Cognitive impairment and dementia: Using cognitive training to cope with the accompanying depression

The Bottom Line

  • Many people with mild cognitive impairment (MCI) or dementia also deal with the depression that often accompanies such conditions. 
  • Cognitive training, which consists of computerized cognitive training; cognitive training and rehabilitation; and cognitive stimulation, can help lessen the severity of depression symptoms. 
  • The individual strategies that comprise cognitive training can produce reductions in severity that range from small to moderate.
  • If you or someone you care for has MCI or dementia and are looking for a way to manage depression, consider trying or suggesting cognitive training.  

Some of the challenges people living with mild cognitive impairment (MCI) encounter include not being able to focus, having trouble learning new things, finding it hard to make important decisions that affect day-to-day life, and being at high-risk for developing dementia (1;2). For those who progress to dementia, these cognitive declines are combined with decreases in functioning, resulting in less independence and a reduced ability to complete basic activities of daily living (2;3)—such as getting dressed, maintaining proper hygiene, and eating.


It is evident that the toll these conditions have on the lives of those diagnosed can be heavy. So, it is not surprising that many people with MCI and dementia also develop depression (4). When you consider that millions of people live with MCI and approximately 50 million people live with dementia, it is clear that strategies that help people cope with the existing or impending negative mental health impacts are needed (1;5).


One recent systematic review looked at the effect of cognitive training on symptoms of depression in people with MCI or dementia. Here, cognitive training was an umbrella term used to encompass several different approaches. First, there was computerized cognitive training, which involved people being instructed to complete a task through the use of a computer. Second, there was cognitive training and rehabilitation, which required people to complete tasks that used particular mental processes such as memory or attention while under personalized guidance or direction. Third, there was cognitive stimulation therapy, which had people participating in programs with themed activities, one example being reminiscence therapy (e.g., the use of various senses to trigger memories). These programs were led by professionals (4).


With various approaches available, let’s dig deeper into what each has to offer from a mental health perspective.


What the research tells us

The review found several encouraging results when comparing depression in people receiving cognitive training vs. those receiving usual care, participating in social and recreational activities, or exposed to other psychosocial strategies.


Overall, cognitive training may reduce depression severity by a moderate amount. More specifically, computerized cognitive training and cognitive stimulation therapy both yield similar results—moderate reductions in depression severity, as opposed to cognitive training and rehabilitation, which may reduce depression severity by a small amount (4).


Taking action to improve mental well-being is one approach to achieving an enhanced quality of life. If you or someone you care for has MCI or dementia, consider trying or suggesting they try cognitive training. Consulting with a health professional for more information on cognitive training and what strategy works best for your specific circumstance is always a great place to start.  

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References

  1. Song D, Yu D, Li P, et al. The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis. Int J Nurs Stud. 2018; 79:155-164. doi: 10.1016/j.ijnurstu.2018.01.002. 
  2. Hill N, Mowszowski L, Naismith S, et al. Computerized cognitive training in older adults with mild cognitive impairment or dementia: A systematic review and meta-analysis. Am J Psychiatry. 2017; 74(4):329-340. doi: 10.1176/appi.ajp.2016.16030360. 
  3. Fink HA, Jutkowitz J, McCarten R, et al. Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: A systematic review. Ann Intern Med. 2018; 168(1):39-51. doi: 10.7326/M17-1529. 
  4. Chan JYC, Chan TK, Kwok TCY, et al. Cognitive training interventions and depression in mild cognitive impairment and dementia: A systematic review and meta-analysis of randomized controlled trials. Age Ageing. 2020; 49:738-747. doi: 10.1093/ageing/afaa063. 
  5. World Health Organization. Dementia. [Internet] 2020. [cited December 2020]. Available from https://www.who.int/news-room/fact-sheets/detail/dementia

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

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