Effectiveness of computer-based interventions for community-dwelling people with cognitive decline: a systematic review with meta-analyses

Abstract

Background Cognitive deficits arise with age and can increase the risk for subjective cognitive decline (SCD) and mild cognitive impairment (MCI), which may result in dementia, leading to health problems, care dependency and institutionalization. Computer-based cognitive interventions (CCIs) have the potential to act as important counteraction functions in preserving or improving cognition concomitant to available pharmacological treatment. The aim was to assess the effectiveness of CCIs performed individually with a personal or tablet computer, game console, virtual, augmented, or mixed reality application on cognition in community-dwelling people with SCD, MCI and dementia. Methods A systematic review with meta-analyses of randomized controlled trials (RCTs) was performed. The systematic literature search was conducted in MEDLINE, CINAHL, Embase, Cochrane CENTRAL, IEEE Xplore Digital Library, Web of Science, Scopus and PsycINFO. In addition, a search for gray literature and backward citation searching were carried out. To judge on the evidence, two reviewers independently used the Cochrane Risk of Bias Tool. The standardized mean difference (SDM) for pooling comparable studies using the random-effects model was applied. Results Twenty-four RCTs were identified, of which 1 RCT examined CCIs in individuals with SCD, 18 RCTs with MCI, and 6 RCTs with dementia. Most interventions were conducted with personal computers. Meta-analyses with 12 RCTs showed significant effects of computer-based cognitive interventions for people with MCI in the domains memory, working memory, attention/concentration/processing speed and executive functioning, but no significant improvements in global cognition and language. Regarding dementia a meta-analysis pooled with 4 RCTs demonstrated a tendency towards, but no significant increase of memory functions (SMD 0.33, CI 95% [-0.10, 0.77]). One RCT regarding SCD reported significant improvements in memory functions for participants conducting a cognitive training on a personal computer. Conclusions The results demonstrated that CCIs have beneficial effects on domain-specific cognition in people with MCI but no significant effects on people with dementia. In terms of SCD, one study showed significant improvements in memory functions. It seems that the beneficial effect for cognitive preservation or improvement due to CCIs occurs at the earliest intervention state. However, more research on SCD is needed. Trial registration PROSPERO International Prospective Register of Systematic Reviews CDR42020184069.

Validity and Reliability Study of Online Cognitive Tracking Software (BEYNEX)

“…With the contribution of today’s digital technology, many online applications have started to be used in the topics of cognitive stimulation, training, and rehabilitation. Research results of programs targeting training and rehabilitation are discussed in various review articles [ 14, 15 ]. Most studies reported that users do not need to be technologically skilled to successfully complete or benefit from training.…”

Effectiveness of Different Neurocognitive Intervention Approaches on Functionality in Healthy Older Adults: A Systematic Review

“…Other more novel approaches to the use of cognitive training are new technologies, such as computer-based cognitive interventions (CCIs) [19], as they can be beneficial for preservation or improvement in healthy people or in the initial stages of cognitive disease, adding motivation and ease of adaptation. Another example is the meta-analysis conducted by Son and colleagues [20], which confirmed among its most relevant results that cognitive training based on virtual reality is a useful tool for improving IADL performance and is therefore ecologically valid.…”