First-of-its-kind primary prevention trial needs more older adults to help researchers determine if a specific type of computer training can reduce the risk of Alzheimer’s disease, other dementias

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The University of South Florida’s Preventing Alzheimer’s with Cognitive Training (PACT) study continues to seek participants for this first-of-its-kind primary prevention trial.  Funded by a $2.7 million National Institutes of Health grant, the study is examining whether a specific type of computerized brain training can reduce the risk of mild cognitive impairment, and dementias like Alzheimer’s disease, in older adults.

The Tampa Bay area has three PACT study training sites, one each in Hillsborough, Pinellas and Polk counties. For more information on site locations and phone numbers, please visit: pactstudy.org/tampa-bay/

Prevention research takes on increased urgency in the wake of recent failures of investigational Alzheimer’s drugs from major pharmaceutical companies to halt brain degeneration.

Research assistant Dorothy St. Pierre, center, chats with a PACT study participant Twyla Sampson in the USF Cognitive Aging Lab.

“Much of what we know about Alzheimer’s disease indicates that early intervention is absolutely critical,” said USF’s Aryn Harrison Bush, PhD, PACT study co-investigator who oversees the Polk County site. “Compelling preliminary evidence has shown that the specific form of adaptive, computer-based cognitive training we are studying decreased the risk of dementia by 29% to 48% compared to older adults who received no training.”

The researchers hope to enroll a total of 1,600 healthy adults age 65 or older, in Tampa Bay and Michigan.  Study participants cannot have dementia or other neurological disorders, but a family history of Alzheimer’s does not disqualify a person. They must commit to three initial visits at the training site, and then complete the remaining brain training sessions independently at home.

Lakeland PACT study participant John Peronto, 71, is the primary caregiver for his wife of 41 years Sue Peronto, diagnosed with Alzheimer’s disease in 2013.  The once vibrant woman, now bedridden, struggles to communicate. But Sue still recognizes and calls her husband by name, and John affectionately refers to his wife as “my Susie Q.”

“I became interested in this study because I’ve seen what this awful disease has done to my wife,” Peronto said. “I’m hoping it expands the knowledge about whether this type of cognitive training can help prevent or slow Alzheimer’s.  Right now only a few drugs are on the market, and all they do is provide some short-term relief of symptoms.”

The researchers hope to recruit a total of 1,600 volunteers — a diverse population of healthy adults age 65 or older — to test whether a specific type of computer brain exercises can reduce the risk of decline in cognitive abilities like thinking, remembering and reasoning.

The USF researchers want to broaden the scientific studies to a more diverse population than ever before to evaluate “whether it’s feasible and effective to ‘prescribe’ such brain training exercises at home,” said Jennifer Lister, PhD, PACT study co-investigator. “We’re enthusiastic about bringing the opportunity to participate in Alzheimer’s prevention research to our community.”

Principal investigator Jerri Edwards, PhD, emphasized the need for African-American and Latino volunteers as the Alzheimer’s Association reports they are populations at highest risk for Alzheimer’s disease and other dementias.

-Video and photos by Allison Long, USF Health Communications and Marketing

10-year study led by USF’s Jerri Edwards concludes computerized brain training program reduces risk of dementia 29 percent

TAMPA, Fla. (Nov. 16, 2017) — Computerized brain training is now the first intervention of any kind to reduce the risk of dementia among older adults. The breakthrough results from a randomized controlled trial were just published in the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions. The article, “Speed of Processing Training Results in Lower Risk of Dementia,” reports on the latest findings from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study funded by the National Institutes of Health.

Jerri Edwards, PhD

“Speed of processing training resulted in decreased risk of dementia across the 10-year period of, on average, 29 percent as compared to the control,” said lead author Jerri Edwards, PhD, of the University of South Florida Department of Psychiatry and Behavioral Neurosciences and College of Community and Behavioral Sciences. “When we examined the dose-response, we found that those who trained more received more protective benefit.”

The ACTIVE Study enrolled 2,802 healthy older adults at six sites around the United States and followed them for 10 years (as they aged from an average of 74 to 84). Participants were randomized into a control group or one of three intervention arms using different types of cognitive training: 1) a group receiving instruction on memory strategies; 2) a group receiving instruction on reasoning strategies; and 3) a group receiving individualized computerized speed of processing training. Participants in the cognitive training groups were offered 10 initial sessions of training (60-75 minutes per session) which was 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 1, 2, 3, 5 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 of dementia – averaging a 29 percent risk reduction.

When reviewing the impact of each computerized speed training session completed, researchers found those who completed more sessions had lower risk. Among those who completed 15 or more sessions across all three intervention groups, the risk 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, a user identified an object (i.e., car or truck) at the center of gaze while at the same time locating a target in the periphery (i.e., car). As the user got the answers correct, the speed of presentation becomes progressively briefer, while the targets become more similar. In the more difficult training tasks, the target in the periphery is obscured by distracting objects, engaging selective attention.

A computerized brain training exercise like that found on BrainHQ.com pushes a user to progressively improve visual speed of processing, with attentional demands both at the center of gaze and periphery.

There is substantial prior scientific literature on this training exercise, which is referred to as “speed of processing training,” “useful field of view training,” or “UFOV training.” The exercise was developed by Dr. Karlene Ball of the University of Alabama Birmingham and Dr. Dan Roenker of Western Kentucky University. It is now exclusively licensed to Posit Science Corporation, and is available as the “Double Decision” exercise of the BrainHQ.com brain training program. |

The paper notes that this particular type of computerized brain training, as updated by its inventors and Posit Science over the years, has previously been shown effective across more than 18 clinical trials in older adults on standard measures of cognitive abilities (e.g., speed of processing and attention) and functional abilities (e.g., maintaining the ability to live independently, depressive symptoms, feelings of control, and health-related quality of life), as well as in real world activities (e.g., driving safety, balance and gait).

