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Background : Various working memory (WM) trainings have been tested, but differences in experimental designs, the lack of theoretical background, and the need of identifying task-related processes such as filtering efficiency limit conclusions about their comparative efficacy.   Objectives : In this study, we compared the efficacy of a model-based WM training with (MB + ) and without (MB) distractor inhibition on improving WM capacity to a dual  n-back  and active control condition.   Methods : This randomized clinical trial included 123 healthy elderly adults (78 women, 45 men; aged 64.1 ± 8.3 years). All groups underwent 12 40-min training sessions over 3 weeks and four cognitive testing sessions. The first two sessions served as double baseline to account for practice effects. Primary outcome was WM capacity post-training measured by complex span tasks. Near and far transfer was assessed by simple span, n-back, visuospatial and verbal learning, processing speed, and reasoning tasks.   Results : Due to preliminary termination (COVID-19), 93 subjects completed the post-training and 60 subjects the follow-up session. On a whole group level, practice effects occurred from prebaseline to baseline in WM capacity ( b  = 4.85,  t  (103)  = 4.01,  p  < 0.001,  r  = 0.37). Linear mixed-effects models revealed a difference in WM capacity post-training between MB +  and MB ( b  = −9.62,  t  (82)  = −2.52,  p  = 0.014,  r  = 0.27) and a trend difference between MB +  and dual  n-back  ( b  = −7.59,  t  (82)  = −1.87,  p  = 0.065,  r  = 0.20) and control training ( b  = −7.08,  t  (82)  = −1.86,  p  = 0.067,  r  = 0.20). Univariate analyses showed an increase between pre- and post-training for WM capacity within MB +  ( t  (22)  = −3.34,  p  < 0.05) only. There was no difference between groups pre- and post-training regarding near and far transfer. Univariate analyses showed improved visuospatial learning within MB +  ( t  (21)  = −3.8,  p  < 0.05), improved processing speed ( t  (23)  = 2.19,  p < 0.05) and  n -back performance ( t  (23)  = 2.12,  p  < 0.05) in MB, and improved  n -back performance ( t  (25)  = 3.83,  p  < 0.001) in the dual  n -back training.   Interpretation : A model-based WM training including filtering efficacy may be a promising approach to increase WM capacity and needs further investigation in randomized controlled studies.

frontiers in aging neuroscience

Investigation of a Model-Based Working Memory Training With and Without Distractor Inhibition and Its Comparative Efficacy: A Randomized Controlled Trial on Healthy Old Adults