Cognitive training helpful for some but not a panacea for fall prevention

Newswise — INDIANAPOLIS – One in four adults, aged 65 or above, experiences an annual fall in the United States. These falls result in around 36,000 fatalities each year within this demographic, positioning it as the primary source of death due to injuries among elderly individuals in the U.S.

A fresh analysis, spearheaded by Briana Sprague, PhD, a Research Scientist at Regenstrief Institute, investigates the potential of cognitive training, particularly in the areas of speed of processing, memory, and reasoning, to mitigate the risk of falls. Notably, the study revealed no discernible impact of the training on the probability of falling among individuals at a low risk of falling. Dr. Sprague also holds a faculty position at Indiana University School of Medicine.

Nonetheless, older adults with a higher susceptibility to future falls, often attributable to a prior fall, exhibited a 31 percent reduced likelihood of experiencing subsequent falls over a span of 10 years when they underwent speed of processing training. In contrast, individuals at high risk for falls who did not receive this cognitive training did not demonstrate such improvements. Speed of processing training entails accurately recognizing progressively intricate visual information, enabling individuals to respond more swiftly to stimuli while disregarding irrelevant ones.

"Recently, there has been a growing interest in understanding the correlation between cognitive abilities and physical mobility. Our study, utilizing extensive data from 2,802 older adults who initially exhibited high mental functioning, observed that cognitive training did not generally prevent falls. However, it did demonstrate efficacy for individuals at a high risk of falling who received a specific type of cognitive intervention – speed of processing training," explained Dr. Sprague. "As our findings indicate, the benefits of cognitive training vary among individuals. Nevertheless, our results support the notion that incorporating cognitive training alongside physical-based interventions can potentially augment fall prevention efforts for certain individuals."

Each year, roughly 3 million elderly individuals in the United States seek medical attention in emergency departments due to fall-related injuries. Additionally, over 800,000 older adults are hospitalized annually for head injuries or hip fractures resulting from falls. These incidents frequently initiate a detrimental decline in mobility and overall health for the affected individuals.

Per the CDC, healthcare expenses linked to falls among individuals aged 65 and above reached a sum of $50 billion in 2015, with Medicare and Medicaid jointly covering 75 percent of this amount.

"Within this study, which we deem to be the initial investigation scrutinizing the impact of cognitive training on the 10-year risk of falls, we observed no correlation between the incidence of falls and demographic factors or cognitive state," remarked Dr. Sprague. "This outcome could potentially be attributed to the baseline high cognitive functioning of the study participants, who ranged from 65 to 94 years of age during the commencement of data collection."

In upcoming research endeavors, Dr. Sprague and collaborators intend to explore the connection between multi-component lifestyle interventions, encompassing aspects such as nutrition and exercise, and their impact on both physical and brain health.

“Does Cognitive Training Reduce Falls across Ten Years?: Data from the ACTIVE Trial” is published in the International Journal of Environmental Research and Public Health.

The ACTIVE Cognitive Training Trial was supported by grants from the National Institutes of Health to six field sites and the coordinating center, including Hebrew Senior-Life, Boston (NR04507), the Indiana University School of Medicine (NR04508), the Johns Hopkins University (AG014260), the New England Research Institutes (AG014282), the Pennsylvania State University (AG14263), the University of Alabama at Birmingham (AG14289), and the University of Florida (AG014276). Briana Sprague also received additional support for this research from the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative.

Authors and affiliations

Briana N. Sprague^1,2, Lesley A. Ross³ and Karlene K. Ball⁴

1 Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA; 2 Center for Aging Research, Regenstrief Institute, Indianapolis, IN 46202, USA; 3 Department of Psychology, Clemson University, Clemson, SC 29634, USA; and 4 Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35233, USA.

About Briana Sprague, PhD

In addition to her role as a research scientist at Regenstrief Institute, Briana Sprague, PhD, is an assistant professor of medicine at Indiana University School of Medicine.

About Regenstrief Institute  

Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform practice and improve the lives of patients around the globe. 

Sam Regenstrief, a nationally successful entrepreneur from Connersville, Indiana, founded the institute with the goal of making healthcare more efficient and accessible for everyone. His vision continues to guide the institute’s research mission. 

About IU School of Medicine  

IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.