“We need to further delineate what makes some computerized cognitive training effective, while other types are not,” said Dr. Edwards. “We also need to investigate what is the appropriate amount of training to get the best results. The timing of intervention is also important. Existing data indicate speed training is effective among older adults with and without mild cognitive impairment, but it is important to understand this is preventative to lower risk of dementia and is not a treatment for dementia. Our ongoing research is examining this intervention among persons with Parkinson’s disease as well as other types of cognitive interventions.”

The preliminary results reported at the Alzheimer’s Association International Conference were confirmed in this report. However, to be more conservative, the publication used a narrower definition of dementia.

The article “Speed of Processing Training Results in Lower Risk of Dementia” reflects the ACTIVE study’s conclusion based on three criteria for dementia: cognitive and functional impairment, outcome of the Mini–Mental State Examination (MMSE) and/or diagnosis of dementia or Alzheimer’s disease as reported by the participant or a relative of the participant. The risk reduction from randomization to speed training ranged from 29 to 33 percent, depending on how dementia was defined.

Older adults interested in participating in similar research can contact the USF Cognitive Aging Laboratory at 813-974-6703.

Watch a demonstration of the speed of processing exercise “Double Decision,” licensed by Posit Science.

Older adults who completed 11 or more sessions of training had a 48 percent reduced risk of dementia over the 10-year study period, a University of South Florida researcher finds

 TAMPA, Fla. (July 25, 2016) – A particular type of brain training can significantly and substantially reduce risk for dementia, said University of South Florida (USF) associate professor Jerri Edwards, PhD, in a presentation made yesterday in Toronto, Canada, at the Alzheimer’s Association International Conference.

“This is the first time a cognitive intervention has been shown to protect against dementia in a large, randomized, controlled trial,” said Dr. Edwards, a faculty member in the USF School of Aging Studies and an associate member of the USF Health Byrd Alzheimer’s Institute. “Relatively small amounts of training resulted in up to a 48 percent decrease in the risk of dementia over the 10-year study period.”

Dr. Edwards reported on the latest results from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, a 10-year study on cognition and aging funded by the National Institute on Aging.

Jerri Edwards, PhD, an associate professor at the USF School of Aging Studies and associate member of the USF Health Byrd Alzheimer’s Institute, studies cognitive performance, including how quickly the brain can process information and act on it.

The ACTIVE Study enrolled 2,802 healthy older adults at six sites around the United States, and randomized the participants into four groups: 1) an intervention group receiving 10 one-hour sessions of classroom instruction on memory strategies; 2) an intervention group receiving the same amount of instruction on reasoning strategies; 3) an intervention group receiving the same amount of computerized brain training, involving perceptual practice and; 4) a control group measured at the same times as the intervention groups.

All participants were assessed on a number of cognitive and functional measures at the completion of the initial 10 sessions of training (after five weeks) and at follow-up visits at years one, two, three, five and 10. Subsets of each intervention group also received four additional “booster” training sessions at years one and three. In releasing the current results, the researchers looked at the risk of developing dementia over the 10-year period across all four groups.

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 brain training group were 33 less likely to develop dementia across 10 years, a statistically significant difference (p=0.012).

The researchers further saw a significant dose-response function. After adjusting for other variables indicating risk for dementia (e.g., race, sex, mental status, physical status, depressive symptoms), participants who engaged in 11 or more sessions of the computerized brain training showed a 48 percent reduction risk of dementia as compared to the control group (p=.005).

Participants in the computerized brain 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, a user identifies an object at the center (i.e., car or truck) of gaze while at the same time locating a target in the periphery (i.e., car). As the user gets the answers correct, the speed of presentation becomes progressively briefer, while the targets become more similar. In the more difficult training tasks, the target in the periphery is obscured by distracting objects, engaging selective attention.

A brain training exercise like that found on BrainHQ.com pushes a user to progressively improve visual speed of processing, with attentional demands both at the center of gaze and periphery.

There is substantial prior scientific literature on this training exercise, which is referred to as “speed of processing training”, “useful field of view training”, or “UFOV training.” The exercise was developed by Dr. Karlene Ball of the University of Alabama Birmingham and Dr. Dan Roenker of Western Kentucky University. It is now exclusively licensed to Posit Science Corporation, and is available as the “Double Decision” exercise of the BrainHQ.com brain training program.

Dr. Edwards noted that this particular training regimen has previously been shown effective in multiple clinical trials and, unlike other approaches, has been found to improve the everyday functional abilities of older adults. “These new data”, she said, “further demonstrate the longitudinal benefit of reducing risk of dementia.”

The benefits of the program are believed to be driven by engaging brain plasticity in a way that improves attention and up-regulates the chemical (neuromodulatory) system.

“We need to further delineate what makes some computerized cognitive training effective, while other types are not,” Dr. Edwards said. “We also need to investigate what is the appropriate amount of training to get the best results, Given that 10 to 14 sessions had these benefits, what would the effects of larger doses be? “

“Clearly, the time spent on effective brain training has potential long-lasting benefits for many aspects of older adults’ lives,” she concluded.

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The University of South Florida is a high-impact, global research university dedicated to student success. USF is a Top 50 research university among both public and private institutions nationwide in total research expenditures, according to the National Science Foundation. Serving nearly 48,000 students, the USF System has an annual budget of $1.5 billion and an annual economic impact of $4.4 billion. USF is a member of the American Athletic Conference.

Media contact:
Shani Fails, M.A., Director, Communications & Marketing
USF Health Byrd Alzheimer’s Institute
sfails@health.usf.edu or 813-396-0675