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The use of commercial computerised cognitive games in older adults: a meta-analysis
Open accessAbstract
Brain training programs are currently one effective solution to prevent cognitive decline in healthy aging. We conducted a meta-analysis of randomized controlled trials assessing the use of commercially available computerised cognitive games to improve cognitive function in people aged above 60 years old without cognitive impairment. 1,543 participants from sixteen studies were included in the meta-analysis. Statistically significant improvements were observed for processing speed (SMD increased 0.40 [95% CI 0.20–0.60], p < 0.001), working memory (0.21 [95% CI 0.08–0.34], p = 0.001), executive function (0.21 [95% CI 0.06–0.35], p = 0.006), and for verbal memory (0.12 [95% CI 0.01–0.24, p = 0.031), but not for attention or visuospatial abilities. No relationship between the age of the participants and the amount of training was found. Commercially available computerised cognitive games are effective in improving cognitive function in participants without cognitive impairment aged over 60 years.
Overview
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TL;DR
This meta-analysis of 16 randomized controlled trials found that commercially available computerised cognitive games produced small-to-moderate improvements in processing speed, working memory, executive function, and verbal memory in cognitively healthy adults over 60. No significant effects were found for attention or visuospatial abilities, and neither participant age nor total training duration was associated with outcomes.
Key findings
- Across 16 studies and 1,543 participants (774 intervention, 769 control; mean age 70 [5] years), statistically significant improvements were found for processing speed (g = 0.40 [95% CI 0.20–0.60], p < 0.001), working memory (g = 0.21 [0.08–0.34], p = 0.001), executive function (g = 0.21 [0.06–0.35], p = 0.006), and verbal memory (g = 0.12 [0.01–0.24], p = 0.031).
- No statistically significant effects were observed for attention (g = 0.06 [−0.16–0.29], p = 0.59) or visuospatial abilities (g = 0.03 [−0.16–0.22], p = 0.18).
- Meta-regression found no significant association between outcomes and participant age (β = −0.008, SE = 0.020, p = 0.69) or total training duration (β = −0.007, SE = 0.006, p = 0.24).
- Of 1,543 participants, 1,344 (87.1%) completed the majority of exercises; dropout did not differ between groups (83 experimental vs. 116 control, p = 0.41). One study reported 81 training-related adverse effects among 487 participants (77% mild, 22% moderate, 1% severe), with no difference between intervention and control.
Methods
- Systematic review and meta-analysis of randomized controlled trials identified from PubMed, Web of Sciences, Embase, Scopus, and ScienceDirect through 31 December 2019, using PICOS criteria: cognitively healthy participants aged over 60, commercially available computerised cognitive games, minimum 1-month training, active or passive control, and untrained cognitive outcomes.
- Sixteen studies were included; outcomes covered processing speed, working memory, executive function, verbal memory, attention, and visuospatial abilities.
- Treatment effect was standardized mean difference using Hedge’s g in random-effects models; outliers were removed, heterogeneity assessed with tau², publication bias assessed with funnel plots, Egger’s test, and trim-and-fill, and meta-regression examined age and training dose.
Limitations
- The paper states that included studies often had relatively small sample sizes and were likely underpowered; assessors were rarely blinded, only 3 of 16 studies used intention-to-treat analysis, and only 4 of 16 were registered.
- The authors state that meta-regression results must be interpreted cautiously due to the small number of studies, and that the analysis was limited to commercially available computerised cognitive games, excluded grey literature, and did not include combined cognitive-physical interventions.
- The text makes evident that attention and visuospatial analyses each included only 4 studies, so null findings may reflect small sample size; the paper also notes insufficient participant characteristics to perform subgroup analyses.
