The ACTIVE trial was a trail of three different training programs using computers on the risk of future Alzheimer dementia: memory training, reasoning training, and visual-motor response speed training. The training programs were done in persons over age 65, and the program s were completed within 3 years. The study had previously reported no change in risk of dementia by any of these interventions at 5 years, but follow up has continued, and the study now reports a significant improvement in the 10 year risk of dementia at 10 years.
Speed of processing is a skill which is used in team sports and in driving in the presence of other vehicles and pedestrians.
The dropout rate from the treatment phase did not have an impact on study results, but the number of visual-motor training sessions had a significant impact on dementia risk at 10 years but not 5 years.
Because the study is ongoing with multiple endpoints, and because the significant measure was not a planned primary outcome but a result of further analysis during follow up, it will need to be confirmed with a further trial to be accepted as fully valid for making future clinical recommendations. In the meantime perhaps the types of video games that require rapid response to unexpected changes in both center and periphery of a busy screen might be recommended to persons at risk for dementia.
ABSTRACT
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Speed of processing training results in lower risk of dementia
In Press, Uncorrected Proof
Alzheimer's & Dementia: Translational Research & Clinical Interventions Authors: Jerri D.Edwards, Huiping Xu, Daniel O.Clark,Lin T.Guey,Lesley A.Ross,Frederick W.Unverzagt
https://doi.org/10.1016/j.trci.2017.09.002
Highlights
• A randomized trial examined the efficacy of three cognitive training programs.
• Speed of processing cognitive training significantly reduced dementia risk.
• Each session of speed training completed was associated with reduced dementia risk.
Abstract
Introduction
Cognitive training improves cognitive performance and delays functional impairment, but its effects on dementia are not known. We examined whether three different types of cognitive training lowered the risk of dementia across 10 years of follow-up relative to control and if greater number of training sessions attended was associated with lower dementia risk.
Methods
The Advanced Cognitive Training in Vital Elderly (NCT00298558) study was a randomized controlled trial (N = 2802) among initially healthy older adults, which examined the efficacy of three cognitive training programs (memory, reasoning, or speed of processing) relative to a no-contact control condition. Up to 10 training sessions were delivered over 6 weeks with up to four sessions of booster training delivered at 11 months and a second set of up to four booster sessions at 35 months. Outcome assessments were taken immediately after intervention and at intervals over 10 years. Dementia was defined using a combination of interview- and performance-based methods.
Results
A total of 260 cases of dementia were identified during the follow-up. Speed training resulted in reduced risk of dementia (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.50–0.998, P = .049) compared to control, but memory and reasoning training did not (HR 0.79, 95% CI 0.57–1.11, P = .177 and HR 0.79, 95% CI 0.56–1.10, P = .163, respectively). Each additional speed training session was associated with a 10% lower hazard for dementia (unadjusted HR, 0.90; 95% CI, 0.85–0.95, P < .001).
Discussion
Initially, healthy older adults randomized to speed of processing cognitive training had a 29% reduction in their risk of dementia after 10 years of follow-up compared to the untreated control group.
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