Digital training program reduces risk of dementia among older adults

UNIVERSITY PARK, Pa. — A collaborative study involving Penn State found that a computerized cognitive training program reduced the risk of dementia among older adults across a 10-year period.

Specifically, researchers found that computerized speed of processing training, or UFOV training, resulted in a decreased risk of dementia across the 10-year period, with a 29 percent lower risk as compared to a control group. Speed of processing training is a well-established computer program designed to improve the processing speed and visual attention of older adults through repeated practice of related tasks that increase in difficulty.

“Similar to our other work, we found that those who received more training also gained a greater protective benefit,” said co-author Lesley Ross, associate professor of human development and family studies.

The findings appear in the November issue of the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions, and reports on the latest results from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study, funded by the National Institutes of Health.

The ACTIVE Study enrolled 2,802 healthy older adults at six sites around the United States and followed them for 10 years. Participants were randomly placed into a control group or one of three intervention groups using different types of cognitive training: one receiving instruction on memory strategies, another receiving instruction on reasoning strategies, and a third group receiving the individualized, computerized speed of processing training.

Participants in the cognitive training groups were offered 10 initial sessions of training, each 60 to 75 minutes, which were conducted over the first six 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 one, two, three, five and 10 years. Subsets of each intervention group also received four additional “booster” training sessions in months 11 and 35 of the study. 

Researchers found no significant difference in risk of dementia for the strategy-based memory or reasoning training groups, as compared to the control group. However, as compared to the control group, the computerized speed training group showed significantly less risk with a 29 percent reduction in risk of dementia.

When reviewing the impact of each computerized speed training session completed, researchers found those who completed more sessions had lower risk of developing dementia. Among those who completed the most sessions across all three intervention groups, the incident rate of dementia for the computerized speed training group was lowest at 5.9 percent, as compared to 9.7 percent and 10.1 percent for the memory and reasoning groups, respectively. The control group, which did not engage in any training, had a dementia incidence rate of 10.8 percent.

Participants in the computerized speed 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 exercises.

To perform the divided attention training task, participants identified a central object — such as a truck — while simultaneously locating a target in the periphery — the car. The speed of these objects became increasingly faster as participants mastered each set. In the more difficult training tasks, additional distracting objects were added to make the task even more challenging, thus engaging selective attention.

Researchers note that the speed of processing training has previously been shown effective across more than 18 clinical trials in older adults on standard measures of cognitive abilities (speed of processing and attention), functional abilities (maintaining the ability to live independently, depressive symptoms, feelings of control and health-related quality of life), and real-world activities (driving safety, balance and gait).

“This is a promising evidence-based cognitive training program. This study, and others, demonstrate that there are differential transfer effects, meaning that one program results in certain types of improvements while another one does not. This highlights the importance of examining specific cognitive training programs separately so we can learn which ones have the most promise before trying to combine them with other interventions,” Ross said.

Researchers are not yet certain what the underlying mechanism of the training is that decreases dementia risk. 

“We next need to discover what makes some computerized cognitive training effective, while other types are not,” Ross said.  “We also need to investigate the optimal timing and dose of training to reduce the risk of dementia and declines in real-world functioning. This ACTIVE study was conducted with a generally healthy sample, so it is important to emphasize these results speak to the delay or potential prevention of dementia and not its treatment. However, there are clearly steps people can take now to reduce their risk.”

Co-authors include Jerri D. Edwards at the University of South Florida, Huiping Xu at Indiana University, Daniel O. Clark at Indiana University Center for Aging Research, Lin T. Guey at Moderna Therapeutics, and Frederick W. Unverzagt at Indiana University School of Medicine.

The study was supported by grants from the National Institute of Nursing Research and the National Institute on Aging, the Indiana Alzheimer Disease Center, and the Cognitive and Aerobic Resilience for the Brain Trial.

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Last Updated November 17, 2017