Older adults aged 65 and above who took part in a short course of cognitive speed training were significantly less likely to develop dementia many years later. The training focused on improving speed of processing, helping participants rapidly locate visual information on a computer screen and cope with progressively more complex tasks under time pressure. Those who completed five to six weeks of training and later attended follow-up or “booster” sessions one to three years afterwards showed a reduced likelihood of being diagnosed with dementia, including Alzheimer’s disease, even up to 20 years later. These outcomes were reported in newly published findings in a leading dementia research journal.
The National Institutes of Health funded the study and represents the first randomised clinical trial to examine dementia outcomes over 20 years. It was conducted as part of a large project designed to explore the long-term effects of different types of cognitive training in older adults. Between 1998 and 1999, researchers enrolled 2,802 participants and randomly assigned them to one of three training programmes—memory, reasoning, or speed of processing—or to a control group that received no training. Participants in the training groups completed up to ten sessions lasting just over an hour, delivered across five to six weeks.
To further test long-term impact, half of those in the training groups were randomly selected to receive additional booster sessions at approximately one and three years after the initial programme. These sessions reinforced the original training and allowed researchers to assess whether ongoing engagement made a difference. Over two decades later, the results showed a clear advantage for those who had received speed-of-processing training with boosters. In this group, 40% were diagnosed with dementia, compared with 49% in the control group, representing a meaningful 25% reduction in incidence.
Researchers based their analysis on Medicare records from 2,021 participants, covering the period from 1999 to 2019. The follow-up group closely resembled the original study population: around three-quarters were women, most were white, and the average age at enrolment was 74. During the long follow-up period, roughly three-quarters of participants died, with an average age at death of 84. Despite these changes over time, the findings remained robust and consistent.
Dementia involves a decline in thinking abilities severe enough to interfere with independent daily living, and it affects a large proportion of older adults. Alzheimer’s disease accounts for the majority of cases, while vascular and other forms make up the remainder. Researchers noted that even modest delays in dementia onset could have substantial public health benefits, reducing both personal suffering and the enormous economic costs associated with long-term care.
The authors suggest that speed training may be particularly effective because it is adaptive, adjusting task difficulty to each person’s performance in real time, and because it relies on implicit learning rather than conscious memorisation strategies. Previous work from the same research programme showed benefits for everyday functioning up to ten years later, with each booster session providing added protection. While further studies are needed to understand the biological mechanisms involved, the findings support the idea that targeted, non-drug cognitive training could play a meaningful role in healthy ageing and dementia prevention.
More information: Norma B. Coe et al, Impact of cognitive training on claims-based diagnosed dementia over 20 years: evidence from the ACTIVE study, Alzheimer’s & Dementia: Translational Research and Clinical Interventions. DOI: 10.1002/trc2.70197
Journal information: Alzheimer’s & Dementia: Translational Research and Clinical Interventions Provided by Johns Hopkins Medicine
