Cited by 46Dementia and Cognitive Impairment ResearchCognitive Abilities and TestingCognitive Functions and Memory

Computerised cognitive training for maintaining cognitive function in cognitively healthy people in midlife

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Gates, Nicola J, Rutjes, Anne WS, Di Nisio, Marcello, Karim, Salman, Chong, Lee-Yee, March, Evrim, Martínez, Gabriel, Vernooij, Robin WM·2019·Cochrane Database of Systematic Reviews

Abstract

BACKGROUND: Normal aging is associated with changes in cognitive function that are non-pathological and are not necessarily indicative of future neurocognitive disease. Low cognitive and brain reserve and limited cognitive stimulation are associated with increased risk of dementia. Emerging evidence now suggests that subtle cognitive changes, detectable years before criteria for mild cognitive impairment are met, may be predictive of future dementia. Important for intervention and reduction in disease risk, research also suggests that engaging in stimulating mental activity throughout adulthood builds cognitive and brain reserve and reduces dementia risk. Therefore, midlife (defined here as 40 to 65 years) may be a suitable time to introduce cognitive interventions for maintaining cognitive function and, in the longer term, possibly preventing or delaying the onset of clinical dementia. OBJECTIVES: To evaluate the effects of computerised cognitive training interventions lasting at least 12 weeks for maintaining or improving cognitive function in cognitively healthy people in midlife. SEARCH METHODS: We searched up to 31 March 2018 in ALOIS (www.medicine.ox.ac.uk/alois), the specialised register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG). We ran additional searches in MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov, and the WHO Portal/ICTRP at www.apps.who.int/trialsearch, to ensure that the search was as comprehensive and as up-to-date as possible, to identify published, unpublished, and ongoing trials. SELECTION CRITERIA: We included randomised controlled trials (RCTs) or quasi-RCTs, published or unpublished, reported in any language. Participants were cognitively healthy people between 40 and 65 years of age (80% of study population within this age range). Experimental interventions adhered to the following criteria: intervention was any form of interactive computerised cognitive intervention - including computer exercises, computer games, mobile devices, gaming console, and virtual reality - that involved repeated practice on standardised exercises of specified cognitive domain(s) for the purpose of enhancing cognitive function; duration of the intervention was at least 12 weeks; cognitive outcomes were measured; and cognitive training interventions were compared with active or inactive control interventions. DATA COLLECTION AND ANALYSIS: For preliminary screening of search results, we used a 'crowd' method to identify RCTs. At least two review authors working independently screened remaining citations against inclusion criteria; independently extracted data; and assessed the quality of the included trial, using the Cochrane risk of bias assessment tool. We used GRADE to describe the overall quality of the evidence. MAIN RESULTS: We identified one eligible study that examined the effect of computerised cognitive training (CCT) in 6742 participants over 50 years of age, with training and follow-up duration of six months. We considered the study to be at high risk of attrition bias and the overall quality of the evidence to be low.Researchers provided no data on our primary outcome. Results indicate that there may be a small advantage for the CCT group for executive function (mean difference (MD) -1.57, 95% confidence interval (CI) -1.85 to -1.29; participants = 3994; low-quality evidence) and a very small advantage for the control group for working memory (MD 0.09, 95% CI 0.03 to 0.15; participants = 5831; low-quality evidence). The intervention may have had little or no effect on episodic memory (MD -0.03, 95% CI -0.10 to 0.04; participants = 3090; low-quality evidence). AUTHORS' CONCLUSIONS: We found low-quality evidence from only one study. We are unable to determine whether computerised cognitive training is effective in maintaining global cognitive function among healthy adults in midlife. We strongly recommend that high-quality studies be undertaken to investigate the effectiveness and acceptability of cognitive training in midlife, using interventions that last long enough that they may have enduring effects on cognitive and brain reserve, and with investigators following up long enough to assess effects on clinically important outcomes in later life.

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  • Three systematic reviews in the general population found no evidence of generalised cognition improvement from specific cognitive interventions, including computerised cognitive training, although the trained domain might improve.

