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In people without cognitive impairment, computerized cognitive training improves cognitive performance by a small amount

Lampit A, Hallock H, Valenzuela M. Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers. PLoS Med. 2014 Nov 18;11(11):e1001756.

Review question

In people without cognitive impairment, does computerized cognitive training improve cognitive performance?

Background

Cognitive decline can involve difficulties with thinking, memory, language, and decision making and may increase risk of dementia. Cognitive stimulation is believed to reduce risk of cognitive decline and subsequent dementia.

Computerized cognitive training presents people with mentally challenging tasks on a computer and may reduce the risk of cognitive decline.

How the review was done

The researchers did a systematic review based on studies available up to July 2014.

They found 52 randomized controlled trials with 4,885 people (average age 60 to 82 years, 60% were women).

Key features of the trials were:

  • people were healthy and did not have major cognitive, neurologic, psychiatric, or sensory impairments;
  • types of training included multidomain training, speed of processing training, working memory training, attention training, and video games;
  • people trained 1 or more times per week for up to 16 weeks for a total of 4 to 60 hours of training;
  • training was done in groups or at home;
  • training was compared with active or passive control; and
  • outcomes were measured immediately after training was completed.

What the researchers found

The quality of the trials varied. 23 trials had scores of 7 or more out of 9 on a scale that measures methodologic and reporting quality. 17 trials were thought to be at low risk for bias.

Compared with control, computerized cognitive training:

  • improved processing speed by a medium amount;
  • improved overall cognitive outcome, nonverbal memory, and working memory by a small amount;
  • improved verbal memory by a very small amount; and
  • did not change executive functioning (problem-solving, judgment, and decision making) or attention.

Overall cognitive outcome was improved by computerized cognitive training when the training was done in groups but not when it was done at home.

Conclusion

In people without cognitive impairment, computerized cognitive training improves cognitive performance by a small amount immediately after training.

Computerized cognitive training for cognitive performance in healthy people

Outcomes

Number of trials

Effect of training*

All cognitive outcomes

51

Small improvement

Processing speed

33

Medium improvement

Nonverbal memory

13

Small improvement

Working memory

28

Small improvement

Visuospatial skills

8

Small improvement

Verbal memory

23

Very small improvement

Executive functions

29

No difference

Attention

11

No difference

*Based on standard mean differences (SMD); very small = less than 0.2 SMD, small = 0.2 to 0.49 SMD, medium = 0.5 to 0.79 SMD, large = 0.8 or more SMD.




Glossary

Cognitive impairment
Trouble remembering, learning new things, concentrating, or making decisions that affect everyday life.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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