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Impact of cognitive training on claims‐based diagnosed dementia over 20 years: evidence from the ACTIVE study
Norma B. Coe, Katherine E. M. Miller, Chuxuan Sun, Elizabeth Taggert, Alden L. Gross, Richard Norman Jones, Cynthia Felix, Marilyn S. Albert et al.. Alzheimer s & Dementia Translational Research & Clinical Interventions, 2026-01-01
Topic: Risk, prevention and care in population studies
Abstract INTRODUCTION The very long‐term effect of cognitive training on the risk of Alzheimer's disease and related dementias (ADRD) is unknown. METHODS This study links data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (a four‐arm randomized controlled trial of cognitive training in a large, diverse sample) to Medicare claims (1999 to 2019). Inclusion in the analyses required being enrolled in traditional Medicare at baseline ( n = 2021). ADRD was measured with the Chronic Conditions Warehouse algorithm. RESULTS Participants randomized to the speed‐training arm who completed one or more booster sessions had a significantly lower risk of diagnosed ADRD (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.59, 0.95), while speed‐trained participants with no booster training did not have a lower risk of diagnosed ADRD (HR: 1.01, 95% CI: 0.81, 1.27). There was no main effect of memory or reasoning training on risk of ADRD. CONCLUSIONS Cognitive training involving speed of cognitive processing has the potential to delay the diagnosis of ADRD. Highlights The ACTIVE study (a four‐arm randomized controlled trial of cognitive training in a large, representative sample) reports that the speed intervention arm of the study showed a reduced likelihood of being diagnosed with ADRD over a 20‐year follow‐up period. No prior cognitive training intervention has been shown to reduce risk of ADRD over a 20‐year period. Cognitive training involving speeded, dual attention, adaptive tasks has the potential to delay the diagnosis of ADRD.
Key findings
- RESULTS Participants randomized to the speed‐training arm who completed one or more booster sessions had a significantly lower risk of diagnosed ADRD (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.59, 0.95), while speed‐trained participants with no booster training did not have a lower risk of diagnosed ADRD (HR: 1.01, 95% CI: 0.81, 1.27).
Why it matters
In this 20-year follow-up of the ACTIVE trial, participants in the speed-training arm who completed booster sessions had a lower risk of diagnosed Alzheimer's and related dementias, while memory and reasoning training showed no main effect. It suggests speed training may delay diagnosis but does not show it prevents or cures the disease.
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Study details
- Study designrandomized controlled trial
- Participants2,021
- Effect sizeHR: 1.01
- Evidence strengthHigh
How this study scored 72/100
Published in a peer-reviewed journal, and it is a randomised controlled trial.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia Translational Research & Clinical Interventions) |
| Journal's citation record | 1 / 4 | Alzheimer s & Dementia Translational Research & Clinical Interventions: journal h-index 84 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,021 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 2 / 7 | Cited 8 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 5 / 6 | Cited 38.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Sherry L. Willis: h-index 59 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41669119) |
| Free to read | 2 / 2 | Free to read |
| Total | 72 / 100 | — |
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Read the original
- DOI: 10.1002/trc2.70197
- PubMed: 41669119
- Original source →
- Free full text: Alzheimer s & Dementia Translational Research & Clinical Interventions →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Coe, N. B., Miller, K. E. M., Sun, C., Taggert, E., Gross, A. L., Jones, R. N., et al. (2026). Impact of cognitive training on claims‐based diagnosed dementia over 20 years: evidence from the ACTIVE study. Alzheimer s & Dementia Translational Research & Clinical Interventions. https://doi.org/10.1002/trc2.70197
Vancouver
Coe NB, Miller KEM, Sun C, Taggert E, Gross AL, Jones RN, 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. doi:10.1002/trc2.70197. PMID: 41669119.
BibTeX
@article{coe2026-41669119,
author = {Coe, Norma B. and Miller, Katherine E. M. and Sun, Chuxuan and Taggert, Elizabeth and Gross, Alden L. and Jones, Richard Norman and Felix, Cynthia and Albert, Marilyn S. and others},
title = {{Impact of cognitive training on claims‐based diagnosed dementia over 20 years: evidence from the ACTIVE study}},
journal = {Alzheimer s \& Dementia Translational Research \& Clinical Interventions},
year = {2026},
doi = {10.1002/trc2.70197},
pmid = {41669119},
url = {https://doi.org/10.1002/trc2.70197}
}
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