Video game training enhances cognitive control in older adults
Open accessAbstract
Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool for cognitive enhancement.
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Playing action video games improved memory and attention in older adults.
“Playing action video games improved memory and attention in older adults (Anguera et al., 2013).”
From The impact of digital technology, social media, and artificial intelligence on cognitive functions: a review (2023) · cites this paper as Anguera et al., 2013
The paper reports improved working memory and sustained attention in older adults after training with NeuroRacer. But it describes NeuroRacer as a custom-designed multitasking game, not an action video game; the claim misidentifies the type of game studied. The relevant passages are in the main text; page numbers are unavailable in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measuredEngaging with digital technology, particularly brain-training apps and interactive games, has been found to have positive effects on cognitive abilities in older adults.
“Engaging with digital technology, particularly brain-training apps and interactive games, has been found to have positive effects on cognitive abilities in older adults as well (Anguera et al., 2013).”
From The impact of digital technology, social media, and artificial intelligence on cognitive functions: a review (2023) · cites this paper as Anguera et al., 2013
The article body reports that training with the custom-designed NeuroRacer video game improved multitasking, sustained attention, and working memory in older adults (passages 3 and 5; page not specified). It does not establish benefits from digital technology or brain-training apps generally; it also notes a lack of transfer after nonspecific online cognitive exercises (passage 2). (LLM, conf=0.85)
Experimental — accuracy not yet measuredMultitasking training with NeuroRacer improved other cognitive skills, including working memory and divided and sustained attention.
“Moreover, the multitasking training improved other cognitive skills, including working memory and divided and sustained attention.”
From Brain health consequences of digital technology use (2020) · cites this paper as [49]
The paper’s results report significant improvements in working memory and sustained attention after NeuroRacer multitasking training (main text, page unavailable). It lists divided attention among the abilities assessed, but describes improvement on the dual-tasking measure only as a statistical trend, not an established training benefit. (LLM, conf=0.88)
Experimental — accuracy not yet measuredVideo game training improves spatial reasoning and cognitive flexibility, especially in older adults.
“These tools improved spatial reasoning and cognitive flexibility, especially in older adults.”
From Cognitive benefits and risks of digital technology engagement (2025) · cites this paper as [15]
The paper’s main text reports that NeuroRacer training improved multitasking, sustained attention, and working memory in older adults. Those findings support a broader claim about cognitive control, but the cited passages do not establish improvements in spatial reasoning or specifically measure cognitive flexibility. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRecent evidence demonstrated that older adults who experienced cognitive gains after video game training also showed more efficient neural function through enhancement of EEG signal in regions associated with cognitive control.
“recent evidence demonstrated that older adults who experienced cognitive gains after video game training also showed more efficient neural function through enhancement of electroencephalography (EEG) signal in regions associated with cognitive control (Anguera et al., 2013).”
From Training Older Adults to Use Tablet Computers: Does It Enhance Cognitive Function? (2016) · cites this paper as Anguera et al., 2013
In volunteers ages 60 to 85, only the multitasking training group (NeuroRacer) showed significant improvements in performance scores, which exceeded untrained individuals in their twenties and were maintained for 6 months without additional training.
“Only the multitasking training group showed significant improvements in performance scores, which not only exceeded that of untrained individuals in their twenties but was maintained for 6 months without additional training.”
From Brain health consequences of digital technology use (2020) · cites this paper as [49]
In the Anguera et al study, out of 46 participants, 16 were trained in multitasking, 15 in single-tasking mode (active controls), and 15 received no training (no-contact controls).
“Out of 46 participants, 16 were trained in multitasking (both driving and sign reading), 15 in single-tasking mode (active controls; either sign reading or driving), and 15 received no training (no-contact controls).”
From Brain health consequences of digital technology use (2020) · cites this paper as [49]
Digital technologies can enhance neuroplasticity, particularly through structured interventions like video game training.
“Several studies demonstrated that digital technologies can enhance neuroplasticity, particularly through structured interventions like video game training [15].”
From Cognitive benefits and risks of digital technology engagement (2025) · cites this paper as [15]
Action video games improve spatial reasoning in older adults by leveraging neuroplasticity.
“For instance, action video games improve spatial reasoning in older adults [15] by leveraging neuroplasticity [19].”
From Cognitive benefits and risks of digital technology engagement (2025) · cites this paper as [15]
Video game training enhances cognitive control in older adults.
“Aging and Neuroplasticity: Video game training enhances cognitive control in older adults [15], supported by multimedia designs that reduce cognitive load and document literacy skills that improve information integration, challenging the notion of rigid brain aging and showcasing technology’s potential to sustain cognitive flexibility.”
From Cognitive benefits and risks of digital technology engagement (2025) · cites this paper as [15]
The cognitive control and attention systems evaluated in these studies are similar to the deficits observed in paediatric patients with ADHD.
“The cognitive control and attention systems evaluated in these studies are similar to the deficits observed in paediatric patients with ADHD.18,19”
From A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial (2020) · cites this paper as [18]
The digital intervention described by Anguera and colleagues improved cognitive performance and these changes were associated with functional electroencephalogram (EEG) changes in the prefrontal cortex.
