Brain Training Could Delay Dementia for Years
Clinical relevance: A long-term study suggests that brief, targeted speed-of-processing brain training—especially with booster sessions—may cut dementia risk by about a quarter over two decades.
- Nearly half of control participants developed Alzheimer’s disease or related dementias.
- But those who completed speed-of-processing training with booster sessions had about a 25% lower risk.
- The findings suggest that targeted, adaptive speed training could stave off clinical dementia.
Just a little bit of brain training as we get older might be enough to stave off the onset of dementia.
That’s the bottom line from a sweeping new analysis that followed older adults for 20 years. The researchers linked participants’ outcomes to Medicare records to determine who eventually received a diagnosis of Alzheimer’s disease or related dementias (ADRD).
The study draws on the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, one of the largest and longest-running randomized cognitive training research projects. Launched in the late 1990s, ACTIVE enrolled more than 2,800 community-dwelling older adults. Researchers randomly assigned participants to one of three training programs – memory, reasoning, or processing speed – or to a no-contact control group.
Participants completed up to 10 training sessions for several weeks. Some later received booster sessions roughly one and three years after the initial intervention.
A New Approach
What sets this study apart is its unusually long follow-up and how they assessed outcomes. Rather than relying on cognitive tests or interviews, investigators linked ACTIVE participants to Medicare claims from 1999 through 2019. They then tracked who ultimately received a clinical diagnosis of ADRD. After excluding people enrolled in Medicare Advantage plans, the final analytic sample included a little more than 2,000 participants.
Over the 20-year follow-up period, nearly half of those in the control group received a dementia diagnosis. That’s a rate that roughly tracks with other estimates of U.S. lifetime dementia risk. When researchers compared outcomes across the four groups, they noticed a clear pattern, but only for one training type.
Participants assigned to speed-of-processing training (and who also completed at least one booster session) boasted a much lower ADRD risk, which lingered about 25% lower than that of the control group. And that’s after researchers adjusted for age, education, cardiovascular risk factors, baseline cognitive performance, and other potential confounders.
On the other hand, speed-training participants who didn’t receive booster sessions saw no protective benefit. Memory and reasoning training, with or without boosters, failed to produce a statistically significant drop in dementia risk.
Why Speed Training Might Matter
University researchers designed speed-of-processing training – also known as Useful Field of View (UFOV) training – to sharpen visual attention and accelerate the integration of information. This approach normally relies on computerized tasks that ramp up in difficulty as participants improve.
Unlike memory and reasoning programs, speed training relies on repeated practice under time pressure, engaging what researchers describe as more procedural, rather than declarative, learning systems.
That distinction might be the difference maker. Previous ACTIVE analyses showed that speed training produced the most durable gains in task performance and everyday functioning, including safer driving, years later. The new results show that it goes further than that, into the realm of diagnosed dementia. And that might suggest that how the brain learns (and how often) could play a role in long-term brain health.
Booster sessions appear to be the catalyst. Among speed-trained participants, those who randomly received additional training much later after baseline fared better than those who completed the initial program alone.
The authors offer up two possible explanations:
- A simple dose effect, in which more training yields greater benefit, or
- A reinforcement effect, in which adaptive tasks continue to challenge the brain as abilities improve, bolstering neural networks involved in attention and processing speed.
The study’s authors point out that the protective association didn’t vary meaningfully by age at the time of training. Adults who began speed training in their late 60s appeared to benefit just as much, on average, as those who started in their 70s or early 80s.
What This Means for Brain Training
The study also helps address a long-standing debate in the brain-training field. While dozens of trials have shown that cognitive training can improve performance on trained tasks, evidence that such programs can alter the long-term risk of dementia has been limited – not to mention controversial.
No other cognitive-training trial, the authors add, has managed to curb dementia risk for such an extended period.
Even so, the findings suggest that targeted, adaptive cognitive training – with reinforcement – might delay the clinical onset of dementia. At a time when disease-modifying treatments remain limited (and expensive), that possibility carries both clinical and public-health significance.
Further Reading
Why Some Alzheimer’s Patients Decline Faster Than Expected
How the ‘Big 5’ Personality Traits Influence Dementia Risk
US Dementia Cases Will Double By 2060
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