Speed-based cognitive exercises may reduce likelihood of falls in high-risk older adults

Key takeaways:

• Participants at high risk for future falls were 31% less likely to experience falls over 10 years after speed of processing training.
• Cognitive training had no significant effect on low-risk older adults.

Speed of processing training reduced the risk for future falls over 10 years in high-risk older adults, while reasoning and memory training did not reduce the likelihood of future falls in this population, according to research.

“Falling is common, costly and the leading cause of nonfatal injury for older adults in the U.S.,” Briana N. Sprague, PhD, MS, assistant professor of general internal medicine and geriatrics at Indiana University School of Medicine and investigator at the Center for Aging Research at Regenstrief Institute, and colleagues wrote in the International Journal of Environmental Research and Public Health. “Even after noninjurious falls, older adults are likelier to experience recurrent falls and increased fear of falling.”

Researchers sought to examine the effect of three cognitive training programs on the risk of experiencing a fall across 10 years in group of community-dwelling older adults.

Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, they enrolled 2,802 adults aged 65 to 94 years (mean age, 73.64 years; 75.83% women; 72.8% white) to speed of processing (n = 702), memory (n = 703) or reasoning (n = 699) training groups or to a no-contact control group (n = 698).

Researchers performed baseline cognitive, physical and health assessments before randomization, and classified participants as low risk (n = 2,360) or high risk (n = 442) for future falls. Falls were assessed at baseline and at 1, 2, 3, 5 and 10 years. Cognitive training consisted of 10 sessions, 60 to 75 minutes in length, conducted in group settings over 6 weeks. At baseline, 442 participants (15.82%) reported a fall in the previous two months, and 983 (35.08%) reported a fall across the entire 10-year period. The average length of time from baseline to first reported fall was 40.67 months.

Researchers reported no significant effects of the training in the low-risk group or the full study sample. However, participants at greater risk for future falls in the speed of processing training group were 31% less likely (HR = 0.69; 95% CI, 0.48-0.998) to experience a subsequent fall during 10-year follow-up compared with matched controls.

Although reasoning and memory training did not reduce the likelihood of future falls in the high-risk group, speed of processing training did reduce the risk of future falls over 10 years this group.

“Engaging in speed-based cognitive exercises such as those available through BrainHQ ... may be useful for older adults who have previously fallen, especially if they exhibit slow gait,” Sprague and colleagues wrote. “Additionally, physical-based interventions to reduce falls may be further enhanced by incorporating cognitive speed of processing training.

“However, future work is needed to replicate these findings in a larger sample of at-risk older adults.”