Long-Term Gain From Brain Training?

brain puzzle

Programs aimed at boosting mental performance in older people showed some benefits after 10 years in objective tests and participants’ self-ratings, but not in performing real-world tasks. These are the conclusions of researchers from Johns Hopkins University.

Background: A number of studies have found mental activity helps stave off cognitive decline. Most of these have been observational or retrospective studies, but some randomized trials have had positive results.

The ACTIVE trial began in 1998 and recruited 2,832 cognitively normal and physically active individuals 65 and older from 6 cities in the USA. The researchers randomized participants to receive an intervention targeting memory, reasoning, or processing speed or to a no-contact control group. The interventions involved 10 sessions over 5 to 6 weeks, each lasting 60-75 minutes. A randomly sleeked 39% of participants also received 4 booster sessions targeting the same cognitive domains 11 and 35 months after the initial training was completed.

Training focused on:

  • Memory – instructions and exercise aimed at improving verbal episodic memory
  • Reasoning – training in solving problems containing serial patterns
  • Processing speed – exercise in visual search and analyzing increasingly complex information presented ever more briefly.

Just over half of each study group remained in the trial through the final evaluation 10 years after initial training.


  • Composite memory – No significant differences
  • Reasoning – On a 75 point scale, baseline was 30. The mean did not define in the group receiving reasoning training, but went down 3-3.9 points in the groups.
  • Processing speed – The training group had an increase in composite scores (24.3 points above baseline average of about 800, on a 1,500 point scale), whereas scores declined in the other groups.

But, improvements were not universal: Declines in scores for actual everyday tasks were similar in all groups.

My Take: It is not surprising that there were declines in everyday tasks. After all, the training only targeted one of the three major cognitive domains. While we have much work to do, it is exciting that the cognitive training could slow declines in some aspects of lab-measured cognitive function: We can enhance cognitive function with a pretty low-intensity type of training program. All the more reason to train your brain. I’m Dr. Michael Hunter.

Reference: Journal of the American geriatric Society 2014; DOI: 10.1111/jgs.12607

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Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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