Can Brain Training Really Lower Dementia Risk? What a 20-Year NIH Study Found

As the number of older adults living with dementia continues to rise in the United States, researchers are searching for ways to help people maintain brain health as they age. Although there is currently no cure for Alzheimer’s disease or other forms of dementia, scientists continue to study whether certain lifestyle habits can help lower the risk or delay the onset of cognitive decline.

One of the most encouraging findings comes from a landmark study funded by the National Institutes of Health (NIH), which suggests that a specific type of computerized brain training may help reduce the likelihood of developing dementia over time.

A Landmark Study That Spanned Two Decades

According to the National Institutes of Health (NIH), the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study is one of the largest and longest-running randomized clinical trials to examine how cognitive training affects brain health in older adults.

Beginning in 1998, researchers enrolled 2,802 community-dwelling adults aged 65 and older from six metropolitan areas across the United States. Participants were randomly assigned to one of four groups: memory training, reasoning training, speed-of-processing training, or a control group that received no cognitive training. Each participant completed up to 10 training sessions lasting approximately 60 to 75 minutes over five to six weeks, and many later received additional “booster” sessions. Researchers then followed participants for 20 years, making it one of the longest studies ever conducted on cognitive training and dementia.

When researchers analyzed the results, they found that only the participants who completed the speed-of-processing training and booster sessions experienced a meaningful reduction in dementia diagnoses. According to findings published in 2026 in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, these participants had a 25% lower incidence of Alzheimer’s disease and related dementias than those in the control group. The same benefit was not observed among participants who completed memory training or reasoning training, suggesting that not all forms of cognitive training have the same long-term effects.

Unlike crossword puzzles or traditional memory games, speed-of-processing training uses computerized exercises designed to improve how quickly and accurately the brain processes visual information. Participants practiced identifying objects, responding to changing visual cues, dividing their attention between multiple tasks, and making rapid decisions. As their performance improved, the exercises automatically became more challenging, continually stimulating the brain with new tasks.

What These Findings Mean

While the results are promising, they should be interpreted carefully. According to the National Institutes of Health, the ACTIVE study does not prove that brain training prevents dementia. Instead, it found that one specific, research-based speed-of-processing training program was associated with a lower incidence of dementia over a 20-year period.

The NIH also emphasizes that these findings should not be applied to all brain-training apps, online games, or commercially available cognitive programs. Many popular brain games have not been evaluated in long-term clinical studies and have not demonstrated the same outcomes.

Researchers are still working to understand why speed-of-processing training appears to be beneficial. The National Institute on Aging (NIA) explains that mentally stimulating activities may help strengthen neural connections and build what scientists call cognitive reserve—the brain’s ability to adapt and continue functioning despite age-related changes or disease. Researchers also believe this type of training may improve attention, processing speed, and executive function, all of which are important for everyday activities and independent living.

Brain Health Requires More Than Brain Training

Although the ACTIVE study highlights the potential benefits of targeted cognitive training, experts agree that brain health is influenced by many factors working together.

According to the National Institute on Aging, healthy aging is supported by a combination of regular physical activity, strength and balance exercises, nutritious eating, quality sleep, managing blood pressure and diabetes, staying socially connected, participating in mentally stimulating activities, and receiving routine medical care. No single activity has been proven to prevent dementia, but adopting multiple healthy lifestyle habits may help support cognitive health and overall well-being as people age.

For many older adults, maintaining these healthy routines becomes easier with the right support. Professional in-home caregivers can encourage participation in mentally engaging activities, assist with physician-approved exercise, prepare nutritious meals, provide meaningful companionship, and help seniors stay involved in hobbies and daily routines. While these services cannot prevent dementia, they can help older adults remain active, independent, and engaged—important components of healthy aging.

The findings from the NIH-funded ACTIVE study offer encouraging evidence that keeping the brain challenged in the right ways may become one valuable part of a healthy lifestyle. Combined with regular physical activity, good nutrition, social connection, and ongoing medical care, supporting brain health today may help older adults maintain their independence and quality of life for years to come.

Sources

• National Institutes of Health (NIH). Cognitive Speed Training Over Weeks May Delay the Diagnosis of Dementia Over Decades. February 10, 2026.
• Coe NB, Miller KEM, Sun C, et al. Impact of Cognitive Training on Claims-Based Diagnosed Dementia Over 20 Years: Evidence From the ACTIVE Study. Alzheimer’s & Dementia: Translational Research & Clinical Interventions. 2026.
• National Institute on Aging (NIA). Cognitive Health and Older Adults.