Repeated speed-based brain training was linked to about 25% fewer dementia diagnoses over 20 years.
Can structured brain exercises do more than improve short-term cognitive test scores and actually delay dementia? To explore this question, researchers followed participants from the long-running ACTIVE trial for two decades using health insurance records.
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The analysis included 2,021 adults aged 65 and older. Participants were randomly assigned to one of three brain training programs or to a control group that did not receive training. The training group completed up to ten sessions lasting 60 to 75 minutes over five to six weeks at the start of the study. Dementia diagnoses were then tracked for up to 20 years. Participants who completed most of the initial training could also be assigned additional booster sessions at 11 and 35 months. The three programs targeted different skills: speed training to improve rapid visual processing and the ability to process multiple streams of information at once, memory training using structured recall strategies, and reasoning training based on identifying patterns in sequences of information.
- In the control group, 48.7% (239 of 491) of the participants were diagnosed with dementia over the study period.
- Compared with the control group, none of the three training programs without booster sessions clearly reduced dementia risk.
- The clearest reduction appeared in the subgroup assigned to speed training with booster sessions. In that group, 39.8% (105 of 264) developed dementia, corresponding to about a 25% lower risk compared with controls.
- Memory and reasoning training did not show clear protection, with or without booster sessions.
The speed training program was computer-based and adaptive, meaning the exercises automatically became more challenging as participants improved. In contrast, the memory and reasoning programs focused on teaching specific strategies, such as mnemonic techniques or pattern-based problem solving. The adaptive format of speed training may more strongly engage neuroplasticity, the brain's ability to reorganize and strengthen neural connections with practice. Importantly, repeated practice appears to be necessary to produce meaningful effects.
The study has limitations. Dementia was identified from health insurance records rather than detailed clinical exams, and booster analyses included only those who completed most of the initial training, which could introduce bias. Overall, the findings support further study of adaptive speed training as a potential part of dementia prevention strategies. In Aliquot #90, Dr. Alex Montagne and I discuss how inflammation early in life can quietly set the stage for dementia and how lifelong healthy habits can help reduce the risk.