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Cognitive speed training builds \u201ccognitive reserve\u201d by strengthening the brain\u2019s implicit learning pathways, offering protection against dementia for decades. Credit: Neuroscience News<\/p>\nSummary: Results from the long-term ACTIVE study reveal that a specific type of cognitive exercise can significantly reduce the risk of dementia for up to two decades. The study, which followed nearly 3,000 older adults for 20 years, found that those who participated in \u201cspeed of processing\u201d training\u2014exercises designed to sharpen visual attention and reaction time\u2014were 25% less likely to be diagnosed with dementia compared to a control group.<\/p>\n
Remarkably, this benefit was only seen in participants who received \u201cbooster\u201d sessions following their initial five-week program. While speed training showed lasting neuroprotective effects, traditional memory and reasoning exercises did not significantly reduce dementia incidence, highlighting the unique impact of training the brain\u2019s processing speed.<\/p>\n
Key Facts<\/p>\n
The Winning Method: \u201cSpeed of processing\u201d training involves computer-based tasks that challenge the brain to identify and locate visual information quickly across a widening field of view.The \u201cBooster\u201d Necessity: The 25% reduction in risk was specific to those who completed initial training plus refresher sessions at 11 and 35 months. Without boosters, speed training showed no significant long-term benefit.Long-Term Durability: The study utilized 20 years of Medicare claims data to track diagnoses, proving that less than 24 hours of total training can have protective effects that last into a person\u2019s 80s and 90s.Implicit vs. Explicit Learning: Researchers believe speed training works because it targets \u201cimplicit\u201d learning (automatic skills), whereas memory and reasoning focus on \u201cexplicit\u201d strategies (facts and logic) which may be less resistant to age-related decline.<\/p>\n
Source: Johns Hopkins Medicine<\/p>\n
Adults age 65 and older who completed five to six weeks of cognitive speed training \u2014 in this case, speed of processing training, which helps people quickly find visual information on a computer screen and handle increasingly complex tasks in a shorter time period \u2014 and who had follow-up sessions about one to three years later were less likely to be diagnosed with\u00a0dementia, including\u00a0Alzheimer\u2019s disease, up to two decades later, according to new findings published today in\u00a0Alzheimer\u2019s & Dementia: Translational Research and Clinical Interventions.<\/p>\n
This National Institutes of Health (NIH)-funded study is the first randomized clinical trial, and only study of its kind, to assess 20-year links with dementia, including Alzheimer\u2019s disease, among adults who participated in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)\u00a0study.<\/p>\n
Cognitive speed training builds \u201ccognitive reserve\u201d by strengthening the brain\u2019s implicit learning pathways, offering protection against dementia for decades. Credit: Neuroscience News<\/p>\n
Investigators enrolled 2,802 adults into this study in 1998\u201399 to assess long-term benefits of participants randomized to three different types of cognitive training \u2014 memory, reasoning and speed of processing \u2014 in comparison to a control group who received no training.<\/p>\n
In the three training groups, participants received up to 10 sessions of 60\u201375 minutes of cognitive training that took place over five to six weeks.<\/p>\n
Additionally, half of participants were randomized to receive up to four additional cognitive training sessions, or boosters, which took place 11 and 35 months after the initial training.\u00a0<\/p>\n
In this 20-year follow-up study, investigators found that 105 out of 264 (40%) participants in the speed-training group with boosters were diagnosed with dementia, which was a 25% reduced incidence compared to 239 out of 491 (49%) adults in the control arm. This was the only intervention with a statistically significant, or meaningful, difference compared to the control group.<\/p>\n
To reach these findings, investigators reviewed Medicare data from 2,021 participants (72% of the original study) between 1999 and 2019. Characteristics of participants in the follow-up study were similar to the original trial.<\/p>\n
Three-fourths of participants were women, 70% were white, and the average age was 74 at the start of the study. During the follow-up period, about three-fourths of participants died (at an average age of 84).\u00a0<\/p>\n
Dementia is characterized as declines in thinking that result in the inability of an individual to live independently or manage on their own on a daily basis. It\u2019s\u00a0estimated\u00a0to affect 42% of adults older than age 55 at some point in their life, and costs the U.S. more than $600 billion each year.<\/p>\n
Alzheimer\u2019s disease, the most common\u00a0type, accounts for about\u00a060%\u201380%\u00a0of dementia cases, while\u00a0vascular dementia\u00a0accounts for about\u00a05%\u201310%. Other types of dementia include\u00a0Lewy body,\u00a0frontotemporal\u00a0or combinations.\u00a0<\/p>\n
\u201cSeeing that boosted speed training was linked to lower dementia risk two decades later is remarkable because it suggests that a fairly modest nonpharmacological intervention can have long-term effects,\u201d says\u00a0Marilyn Albert, Ph.D., the corresponding study author and director of the\u00a0Alzheimer\u2019s Disease Research Center\u00a0at Johns Hopkins Medicine.<\/p>\n
