A modest amount of brain training may offer significant, long-term protection against dementia, according to a study published this month in Alzheimer’s & Dementia: Translational Research & Clinical Interventions. Researchers found that older adults who participated in cognitive speed training exercises in the 1990s showed a 25% lower rate of dementia diagnoses over the following two decades.
The findings stem from a follow-up to the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study, a randomized controlled trial funded by the National Institutes of Health that began in 1998. The original study involved 2,802 participants and compared the effects of different types of brain training – memory, reasoning, and speed – on cognitive function. Researchers used Medicare records to track dementia diagnoses among participants over a 20-year period.
While exercises designed to boost memory and reasoning showed limited long-term impact, those focused on increasing processing speed demonstrated a sustained benefit. “We now have a gold-standard study that tells us that there is something we can do to reduce our risk for dementia,” said Marilyn Albert, a professor of neurology at Johns Hopkins University School of Medicine and an author of the study.
The speed training involved roughly hour-long sessions, typically eight to ten in total, with at least one booster session. The exercises challenged participants to quickly identify objects and locations, pushing them to process information more efficiently. George Kovach, 74, of Vienna, Virginia, began incorporating similar exercises into his routine a decade ago, using an online program called BrainHQ, which utilizes the same speed training techniques as the ACTIVE study.
“I was interested in taking care of my neurons,” Kovach said. He has completed over 1,300 BrainHQ sessions, describing the exercises as challenging but rewarding, comparing them to doing sit-ups. Kovach too maintains a heart-healthy diet and engages in regular high-intensity aerobic exercise, recognizing the broader benefits of a healthy lifestyle for brain health.
Neuroscientists believe the benefits of speed training may be linked to a process called implicit learning – the acquisition of unconscious skills. “We know that implicit learning operates differently in the brain and has more long-lasting effects,” Albert explained. Henry Mahncke, a neuroscientist and CEO of Posit Science, the parent company of BrainHQ, likened the effect to learning to ride a bike. “You can learn to ride a bike in about 10 hours of training,” he said, “And even if you don’t practice for the next 20 years, you [will] still have ‘a bike-riding brain.'”
The BrainHQ speed-training exercise, known as “Double Decision,” requires users to quickly identify a vehicle – a car or truck – that flashes on a screen, while simultaneously noting the location of a road sign appearing in the periphery. The difficulty increases as the vehicles become more similar and distractions are added to the periphery, forcing the brain to work harder to maintain focus and processing speed.
Researchers are now investigating whether more extensive training could yield even greater benefits. The Preventing Alzheimer’s with Cognitive Training (PACT) study, funded by the National Institutes of Health, is currently enrolling approximately 7,500 participants age 65 and older. PACT participants are completing 45 training sessions over several years, a significantly higher dose than the 10 or more hours used in the ACTIVE study.
Jennifer O’Brien, an associate professor of psychology at the University of South Florida who was not involved in the research, noted the surprising impact of a relatively modest amount of training. “The results with ACTIVE suggest that just 10 hours of training, with some booster sessions, can make a difference,” she said. The first results from the PACT study are expected in 2028, which will provide further insight into the optimal dosage and long-term effects of cognitive training.
