), Franck Tarpin-Bernard (2) 2007 (1) Centre Mémoire de Ressources et