\u201cEven small delays in the onset of dementia may have a large impact on public health and help reduce rising health care costs.\u201d\u00a0<\/p>\n
Albert explained that additional studies are needed to understand underlying mechanisms that may help explain these associations and to understand why the reasoning and memory interventions didn\u2019t have the same 20-year associations.<\/p>\n
Findings from this 20-year study expand on\u00a0prior research from the ACTIVE trial, which is the largest study in the U.S. to assess different types of cognitive training in adults. ACTIVE researchers previously found that cognitive training helped participants improve everyday tasks involved with thinking, remembering, reasoning and quickly making decisions for\u00a0up to five years.<\/p>\n
All three training arms were also linked to improved outcomes with everyday function\u00a010 years later. Additionally, those who completed speed training had a\u00a029% lower incidence of dementia\u00a010 years later compared to the control group. Each booster session was linked to further risk reductions.<\/p>\n
The authors explain that speed training may have been particularly effective because the program was\u00a0adaptive\u00a0\u2013 it adapted its level of challenge for each participant\u2019s individual performance level that day.<\/p>\n
People who were faster at the start moved to faster challenges quickly, and people who needed more time started at slower levels. The memory and reasoning programs were not adaptive \u2014 everyone in the group learned the same strategies.<\/p>\n
Additionally, speed training drives\u00a0implicit\u00a0learning (more like an unconscious habit or a skill), while memory training and reasoning training drive\u00a0explicit\u00a0learning (more like learning facts and strategies).<\/p>\n
Scientists already know that implicit learning works very differently in the brain than explicit learning, and this may contribute to the results seen with dementia in the current analysis.\u00a0<\/p>\n
\u201cOur findings provide support for the development and refinement of cognitive training interventions for older adults, particularly those that target visual processing and divided attention abilities,\u201d says site principal investigator\u00a0George Rebok, Ph.D., a lifespan developmental psychologist who creates community programs for healthy aging and is a professor emeritus of mental health at the\u00a0Johns Hopkins Bloomberg School of Public Health.<\/p>\n
\u201cIt is possible that adding this cognitive training to lifestyle change interventions may delay dementia onset, but that remains to be studied.\u201d \u00a0<\/p>\n
The authors also note that speed training may synergistically support other\u00a0lifestyle interventions\u00a0that strengthen neural connections, but more research is needed to understand these interactions and to confirm this.<\/p>\n
Other activities that have been associated with reduced risk of cognitive decline include taking steps to support\u00a0cardiovascular health, such as monitoring blood pressure, blood sugar, cholesterol and body weight, and engaging in regular physical activity.\u00a0<\/p>\n
Additional study authors include Norma B. Coe, Chuxuan Sun and Elizabeth Taggert (University of Pennsylvania), Katherine E. M. Miller and Alden L. Gross (the Johns Hopkins Bloomberg School of Public Health), Richard N. Jones (Brown University), Cynthia Felix (University of Pittsburgh), Michael Marsiske (University of Florida), Karlene K. Ball (University of Alabama at Birmingham) and Sherry L. Willis (University of Washington).\u00a0<\/p>\n
Funding:This study is funded by NIH grants from the National Institute on Aging (R01AG056486).<\/p>\n
The original ACTIVE trial was supported by NIH grants to six field sites and the coordinating center. This includes Hebrew Senior-Life, Boston (NR04507), the Indiana University School of Medicine (NR04508), The Johns Hopkins University (AG014260), the New England Research Institutes (AG014282), the Pennsylvania State University (AG14263), the University of Alabama at Birmingham (AG14289) and Wayne State University\/University of Florida (AG014276).<\/p>\n
Key Questions Answered:Q: Is this the same as doing a daily crossword or Sudoku?<\/p>\n
A: No. This study found that memory and reasoning exercises (like those used in crosswords) did not lower dementia risk over 20 years. The benefit came specifically from speed training, which forces the brain to process visual information faster and manage divided attention.<\/p>\n
Q: How much training do I actually need to see a benefit?<\/p>\n
A: Surprisingly little. Participants completed just 10 sessions (about 10-12 hours) initially, with a few hours of \u201cbooster\u201d sessions a year or two later. Total training time was under 24 hours spread over three years.<\/p>\n
Q: Can I do this specific training at home?<\/p>\n
A: Yes. The specific \u201cspeed of processing\u201d exercises used in the study have been developed into commercial software (often found under the name \u201cDouble Decision\u201d).<\/p>\n
Editorial Notes:This article was edited by a Neuroscience News editor.Journal paper reviewed in full.Additional context added by our staff.About this cognitive training and Alzheimer\u2019s disease research news<\/p>\n
Author: Jessica Frost<\/a>
Source: Johns Hopkins Medicine<\/a>
Contact: Jessica Frost \u2013 Johns Hopkins Medicine
Image: The image is credited to Neuroscience News<\/p>\n