A randomized trial showing mnemonic strategy training increases memory, brain activation, and functional connectivity more than vanishing cue training in cognitively intact older adults

Objectives: This single-blind, parallel groups, randomized controlled trial examined whether (1) mnemonic strategy training (MST) improved memory for face-name associations relative to vanishing cue training (VCT) and (2) the interventions modulated blood oxygen level dependent (BOLD) signal in a training-specific manner. Methods: We randomized 30 cognitively intact older adults to either MST or VCT (1:1 basis). Memory for face-name associations (primary outcome) was evaluated at baseline and post-training using functional magnetic resonance imaging (fMRI) and again at 1-month follow-up (memory test only). During training sessions, MST participants applied a 3-step strategy while those receiving VCT recalled the targeted name across trials with letters subtracted (correct trials) or added (incorrect trials) as appropriate. Results: There were no adverse events and excellent retention. The magnitude of memory test improvement was significantly greater after MST at both post-training and 1-month relative to VCT. The MST group also showed significantly greater BOLD signal changes in multiple brain regions as well as increased functional connectivity between networks relative to the VCT group. Conclusions: MST is superior to VCT for enhancing long-term retention of face-name associations in cognitively intact older adults and appears to enhance use of lateral frontoparietal regions and networks involved in top-down processing.