Brain Training Game Linked to 20-Year Dementia Protection

A comprehensive study has revealed that engaging in a specific brain training video game may significantly reduce the risk of developing dementia for up to 20 years. This research, published in the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions, provides compelling evidence that cognitive training can lead to long-lasting changes in brain function.

The findings are based on a long-term follow-up of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. Participants who underwent up to 23 hours of a targeted cognitive training called speed training over a three-year period exhibited a remarkable 25% lower risk of developing Alzheimer’s and other forms of dementia during a 20-year follow-up. This confirms earlier research from the same trial, which indicated a reduced risk of dementia after a decade.

Study Overview and Methodology

The ACTIVE study, funded by the National Institutes of Health (NIH), involved nearly 3,000 participants aged 65 and older from six different geographical regions. None of the participants had significant prior cognitive impairment, and approximately 25% were minorities, with a majority being women. Women are particularly vulnerable to Alzheimer’s disease, developing dementia at nearly twice the rate of men.

Participants were divided into various cognitive training programs, including speed training, memory training, and reasoning training, with a control group receiving no training. Speed training focused on enhancing the brain’s ability to process visual information quickly and accurately. Participants engaged in exercises that required them to rapidly identify objects on a screen, similar to decision-making while driving.

According to Marilyn Albert, director of the Johns Hopkins Alzheimer’s Disease Research Center, the results were unexpected. “It’s very surprising,” she noted, emphasizing the study’s groundbreaking implications for cognitive training.

Significance of Speed Training

Participants who completed speed training and received booster sessions demonstrated a significant reduction in dementia risk compared to those who did not. In contrast, no protective effect was observed in those who engaged in memory or reasoning training. This raises intriguing questions about the mechanisms behind the success of speed training, which may involve implicit learning—a process that allows skills to be acquired unconsciously.

Dr. Richard Isaacson, a preventive neurologist, highlighted the potential of small efforts leading to significant long-term benefits. He stated, “It builds on the concept that relatively small amounts of effort can really pay dividends for decades to come.”

Dr. Thomas Wisniewski, director of cognitive neurology at NYU Langone Health, described the study as “astonishing,” emphasizing that it represents the strongest evidence to date supporting the efficacy of cognitive training in lowering dementia risk.

One possible explanation for the effectiveness of speed training lies in the concept of neuroplasticity, the brain’s ability to adapt and rewire itself in response to learning. Once the brain develops these skills, the changes may endure even without continuous practice, much like learning to ride a bike.

Dr. Sanjula Singh, a physician-scientist at Harvard Medical School, explained that speed training might engage broader neuronal networks, enhancing cognitive reserve—the brain’s ability to resist the effects of dementia. This contrasts with memory and reasoning training, which did not yield similar benefits.

Implications and Recommendations

The speed training program used in this study was initially developed by psychologists Karlene Ball and Daniel Roenker and has since evolved into an exercise called “double decision,” available through the online platform BrainHQ. Based on the study’s results, Albert recommends this training for individuals over 65. However, she suggests that younger adults in their 40s or 50s might also benefit, although more research is needed to confirm this.

Experts emphasize that while these findings are promising, Alzheimer’s disease and other forms of dementia are multifaceted conditions with no singular solution. Dr. Isaacson noted, “Anyone with a brain is at risk of Alzheimer’s, and everyone should be paying attention to their brain health.”

The Alzheimer’s Association estimates that approximately 7 million people in the United States currently live with Alzheimer’s, with projections suggesting this number could approach 13 million by 2050. Fortunately, addressing specific risk factors may help mitigate the onset of dementia.

Dr. Kellyann Niotis, a preventive neurologist at Weill Cornell Medicine, advises her patients to manage metabolic risk factors, undergo hearing screenings, and correct vision impairment, as vision loss is a known risk factor for dementia. Engaging in regular exercise, which increases blood flow to the brain, is also beneficial.

Emerging research indicates that vaccinations, such as the shingles vaccine, may offer additional protection against cognitive decline. A significant study published in 2025 found that individuals vaccinated against shingles were 20% less likely to develop dementia over a seven-year period compared to those who were not vaccinated.

As the field of dementia research continues to evolve, the implications of this study underscore the importance of proactive cognitive health measures and the potential role of brain training in safeguarding against cognitive decline.