A cognitive “speed training” game that cuts dementia risk by 25 per cent alters levels of beta-amyloid, a protein that clogs up the brain in Alzheimer’s disease, in men, but not in women.

It is the first time brain training has been shown to influence the levels of a neurodegenerative marker, strengthening the evidence suggesting that mental exercises can boost brain health.

“One of the main markers that’s indicative of future dementia risk got better for men who completed cognitive speed training,” says  at Clemson University in South Carolina, who presented the research at the Alzheimer’s Association International Conference in London on 12 July.

The computer-based speed training involves recalling where objects have flashed up, with the task becoming harder as performance improves. A prior 20-year study by some of Chai’s colleagues showed that people aged 65 and older, who did the training were 25 per cent less likely to be diagnosed with Alzheimer’s disease or a related form of dementia compared with a control group.

In the latest study, Chai and her team recruited a separate group of 53 people from the US aged 65 and older, 13 of whom were male. About a third of the participants were asked to complete between 2 and 4 hours of speed training each week for 4.5 months.

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The remaining participants were either told to spend the same amount of time playing games such as Solitaire, word search and a game similar to Connect 4, or to complete another kind of brain training in which they had to strategically track objects and switch between tasks.

To explore how speed training may reduce dementia risk, the team collected blood samples from all of the participants at the start and end of the training period.

This revealed that, among men, speed training increased the ratio of two forms of beta-amyloid found in the blood, which suggests the training boosted the brain’s ability to clear beta-amyloid 42. This protein forms clumps called plaques in the brain during Alzheimer’s disease, disrupting brain function. The other two kinds of training had no effect.

“It’s a really cool finding,” says  at McGill University in Montreal. “It is definitely strengthening what they’ve [previously] shown with the reduction in dementia.”

Some Alzheimer’s treatments, such as lecanemab, have been designed to help clear amyloid from the brain, but they only marginally slow cognitive decline during Alzheimer’s disease. The limited benefit seen in trials is probably down to these treatments being taken at a relatively late stage of the condition, when substantial brain damage has already occurred, says at University College London.

Engaging in cognitive training to reduce beta-amyloid build-up before dementia develops may have a bigger effect on dementia because it would be done before much brain damage has occurred, says Castegnaro.

However, cognitive training had no effect on amyloid levels in female participants in the study. This suggests that speed training reduces dementia risk in different ways in women and men, says Chai.

The team hopes to explore how speed training may benefit women in future studies, says Chai. But first, the findings need to be verified in geographically and ethnically diverse groups, says Novozhilova.

Dementia rates are increasing more rapidly in China than almost anywhere else in the world, with cases more than quadrupling in the country over the past few decades.

at Fudan University in China and her colleagues analysed dementia rates in 204 countries and regions around the world between 1990 and 2021. They used a World Health Organization database to collect information on dementia deaths and cases in people aged 40 and older, focusing on Alzheimer’s disease and some other forms of dementia, such as vascular dementia and frontotemporal lobe dementia.

The researchers found that the number of people with dementia worldwide more than doubled during this period, from almost 22 million in 1990 to close to 57 million in 2021. The increase was even more drastic in China, where cases more than quadrupled, rising from roughly 4 million to nearly 17 million over the same time frame.

Further analysis revealed that population growth was the main culprit. Birth rates in China spiked in the 1950s. “So those people are getting older today – they are now in their 70s, which is the highest risk group for dementia,” says at Yale University, who wasn’t involved with the study. “Many countries have baby boomers, but not as large a cohort as China’s baby boomers. So that’s the main issue.”

The team identified three other major factors contributing to China’s rising dementia rates. The first, smoking, almost exclusively affects men, as only 2 per cent of women in China smoke cigarettes while . This is in sharp contrast to wealthier countries such as the US and the UK, where smoking rates have steadily declined, says Chen.

One Western trend that China has echoed is a jump in rates of diabetes and obesity, particularly in the past few decades, both of which are risk factors for dementia. This is probably because people in China are adopting a more Western diet high in fats and calories, says Chen. He believes that dementia rates in China will eventually resemble those in the US or UK, as younger generations tend to smoke less than older ones. But the condition will still have a huge impact on China in the meantime.

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“Dementia is one of the most expensive diseases in the world. It requires a lot of caregiving and treatment,” says Chen. “And in terms of an ageing population, China is still the largest in the world. There are fewer young people taking care of a larger cohort of older people with dementia. So, these are all challenges.”