    “Three systematic reviews in the general population found no evidence of generalised cognition improvement from specific cognitive interventions, including computerised cognitive training, although the domain trained might improve.52, 53, 54”

    From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [54]

    The Authors’ conclusions (page unavailable) say the review could not determine whether computerised cognitive training maintains global cognition in healthy adults in midlife. The Discussion (page unavailable) reports a possible small improvement in executive function, but the sole eligible trial did not measure global cognition. The claim extends this limited finding to the general population and to cognitive interventions beyond the computerised training assessed here. (LLM, conf=0.84)

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  1. Medicine, ECIM 2010 Berlin, Germany. 2010; Vol. Conference Start: 20101203. Conference End: 20101204: 264.
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  7. Yassuda 2015 {published data only} Yassuda MS, Camargo MC, Brum PS, Bento T, Silva L, Spindola L. Working memory training: effects on cognition and psychological wellbeing of seniors without dementia and depression. Conference: Alzheimer's Association International Conference 2015 Washington, DC, United States 2015;Conference Start: 20150718. Conference End: 20150723:P462.
  8. "memory enhance*".ti,ab. 37. "memory rehab*".ti,ab. 38. "brain exercis*".ti,ab. 39. "cognitive rehab*".ti,ab. 40. "cognitive rehab*".ti,ab. 41. "mnemonic train*".ti,ab. 42. CST.ti,ab. 43. (mental adj3 activit*).ti,ab. 44. "cognitive intervention*".ti,ab. 45. "cognitive motor intervention*".ti,ab. 46. "cognition based intervention*".ti,ab. 47. "cognitive enrich*".ti,ab. 48. "reality orientation".ti,ab. 49. (memory adj2 game*).ti,ab. 50. or/31-49 51. 18 and 30 and 50 52. *Cognition/ 53. (MCI or "mild cognitive impairment" or elderly or "old* adults" or "middle age*") .ti 54. ("cognitive stimulation" or "cognitive training").ti,ab. 55. 19 or 20 or 21 56. 52 and 53 and 54 and 55 57. 51 not 56 CINAHL (EBSCOhost) [Date of most recent search: 31 March 2018] Jan 2015: 390 Jul 2015: 13 Feb 2016: 57 Jul 2016: 12 Mar 2018: 125 ISI Web of Science [includes: Web of Science (1945-present); BIOSIS Pre- views (1926-present); MEDLINE (1950- present); Journal Citation Reports]; BIO- ("mild cognitive impairment" OR elderly OR "age* subjects" OR "old* adult*" OR "middle age*" OR MCI) AND TOPIC: ("randomly allocated" OR "random alloca- Jan 2015: 333 Jul 2015: 44 Feb 2016: 108 Jul 2016: 35 (Continued) SIS Previews [Date of most recent search: 31 March 2018]

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Authors
Gates, N. J., Rutjes, A. W., Di Nisio, M., Karim, S., Chong, L.-Y., March, E., Martínez, G., & Vernooij, R. W.
Affiliations
  • UNSW Sydney (AU)
  • University of Bern (CH)
  • University "G. D'Annunzio" of Chieti-Pescara; Department of Medicine and Ageing Sciences; Via dei Vestini 31 Chieti Scalo Italy 66013
  • Lancashire Care NHS Foundation Trust (GB)
  • Cochrane (GB)
  • St Vincent's Hospital Melbourne (AU)
  • Universidad de Antofagasta (CL)
  • Iberoamerican Cochrane Centre (ES)
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2019-03-13
Volume
3
Pages
CD012278-CD012278
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
OpenAlex
W3007410866
Cited by
46
References
316
Citations by year
2026: 5 · 2025: 4 · 2024: 8 · 2023: 2 · 2022: 7 · 2021: 9 · 2020: 4 · 2019: 6 · 2018: 1
FWCI
1.09
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • BORIS (University Library Bern) (submittedVersion, other-oa)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
Funders
National Institute for Health and Care Research (13/89/22)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Keywords
computerized cognitive training, cognitive function maintenance, midlife, dementia prevention, brain reserve, cognitive stimulation, cognitive training games, virtual reality, cognitive decline, mild cognitive impairment, cognitive aging
MeSH terms
Healthy Aging, Aged, Cognition, Computer-Assisted Instruction, Dementia, Humans, Middle Aged, Time Factors, Cognitive Dysfunction, Memory, Episodic

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