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In the paper
“the results of only 3 out of the 16 studies19–21 were analyzed in intention-to-treat”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
What the sources say
- Check pendingcites [19] Mahncke, H. W. et al. Memory enhancement in healthy older adults using a brain plasticity-based training program: A randomized, controlled study. Proc. Natl. Acad. Sci. U.S.A. 103, 12523–12528 (2006). source
- Check pendingcites [20] Nouchi, R., Saito, T., Nouchi, H. & Kawashima, R. Small acute benefits of 4 weeks processing speed training games on processing speed and inhibition performance and depressive mood in the healthy elderly people: Evidence from a randomized control trial. Front. Aging Neurosci. 8, 302 (2016). source
- Supportedcites [21] Smith, G. E. et al. A cognitive training program based on principles of brain plasticity: results from the improvement in memory with plasticity-based adaptive cognitive training (IMPACT) study. J. Am. Geriatr. Soc. 57, 594–603 (2009). source
The Methods > Analysis section of our copy states that 'A predefined analysis plan specified sample size, the ITT population, and the statistical approach' and that the linear mixed models 'allow the use of the entire ITT group', with the Results reported under the heading 'Training Effects on Outcome Measures (ITT Sample)' (n = 487; ET = 242; AC = 245). So the IMPACT study is indeed one of the studies whose results were analysed in intention-to-treat, which is the part this citation is offered for. The tally '3 out of the 16 included studies' is the citing authors' own review-level count and is not, and need not be, stated in this paper. (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not find any significant associations between the age of the participants and the outcome (β = − 0.008, SE = 0.020, p = 0.69)”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
plainn = 16- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption not shown here.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Statistically significant improvements were observed for processing speed (SMD increased 0.40 [95% CI 0.20–0.60], p < 0.001), working memory (0.21 [95% CI 0.08–0.34], p = 0.001)”
- Also stated in: § Results · plain
“The effect of ccCG on working memory is small and statistically significant (g = 0.21 [0.08–0.34], p = 0.001), 0.28 [0.06–0.51] with the adjusted model.”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Abstract
plainstates a causen = 917 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on 2 assumptions not shown here.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“0.13 [0.02–0.24] for the adjusted model”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
plainstates an associationn = 907 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on 2 assumptions not shown here.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the adjusted value is 0.11 [− 0.27–0.50]”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
plainn = 216- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on 2 assumptions not shown here.
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Discussion
“Only one study reported some minor adverse effects, suggesting that ccCG is safe.”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Discussion
“81 training-related adverse effects were reported (77% mild, 22% moderate, 1% severe)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
“For the domain of working memory, 9 studies, with 917 participants, were included20–26,29,30.”
§ The use of commercial computerised cognitive games in older adults: a meta-analysis > Results
“The forest plot revealed two outlier studies26,31 that reported extremely large SMD”
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Self-citation
Metadata
- Authors
- Bonnechère, B., Langley, C., & Sahakian, B. J.
- Affiliations
- Université Libre de Bruxelles (BE)
- University of Cambridge (GB)
- Corresponding author
- Bonnechère, Bruno
- Venue
- Scientific Reports
- Published
- 2020-09-17
- Volume
- 10
- Issue
- 1
- Pages
- 15276-15276
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7498601
- OpenAlex
- W3087686032
- Semantic Scholar
- ecfec379ecf3a73dcd2c4b478023037a256f4c85
- Cited by
- 126
- References
- 91
- Citations by year
- 2026: 15 · 2025: 25 · 2024: 23 · 2023: 19 · 2022: 24 · 2021: 17 · 2020: 2
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Apollo
- Funders
- Fondation Philippe Wiener - Maurice Anspach
- Wellcome Trust Collaborative Award (200181/Z/15/Z)
- NIHR MedTech and in vitro diagnostic Co-operative
- NIHR Cambridge Biomedical Research Centre (BRC) Mental Health theme
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- brain training, older adults, healthy aging, cognitive decline prevention, processing speed, working memory, executive function, verbal memory
- MeSH terms
- Healthy Aging, Aged, Aged, 80 and over, Brain, Cognition, Dementia, Female, Humans, Male, Memory, Short-Term, Middle Aged, Video Games, Executive Function, Cognitive Dysfunction, Memory, Episodic
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.
A language model drew the claims from the paper on 2026-11-14, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-11-14 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (qwen3.8-omni-flash).
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 ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
