Tuesday, February 10, 2026
NIH-funded effort finds positive outcomes with strategies that engaged mostly unconscious, rather than conscious, thinking.
A National Institutes of Health (NIH)-funded study that followed adults age 65 and older over 20 years has linked a specific cognitive training regimen to reduced diagnoses of Alzheimer disease and related dementias (ADRD). While the authors assessed three different kinds of training, only one, which challenged participants with rapid object detection tasks, was associated with a 25% lower rate of dementia diagnosis, as indicated by Medicare claims data.
“This study shows that simple brain training, done for just weeks, may help people stay mentally healthy for years longer,” said NIH Director Jay Bhattacharya, M.D., Ph.D. “That’s a powerful idea — that practical, affordable tools could help delay dementia and help older adults keep their independence and quality of life.”
“The findings reported here suggest that moderate cognitive training could delay the onset of dementia over subsequent years. There is still more research to be done to determine about how this works, but this promising lead may move the field further into developing effective interventions to delay or prevent onset of dementia,” said Richard Hodes, M.D., director of the NIH’s National Institute on Aging (NIA), which funded this research.
As part of a now completed clinical trial, participants were randomized into cognitive training sessions, each lasting 60–75 minutes twice a week, over five to six weeks in 1999. Then, half of the participants were randomized into another round of training 11 and 35 months later. The study authors evaluated the effect of each training regimen by analyzing Medicare data collected as recently as 2019 from 2,021 study participants.
The interventions were designed to improve one of three kinds of cognitive function: memory, reasoning, and visual speed of processing. The only subgroup in this study that experienced delayed dementia diagnosis was the one that received speed training followed by additional training at a later date, designed to enhance the effect.
The speed training task first asked participants to identify which of two objects appeared in the center of a computer screen. The visual presentation of the stimuli became shorter over time until participants achieved a certain level of performance. Next the training asked participants to identify the central target, while concurrently detecting a similar peripheral target which appeared over increasingly short durations. Lastly, the position of the peripheral target around the computer screen varied, with each additional phase of the task making it more difficult.
Unlike memory or reasoning training, speed training sessions were unique, as difficulty of the tasks increased adaptively to make the tasks more difficult as an individual’s performance improved over time. The authors note that this adaptive nature, which was exclusive to speed training, could partly explain the standout findings from this group.
Another potential driver for the delayed diagnosis may be the speed training regimen’s tendency for engaging automatic, unconscious thought rather than slower, deliberate thinking. The specifics of how one would lead to the other, and why the other two training types did not yield the same results, are questions that still need to be addressed. The researchers suspect that speed training may synergize with lifestyle interventions associated with lowered risk of cognitive decline such as increased physical activity and improved diet.
“This work conveys a clear message but also leads us to ask many new questions. We are keen to dig deeper to understand the underlying mechanisms at play here, but ultimately this is a great problem to have,” said Marilyn Albert, Ph.D., the corresponding study author and director of the Johns Hopkins Alzheimer’s Disease Research Center at the Johns Hopkins School of Medicine.
This research was supported by NIA through grants R01AG056486, U01AG014260, U01AG014282, U01AG14263, U01AG14289, and U01AG014276 and by the National Institute of Nursing Research (NINR) through grants U01NR004507 and U01NR004508.
About the National Institute on Aging (NIA): NIA seeks to understand the nature of aging and diseases associated with growing older, with the goal of extending the healthy, active years of life. https://www.nia.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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Reference
Norma B. Coe et al. Impact of Cognitive Training on Claims-Based Diagnosed Dementia Over 20 Years: Evidence from the ACTIVE Study. Alzheimer’s & Dementia: Translational Research and Clinical Interventions. 2026 DOI: https://doi.org/10.1002/trc2.70197