Speed Training May Delay Dementia by 25% – 20-Year Study

Older adults who participated in a focused training program to improve the speed and efficiency of their visual processing experienced a significantly lower risk of developing dementia, including Alzheimer’s disease, up to 20 years later. The training, known as speed of processing training, involves rapidly identifying visual details on a computer screen and mastering increasingly complex tasks with diminishing time. The findings, published February 9 in Alzheimer’s & Dementia: Translational Research and Clinical Interventions, suggest a relatively simple intervention could have lasting benefits for cognitive health.

The research, funded by the National Institutes of Health (NIH), represents the first randomized clinical trial to track dementia outcomes over two decades in individuals who underwent cognitive training. The study, known as the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, began enrolling participants in 1998-99, ultimately including 2,802 healthy older adults who were randomly assigned to one of three cognitive training groups or a control group receiving no training.

The three training interventions focused on memory, reasoning, and speed of processing. Participants in the training groups completed up to 10 sessions, each lasting 60-75 minutes, over a period of five to six weeks. Approximately half of the participants also received booster sessions at 11 and 35 months after the initial program.

A 25% Reduction in Dementia Risk

After 20 years of follow-up, researchers analyzed long-term outcomes using Medicare data from 2,021 participants (72% of the original cohort). Among those who completed the speed training program with booster sessions, 105 out of 264 (40%) were diagnosed with dementia. This contrasts with 239 out of 491 (49%) in the control group who developed dementia, representing a 25% reduction in dementia incidence for those who underwent speed training with boosters. Importantly, speed training was the only intervention that demonstrated a statistically significant difference compared to the control group.

The follow-up group closely mirrored the original study population, with approximately three-quarters being women, 70% identifying as white, and an average age of 74 at the study’s outset. Over the 20-year period, roughly three-quarters of participants died, at an average age of 84.

Why Preventing Dementia Matters

Dementia encompasses a decline in cognitive function – thinking and memory – severe enough to interfere with daily life and independent living. We see estimated to affect 42% of adults over the age of 55 at some point in their lives and carries a substantial economic burden, costing the United States more than $600 billion annually. Alzheimer’s disease accounts for approximately 60-80% of dementia cases, while vascular dementia comprises about 5-10%. Other forms include Lewy body dementia, frontotemporal dementia, and mixed types.

How Speed Training May Offer Protection

“Seeing 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,” says Marilyn Albert, Ph.D., the corresponding study author and director of the Alzheimer’s Disease Research Center at Johns Hopkins Medicine. “Even small delays in the onset of dementia may have a large impact on public health and help reduce rising health care costs.”

These findings build upon earlier results from the ACTIVE trial, which showed that cognitive training improved everyday thinking skills for up to five years. After 10 years, all three training types were associated with better daily functioning, and speed training was linked to a 29% lower dementia incidence compared to the control group. Each booster session was associated with further reductions in risk.

Researchers hypothesize that speed training may have been particularly effective due to its adaptive nature. The program adjusted the difficulty level based on each participant’s performance, allowing those who excelled to progress to more challenging tasks while providing a slower pace for those who needed it. In contrast, the memory and reasoning programs employed a standardized approach, teaching the same strategies to all participants.

speed training relies on implicit learning – a process akin to building a skill or habit – while memory and reasoning training depend on explicit learning, which involves consciously acquiring facts and techniques. Scientists believe that implicit and explicit learning engage different brain systems, potentially explaining why only speed training was associated with a reduced dementia risk in this analysis.

Looking Ahead

“Our 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,” says George Rebok, Ph.D., a lifespan developmental psychologist and site principal investigator. “adding this cognitive training to lifestyle change interventions may delay dementia onset, but that remains to be studied.”

The authors emphasize that speed training could potentially complement other healthy aging strategies known to support brain health, such as maintaining cardiovascular health through blood pressure, blood sugar, and cholesterol management, as well as engaging in regular physical activity. However, they acknowledge that further research is needed to confirm these synergistic effects.