Brain train game may help protect against dementia for up to 20 years

A long‑term follow‑up of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial found that seniors who completed up to 23 hours of “speed” brain‑training over three years had a 25 % lower risk of Alzheimer’s disease or other dementias during a 20‑year follow‑up.

Study Design and Key Findings

The ACTIVE study was a randomized controlled trial funded by the National Institutes of Health that enrolled nearly 3,000 participants aged 65 and older from six U.S. Regions. Participants had no significant cognitive impairment at baseline, about 25 % were minorities, and most were women.

After an initial five‑week regimen of up to ten training sessions (60–75 minutes each, twice weekly), roughly half of each training group received booster sessions, adding up to 23 hours of training over three years. Researchers used Medicare records to track diagnoses of Alzheimer’s, vascular, and frontotemporal dementia.

Only the group that performed speed training with booster sessions showed a 25 % reduction in dementia risk compared with the control group. Memory and reasoning training did not produce a protective effect.

Did You Know? The ACTIVE trial’s participants were followed for two decades, making this one of the longest studies to examine cognitive training and dementia risk.

Why Speed Training May Matter

Speed training focuses on rapid visual processing: participants identify objects on a screen and make quick decisions, a skill likened to the split‑second judgments required while driving. Researchers suggest that this form of implicit learning may trigger durable neuroplastic changes, similar to how a child learns to ride a bike.

Harvard neurologist Dr. Sanjula Singh notes that such training could engage broader neuronal networks, potentially boosting “cognitive reserve,” the brain’s capacity to withstand disease‑related damage.

Another possible advantage is that the programme adapts its difficulty to the user’s performance, ensuring that faster learners face increasingly challenging tasks.

Expert Insight: Samantha Carter, senior health editor, observes that the study provides the strongest randomized evidence to date that a modest, adaptive visual‑speed exercise can translate into a measurable reduction in dementia risk. While the findings are compelling, she cautions that brain health remains multifactorial; combining training with lifestyle measures could amplify protective effects.

Should You Try Speed Training?

The speed‑training protocol was originally created by psychologists Karlene Ball and Daniel Roenker with NIH support and is now offered as the “Double Decision” game through the BrainHQ subscription platform. For now, experts recommend it mainly for adults 65 and older, reflecting the age range studied.

Because Alzheimer’s‑related brain changes can begin decades before symptoms appear, it is possible—though not yet proven—that younger adults might also benefit from early adoption of such training.

Click here to try a free version of the Double Decision brain game.

Other Strategies to Lower Dementia Risk

About 7 million Americans currently live with Alzheimer’s, a number projected to approach 13 million by 2050. The 2024 Lancet Commission report estimates that nearly half of dementia cases could be delayed or prevented by addressing modifiable risk factors.

Preventive neurologist Dr. Kellyann Niotis recommends regular hearing screenings, management of cholesterol, blood sugar, and blood pressure, and correction of vision problems, all of which are linked to dementia risk.

Physical activity that increases cerebral blood flow is also beneficial; some clinicians suggest pairing exercise with cognitively stimulating tasks, such as walking meetings or using a brain‑training programme on a stationary bike.

Emerging evidence indicates that the shingles vaccine may reduce dementia risk by about 20 % over seven years, according to a 2025 Nature study.

Frequently Asked Questions

What type of brain training was linked to reduced dementia risk?

The study identified “speed” training—rapid visual‑processing exercises—as the only training type associated with a 25 % lower risk of dementia over 20 years.

Did memory or reasoning training provide any benefit?

No. Participants who received memory or reasoning training did not show a statistically significant reduction in dementia risk compared with the control group.

How much training was required to see the benefit?

Participants who completed up to 23 hours of speed training, including booster sessions over three years, experienced the reduced risk; those without booster sessions did not see a benefit.

Given these findings, how might you incorporate brain‑training activities into your own routine to support long‑term cognitive health?