First Ever Effective Intervention Against Dementia Shown in Large Study

Researchers just published the first randomized controlled trial ever to show an intervention effective at lowering the risk of dementia.  A computerized brain exercise licensed exclusively by Posit Science, maker of the online (and in app) BrainHQ brain training platform, significantly reduced the risk of dementia among older adults over a 10-year period, according to an article in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, a peer-reviewed journal of the Alzheimer’s Association.

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“Relatively small amounts of training resulted in a decrease in risk of dementia over the 10-year period of 29 percent, as compared to the control,” said Dr. Jerri Edwards, lead author of the article and a Professor at the University of South Florida, College of Medicine, “And, when we looked at dose-response, we saw that those who trained more got more protective benefit.”

To place the size and importance of this protective effect in context, the researchers quantitatively compared the risk reduction for dementia from the computerized brain training to the risk reduction for major cardiovascular events (such as heart failure, heart disease and stroke) yielded by blood pressure medications, and found that this non-pharmacological intervention had a 2-4 times greater protective effect against its targeted disease condition.

“No health professional would suggest that any person with hypertension forego the protection offered by prescribed blood pressure medication,” observed Dr. Henry Mahncke, CEO of Posit Science. “We expect these results will cause the medical community to take a much closer look at the many protective benefits of these exercises in both older and clinical populations.”

The journal article, “Speed of Processing Training Results in Lower Risk of Dementia,” reports on the latest results from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study, funded by the National Institutes of Health. That study followed 2,802 healthy older adults for 10 years (as they aged from an average of 74 to 84).

The ACTIVE Study looked at the impact on aging of different types of cognitive training by randomizing participants into a control group and three intervention arms: 1) a memory group receiving classroom instruction on memory strategies; 2) a reasoning group receiving classroom instruction on reasoning strategies; and 3) a speed of processing group receiving individualized computerized brain training in a classroom setting. Participants in the cognitive training groups were asked to engage in a total of 10 sessions of training (about an hour per session) conducted over the first five weeks of the study.

All participants were assessed on a number of cognitive and functional measures at the beginning of the study, after the first six weeks, and at the end of years 1, 2, 3, 5 and 10. Subsets of each intervention group also received four additional “booster” training sessions in the weeks before the assessments at the end of years 1 and 3.

At the end of 10 years, researchers found no significant difference in incidence of dementia for the strategy-based memory or reasoning training groups, as compared to the control group. However, the speed of processing group engaged in computerized brain training showed a significant reduction in incidence of dementia – with a 29 percent reduction in the hazard of dementia.

When reviewing the impact of each computerized speed training session completed, researchers found those who completed more sessions had lower risk.  The researchers also reported on the dementia incidence rate of those who completed the most sessions of each type of training (including five or more booster sessions) and the control. The incident rate of dementia for those who completed the most sessions in speed training (at 5.9 percent) was 45 percent lower than the control (at 10.8 percent); 42 percent lower than the incidence rate for those who did the most memory training (at 10.1 percent); and 39 percent lower than the incidence rate for those who did the most reasoning training (at 9.7 percent). Only the comparison of the entire speed group to the control was reported as significant.

The newly published results confirm and extend preliminary results first announced last year.  Those results used a broader definition of dementia to reflect the under-reporting of dementia in the community. The preliminary results, indicating a 33 percent reduction in risk, relative to the control are contained in this report. However, to be more conservative, the authors now also include and highlight a narrower definition of dementia (restricted to reports of a dementia diagnosis or falling below a cut-point on a standard test). Even with the narrower definition, the effects are substantially similar – with a 29 percent reduction in dementia risk (at any given point in time) for the overall speed group as compared to the control.

Participants in the computerized brain training group were trained on a highly specific task designed to improve the speed and accuracy of visual attention, including both divided and selective attention. To perform the divided attention training task, a user identified an object (i.e., car or truck) at the center of gaze while at the same time locating a target in the periphery (i.e., car). As the user gets the answers correct, the speed of presentation becomes faster.  In the more difficult training tasks, the target in the periphery is obscured by distracting objects.

There is substantial prior scientific literature on this training exercise, which is referred to as “speed of processing training”, “useful field of view training”, or “UFOV training.” The exercise was developed by Dr. Karlene Ball of the University of Alabama at Birmingham and Dr. Dan Roenker of Western Kentucky University. It is now exclusively licensed to Posit Science, and is available as the “Double Decision” exercise of the brain training program.

The paper notes that this particular type of computerized brain training, as updated by its inventors and Posit Science over the years, has previously been shown effective across multiple clinical trials in older adults on standard measures on cognitive abilities (e.g., speed of processing, attention and memory) and functional abilities (e.g., maintaining the ability to live independently, depressive symptoms, feelings of control, and health-related quality of life), as well as in real world activities (e.g., driving safety, balance and gait). In other studies in pre-dementia conditions, it has shown improvements in cognitive and functional abilities, as well as brain structure.

“This study highlights that not all cognitive training is the same,” said Dr. Edwards. “Plasticity-based, computerized, speed of processing training has differentiated itself based both on the data and on the neurophysiological model from which it was developed.”

“There are now well over 100 peer-reviewed studies on the benefits of our brain exercises and assessments across varied populations,” said Dr. Mahncke. “The neuroplasticity-based mechanisms that drive beneficial changes across the brain from this type of training are well-documented, and are increasingly understood even by brain scientists not directly involved in their development. This type of training harnesses plasticity to engage the brain in an upward spiral toward better physical and functional brain health.”

“We work with a global team of independent researchers who are continuously pushing the boundaries of our understanding of the brain,” Dr. Mahncke observed. “We expect many more exciting announcements in the year ahead, and we plan to work with the medical community and regulators to expand beyond our wellness and performance offerings to assist people with specific medical conditions and concerns.”