Effect of computerised cognitive training on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis

Abstract

ObjectivesTo determine the effect of computerised cognitive training (CCT) on improving cognitive function for older adults with mild cognitive impairment (MCI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Web of Science and the Cochrane Library were searched through January 2018.Eligibility criteriaRandomised controlled trials comparing CCT with control conditions in those with MCI aged 55+ were included.Data extraction and synthesisTwo independent reviewers extracted data and assessed the risk of bias. Effect sizes (Hedges’ g and 95% CIs) were calculated and random-effects meta-analyses were performed where three or more studies investigated a comparable intervention and outcome. Heterogeneity was quantified using the I2 statistic.Results18 studies met the inclusion criteria and were included in the analyses, involving 690 participants. Meta-analysis revealed small to moderate positive treatment effects compared with control interventions in four domains as follows: global cognitive function (g=0.23, 95% CI 0.03 to 0.44), memory (g=0.30, 95% CI 0.11 to 0.50), working memory (g=0.39, 95% CI 0.12 to 0.66) and executive function (g=0.20, 95% CI −0.03 to 0.43). Statistical significance was reached in all domains apart from executive function.ConclusionsThis meta-analysis provides evidence that CCT improves cognitive function in older people with MCI. However, the long-term transfer of these improvements and the potential to reduce dementia prevalence remains unknown. Various methodological issues such as heterogeneity in outcome measures, interventions and MCI symptoms and lack of intention-to-treat analyses limit the quality of the literature and represent areas for future research.

Technologies for Cognitive Training and Cognitive Rehabilitation for People With Mild Cognitive Impairment and Dementia. A Systematic Review

“…Thirdly, the effectiveness of the computerized programs was not analyzed since the aim of the study was not to establish the usefulness of the software. Several recent systematic reviews concerning the efficacy of cognitive computer software are available (García-Casal et al, 2016;Gates et al, 2019a,b;Hu et al, 2019;Zhang et al, 2019). Furthermore, due to the lack of cost-effectiveness information, it was not possible to compare the programs with this respect.…”

“…Cognitive training, stimulation, and rehabilitation provided via digital devices are promising strategies for maintaining the cognitive function of healthy older adults and people with MCI (Zhang et al, 2019). Computerized cognitive interventions are not only useful for improving cognition, memory, and attention but also have a positive influence on the psychosocial functioning of older adults with MCI (Hill et al, 2017).…”

Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review

“…We included a broad range of non-pharmacological interventions, where the planned mechanism of action was a change in participants' lifestyle (diet or exercise), social activities or psychological approaches. We excluded studies of computerised cognitive training interventions, as these were not considered to act through these mechanisms (and have been extensively, recently reviewed (Bhome et al, 2018;Zhang et al, 2019)). We also excluded studies that involved taking dietary supplements, which we judged to be pharmacological.…”

Computer-based cognitive interventions in acquired brain injury: A systematic review and meta-analysis of randomized controlled trials

“…Several meta-analyses have addressed the efficacy of computer-based cognitive interventions in Dementia [9,10], Mild Cognitive Impairment (MCI) [11] and healthy population [12]. Although the trials included in these studies had methodological problems that could be improved, they showed a general positive small effect on cognition.…”