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Impact of cognitive training on claims-based diagnosed dementia over 20 years: evidence from the ACTIVE study
Norma B Coe1,2, Katherine E M Miller3, Chuxuan Sun1
1Department of Medical Ethics and Health Policy Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.
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.
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