A 20-year study found that a specific computer-based speed training, paired with booster sessions, reduced dementia risk by 25%.
Study Overview
A large, long-term study published in Alzheimer's & Dementia: Translational Research & Clinical Interventions indicates that older adults who completed a specific computer-based cognitive speed training program, combined with follow-up "booster" sessions, were less likely to receive a dementia diagnosis over a 20-year period compared to a control group. No significant reduction in dementia risk was observed for participants who engaged in memory or reasoning training.
Study Design and Participants
The research is a 20-year follow-up to the Advanced Cognitive Training for the Independent and Vital Elderly (ACTIVE) study, a randomized controlled trial funded by the National Institutes of Health and initiated in 1998–99.
Participants: The ACTIVE study enrolled 2,802 to 2,832 community-dwelling adults, aged 65 and older, across multiple U.S. sites. Participants were healthy at the time of enrollment, with no significant cognitive impairment or conditions hindering participation.
Randomization: Participants were randomly assigned to one of four groups:
- Memory training
- Reasoning training
- Speed-of-processing training
- A no-contact control group
Initial Training: Participants in the three training groups completed up to 10 sessions, each lasting 60 to 75 minutes, over a period of five to six weeks.
Booster Sessions: Approximately half of the participants in each training group were also randomly selected to receive up to four additional "booster" training sessions. These boosters were administered at 11 months and 35 months after the initial training.
Key Findings on Dementia Risk
For the 20-year analysis, researchers reviewed Medicare claims data from 1999 to 2019 for 2,021 participants (72% of the original cohort) to identify diagnoses of Alzheimer's disease and related dementias (ADRD).
Primary Result: Participants in the speed-of-processing training group who also completed the booster sessions showed a 25% lower risk of receiving a dementia diagnosis compared to the control group (adjusted hazard ratio 0.75; 95% CI 0.59 to 0.95). In the control group, 239 out of 491 adults (49%) received a dementia diagnosis. In the speed-training-with-boosters group, 105 out of 264 adults (40%) received a dementia diagnosis.
Booster Requirement: This statistically significant reduction in dementia risk was observed only in participants who completed both the initial speed training and the booster sessions. Participants who completed the initial speed training without boosters did not show a significant benefit.
Other Training Types: The memory and reasoning training groups, with or without booster sessions, did not show a statistically significant reduction in dementia risk compared to the control group over the 20-year period.
The Speed Training Intervention
The speed-of-processing training is a computer-based exercise designed to improve visual attention and the speed at which the brain processes visual information.
- Task: A common exercise, called "Double Decision," requires users to identify a central object (e.g., a vehicle) and a peripheral object (e.g., a road sign) that appear briefly on the screen.
- Adaptive Difficulty: The program automatically adjusts the speed of the task and introduces distractions as the participant’s performance improves, making the exercise progressively more challenging.
- Mechanism: Researchers hypothesize that this training promotes "implicit learning," which involves the unconscious acquisition of skills. This type of learning is thought to engage different brain networks than "explicit learning" (memorizing facts or strategies) and may lead to more durable brain changes.
Context and Expert Commentary
- Dementia Definition: Dementia is characterized by a decline in cognitive abilities severe enough to impair independent living. Alzheimer's disease accounts for 60% to 80% of dementia cases. It is estimated that 42% of adults over 55 will develop dementia at some point in their lives, with annual costs exceeding $600 billion in the U.S.
- Cognitive Reserve: A leading hypothesis for the study's results is the concept of "cognitive reserve," which suggests that mental stimulation can help the brain build a buffer that delays the onset of symptoms, even if underlying brain pathology is present.
- Study Limitations: The authors note that dementia diagnoses were derived from Medicare claims data, not from in-person clinical evaluations. The study excluded enrollees in Medicare Advantage plans. The precise biological mechanism by which speed training might affect dementia risk is not yet understood.
- Caveats on Brain Training: The brain-training industry has faced scrutiny. In 2016, Lumos Labs (maker of Lumosity) settled with the U.S. Federal Trade Commission for $2 million over claims that its games could prevent memory loss.
- Future Research: An ongoing NIH-funded study, the Preventing Alzheimer's with Cognitive Training (PACT) study, is currently enrolling approximately 7,500 participants aged 65 and older to investigate the effects of a more intensive speed-training regimen. Initial results are anticipated around 2028. Researchers also suggest that future studies should explore whether combining speed training with other lifestyle interventions, such as physical exercise and cardiovascular health management, could yield further benefits.
- Commercial Availability: The specific speed-training program used in the ACTIVE study is commercially available on the BrainHQ platform.