A specific type of video game–style brain training may significantly lower the risk of dementia decades later, according to long-term research tracking older adults for 20 years.
The findings come from the Advanced Cognitive Training for Independent and Vital Elderly study, known as the ACTIVE trial, one of the largest cognitive training studies ever conducted. Funded by the National Institutes of Health, the trial followed nearly 2,800 adults age 65 and older beginning in the late 1990s.
Participants were randomly assigned to one of three types of cognitive training: memory, reasoning, or speed-of-processing exercises. A fourth group received no training and served as a control.
Two decades later, researchers found that the group who completed speed-of-processing training showed a 26 percent lower risk of developing dementia compared with the control group. The protective effect was strongest among those who completed additional booster sessions, totaling up to about 23 hours of training over three years.
The 20-year results, published in Alzheimer’s & Dementia, build on earlier studies indicating that specific cognitive training methods can lead to sustained brain health benefits.
Unlike traditional memory drills, speed-of-processing training focuses on how quickly the brain can take in and respond to visual information. One commonly known exercise, Double Decision, presents users with objects in the center of a screen while simultaneously asking them to identify targets in their peripheral vision. As performance improves, the tasks become faster and more complex.
Researchers say this repeated challenge strengthens neural efficiency. By training the brain to process information more rapidly and divide attention across multiple stimuli, the exercises appear to improve the speed and coordination of brain networks. Over time, that increased efficiency may help build cognitive reserve, allowing the brain to better withstand age-related changes.
Analysts at Johns Hopkins University, which has examined long-term ACTIVE trial outcomes, report that memory and reasoning training did not show the same association with reduced dementia risk. The speed training group was the only one to demonstrate a statistically significant protective effect over 20 years.
Researchers state that cognitive training is not a substitute for overall brain health practices. Physical activity, cardiovascular health management, social engagement, and continued learning all play established roles in reducing dementia risk. Still, the findings suggest that structured, adaptive brain exercises may be a practical and scalable tool for older adults.
As rates of Alzheimer’s disease and related dementias continue to rise, the ACTIVE trial provides rare long-term evidence that targeted cognitive intervention can have measurable effects decades after the training ends.
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