Journal of the International Neuropsychological Society

Research Articles

ACTIVE Cognitive Training and Rates of Incident Dementia

Frederick W. Unverzagta1 c1, Lin T. Gueya2, Richard N. Jonesa3, Michael Marsiskea4, Jonathan W. Kinga5, Virginia G. Wadleya6, Michael Crowea7, George W. Reboka8 and Sharon L. Tennstedta2

a1 Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana

a2 New England Research Institutes, Watertown, Massachusetts

a3 Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts

a4 Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida

a5 Division of Behavioral and Social Research, National Institute on Aging, Bethesda, Maryland

a6 Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama

a7 Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama

a8 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland


Systematic cognitive training produces long-term improvement in cognitive function and less difficulty in performing activities of daily living. We examined whether cognitive training was associated with reduced rate of incident dementia. Participants were from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 2,802). Incident dementia was defined using a combination of interview- and performance-based methods. Survival analysis was used to determine if ACTIVE treatment affected the rate of incident dementia during 5 years of follow-up. A total of 189 participants met criteria for incident dementia. Baseline factors predictive of incident dementia were older age, male gender, African American race, fewer years of education, relationship other than married, no alcohol use, worse MMSE, worse SF-36 physical functioning, higher depressive symptomatology, diabetes, and stroke (all p < .05). A multivariable model with significant predictors of incident dementia and training group revealed that cognitive training was not associated with a lower rate of incident dementia. Cognitive training did not affect rates of incident dementia after 5 years of follow-up. Longer follow-up or enhanced training may be needed to fully explore the preventive capacity of cognitive training in forestalling onset of dementia. (JINS, 2012, 18, 1–9)

(Received March 28 2011)

(Revised September 21 2011)

(Accepted October 03 2011)


c1 Correspondence and reprint requests to: Frederick W. Unverzagt, Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10th Street, Suite PB 218A, Indianapolis, IN 46202. E-mail: