Cognitive-based training can enhance cognitive function in healthy older adults

Chiu H, Chu H, Tsai J, et al. The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials PLoS One. 2017;12: e0176742.

Review question

What is the effect of cognitive-based training on overall cognitive function, memory, attention, executive function, and visual-spatial ability in healthy older people? What characteristics of cognitive-based training are the most effective?

Background

Cognitive functions – memory, attention, executive function (e.g. motor control, problem solving, organization), and visual-spatial ability (e.g. responding to objects in space) – decline as people age, making it harder for older adults to understand and respond to external information and cues. Cognitive-based training, which involves cognitive stimulation, training, and rehabilitation, aims to maintain cognitive functions in older adults, as opposed to teaching them new developmental skills.

How the review was done

This is a meta-analysis of 31 randomized controlled trials published between 2002 and 2015, including a total of 6003 participants.

• Participants were healthy older adults 57 years of age and older.
• Study participants took part in various forms of cognitive-based training, such as: memory training, reasoning training, speed-of processing training, video games (e.g. non-action and real-time strategy games), computerized cognitive training, robot-assisted training, brain training games, multi-domain and single domain cognitive training, cognitive rehabilitation training, learning therapy, physical activity, combined cognitive and physical activity training, visual and auditory tasks, and interactive television-based cognitive training.
• The frequency of the training sessions varied. The length of the sessions ranged between 20 - 180 minutes per day for 1 - 5 days a week. The number of total weeks ranged between 2 - 24, while the number of total sessions ranged between 4 - 120.  
• Researchers measured change in the participants’ overall cognitive function, memory, attention, executive function, and visual-spatial ability.
• Results were compared to people in control groups, which included being on a waiting-list to receive cognitive training, education, usual care, no treatment or contact, actively engaging in some activity, reading a book and having a discussion, late training, sham computer-assisted cognitive training, or an attention control completing a computerized crossword puzzle.

What the researchers found

Healthy older adults who participated in cognitive-based training experienced moderate improvements in overall cognitive function and executive function, as well as a small positive effect on memory, attention and visual-spatial ability. Training for eight or more weeks appeared to enhance attention, while executive function appeared to be boosted by the occurrence of training sessions at three or more times per week and a total number of 24 sessions or more. The majority of the studies were of good methodological quality.

Conclusion

Cognitive-based training can moderately improve overall cognitive function and executive function (24 or more sessions, three or more times per week) in healthy older adults, while also having a small positive effect on memory, attention (training for 8 or more weeks) and visual-spatial ability.