Brain Training Can Reduce Dementia Risk

Researchers have found that a specific type of brain training lowered dementia risk in healthy older adults by up to 29% [1]. The training, called "speed-of-processing," is designed to improve the speed and accuracy of a person's visual attention.

The findings come from a large, 10-year randomized controlled clinical trial called Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) [2]. The ACTIVE study was designed to test the effects of different cognitive training programs on the incidence of cognitive decline and dementia. Over 2,800 healthy older adults (average age 73.6 years) were randomly assigned to one of three brain-training groups—in-person training on verbal memory skills, in-person training on reasoning and problem-solving, or computer-based speed-of-processing training on visual attention—or to a control group that received no cognitive training. Participants in the training groups completed ten 60–75 minute training sessions over 5-6 weeks, and some participants received "booster" sessions (up to 4 hours of additional training after 1 and 3 years). The participants completed follow-up tests of cognition and function after 1, 2, 3, 5, and 10 years.

After 10 years, people assigned to the speed-of-processing training had a 29 percent lower incidence of dementia than people receiving no training. People who completed the "booster" sessions had an even greater reduction. For each additional booster training session, there was a 10% lower risk for dementia. When an effect is greater with more treatment—commonly referred to as a "dose-response relationship"—there is more confidence that the treatment is responsible. In contrast, the study found that people in the memory training and reasoning training groups did not have a significant reduction in dementia risk.

Further studies are needed to investigate why speed-of-processing training was protective while other types of brain training were not. In speed-of-processing training, the participant identifies an object (e.g., a truck) at the center of a computer screen while at the same time identifying a target in the periphery (e.g., a road sign). As the participant gets more answers correct, the test becomes more challenging with shorter presentation of increasingly similar objects. This type of brain training is available online as an exercise called "Double Decision" in BrainHQ [3].

The results will need to be replicated so we can be certain that the effects on dementia prevention are consistent and reliable. More training conferred greater protection in the ACTIVE trial, but we don't yet know the optimal amount of training for dementia prevention. We also don't know if this type of training is protective in people who already have impaired cognition or if it will protect younger people from cognitive decline and dementia many decades later. Researchers of the ACTIVE trial speculated that speed-of-processing training may lower dementia risk by improving the capacity or efficiency of the brain, or by promoting the health of brain tissue [1]. Brain imaging and other types of studies could help clarify the mechanisms underlying the protective effects of speed-of-processing training. Still, these findings are exciting and suggest for the first time that brain training can reduce dementia risk.

1. Edwards JD, Xu H, Clark DO et al. (in press) Speed of processing training results in lower risk of dementia. Alzheimer's & Dementia: Translational Research & Clinical Interventions.
2. Ball K, Unverzagt FW, Rebok G et al. (2014) ACTIVE: Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE). ClinicalTrialsgov.
3. Try Double Decision—A Brain-Training Exercise. BrainHQcom.

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