“The digital intervention improved cognitive performance and these changes were associated with functional electroen cephalogram (EEG) changes in the prefrontal cortex.”
From A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial (2020) · cites this paper as [18]
The current study findings of improved attention via TOVA API following treatment with AKL-T01 are consistent with benefits reported in previous uncontrolled studies.
“The current study findings of improved attention (via TOVA API) following treatment with AKL-T01 are consistent with benefits reported in previous uncontrolled studies.18,20”
From A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial (2020) · cites this paper as [18]
Improvements in multi-tasking were maintained in the Neuroracer treatment group after 6 months of no treatment, and this maintenance correlated with EEG-based neurological changes.
“Improvements in multi-tasking were maintained in the treatment group after 6 months of no treatment, and this maintenance effect also correlated with the same EEG-based neurological changes.”
From Proof-of-concept study of an at-home, engaging, digital intervention for pediatric ADHD (2018) · cites this paper as [23]
Gazzaley and colleagues demonstrated that a game-like cognitive intervention built to target a critical neural process underlying cognitive control can achieve cognitive remediation.
“Gazzaley and colleagues identified a critical neural process underlying cognitive control ability, and demonstrated that a game-like cognitive intervention built to specifically target this system can achieve cognitive remediation [22, 23].”
From Proof-of-concept study of an at-home, engaging, digital intervention for pediatric ADHD (2018) · cites this paper as [23]
After completing the Neuroracer regimen, changes in EEG signals occurred at neurological loci associated with cognitive control.
“they showed that changes in EEG signals occurred at neurological loci associated with cognitive control after completing the prescribed therapeutic regimen.”
From Proof-of-concept study of an at-home, engaging, digital intervention for pediatric ADHD (2018) · cites this paper as [23]
In older adults, Neuroracer reduced interference susceptibility and cognitive benefits transferred to untrained tests of attention, impulsivity, and multitasking.
“Results of the study indicated that interference susceptibility was reduced and demonstrated that cognitive benefits transferred to performance on untrained tests of attention, impulsivity, and multitasking [23].”
From Proof-of-concept study of an at-home, engaging, digital intervention for pediatric ADHD (2018) · cites this paper as [23]
Project: EVO is a digital treatment based on the Neuroracer model that deploys interference-based cognitive control-targeting mechanics in a high-quality action video game-like interface.
“Project: EVO (EVO) is a digital treatment based on the Neuroracer model that deploys the interference-based cognitive control-targeting mechanics in a high-quality action video game-like interface.”
From Proof-of-concept study of an at-home, engaging, digital intervention for pediatric ADHD (2018) · cites this paper as [23]
Video games without exercise improve executive and cognitive control, and selective attention in older adults.
“Video games without exercise have been shown to improve executive and cognitive control, and selective attention in older adults. (Anguera, Boccanfuso, Rintoul, Al-Hashimi, Faraji, Janowich, Kong, Larraburo, Rolle, Johnston, and Gazzaley 2013;Basak, Boot, Voss, and Kramer 2008;Belchior, Marsiske, Sisco, Yam, and Mann 2012)”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Anguera, Boccanfuso, Rintoul, Al-Hashimi, Faraji, Janowich, Kong, Larraburo, Rolle, Johnston, and Gazzaley 2013
Boosted by the publication of a Nature letter showing that video game training can enhance cognitive control in older adults, serious games specifically adapted to people with AD have been developed and employed to train physical and cognitive abilities, showing preliminary but encouraging results.
“Boosted by the publication of a Nature letter showing that video game training can enhance cognitive control in older adults (343), SG specifically adapted to people with AD have been developed and employed to train physical and cognitive abilities, showing preliminary but encouraging results (341, 344–348).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [343]
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- Authors
- Anguera, J. A., Boccanfuso, J., Rintoul, J. L., Al-Hashimi, O., Faraji, F., Janowich, J., Kong, E., Larraburo, Y., Rolle, C., Johnston, E., & Gazzaley, A.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Anguera, J. A.
- Gazzaley, A.
- Venue
- Nature
- Published
- 2013-09
- Volume
- 501
- Issue
- 7465
- Pages
- 97-101
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC3983066
- OpenAlex
- W2078346039
- Cited by
- 1,666
- References
- 66
- Citations by year
- 2026: 75 · 2025: 123 · 2024: 109 · 2023: 96 · 2022: 113 · 2021: 145 · 2020: 145 · 2019: 177 · 2018: 143 · 2017: 152 · 2016: 135 · 2015: 124 · 2014: 108 · 2013: 18
- FWCI
- 173.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging (R01AG040333, L30 AG040556)
- National Institute of General Medical Sciences (T32GM008155)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- cognitive control, multitasking, video game training, older adults, cognitive aging, neuroplasticity, sustained attention, working memory, frontal theta power, prefrontal cortex, cognitive enhancement, age-related cognitive decline, transfer of training, EEG
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aging, Automobile Driving, Brain, Cognition, Electroencephalography, Humans, Male, Memory, Short-Term, Middle Aged, Neuropsychological Tests, Psychomotor Performance, Theta Rhythm, Time Factors, Video Games, Biomedical Enhancement, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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