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Published Online: 14 November 2016

Computerized Cognitive Training in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis

Abstract

Objective:

Previous meta-analyses indicate that computerized cognitive training (CCT) is a safe and efficacious intervention for cognition in older adults. However, efficacy varies across populations and cognitive domains, and little is known about the efficacy of CCT in people with mild cognitive impairment or dementia.

Method:

The authors searched Medline, Embase, PsychINFO, CINAHL, and CENTRAL through July 1, 2016, for randomized controlled trials of CCT in older adults with mild cognitive impairment or dementia. Overall cognition, individual cognitive domains, psychosocial function, and activities of daily living were pooled separately for mild cognitive impairment and dementia trials.

Results:

The overall effect on cognition in mild cognitive impairment across 17 trials was moderate (Hedges’ g=0.35, 95% CI=0.20–0.51). There was no evidence of publication bias or difference between active- and passive-controlled trials. Small to moderate effects were found for global cognition, attention, working memory, learning, and memory, with the exception of nonverbal memory, and for psychosocial functioning, including depressive symptoms. In dementia, statistically significant effects were found on overall cognition (k=11, g=0.26, 95% CI=0.01–0.52) and visuospatial skills, but these were driven by three trials of virtual reality or Nintendo Wii.

Conclusions:

CCT is efficacious on global cognition, select cognitive domains, and psychosocial functioning in people with mild cognitive impairment. This intervention therefore warrants longer-term and larger-scale trials to examine effects on conversion to dementia. Conversely, evidence for efficacy in people with dementia is weak and limited to trials of immersive technologies.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 329 - 340
PubMed: 27838936

History

Received: 27 March 2016
Revision received: 11 August 2016
Accepted: 22 August 2016
Published online: 14 November 2016
Published in print: April 01, 2017

Keywords

  1. Dementia-Alzheimer-s Disease
  2. Cognitive Therapy

Authors

Details

Nicole T.M. Hill, M.BMSc.
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.
Loren Mowszowski, D.Psych.
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.
Sharon L. Naismith, D.Psych.
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.
Verity L. Chadwick, B.Sc. (Hons.)
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.
Michael Valenzuela, Ph.D.
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.
Amit Lampit, Ph.D.
From Black Dog Institute, the University of New South Wales, New South Wales, Australia; the Regenerative Neuroscience Group and Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, New South Wales, Australia; the School of Psychology, University of Sydney, New South Wales, Australia; and the School of Medical Sciences, University of Sydney, New South Wales, Australia.

Notes

Address correspondence to Dr. Lampit ([email protected]).

Funding Information

National Health and Medical Research Council10.13039/501100000925: 1108520
Dr. Mowszowski is supported by a National Health and Medical Research Council of Australia/Australian Research Council (NHMRC-ARC) Dementia Research Development Fellowship. Dr. Naismith is an NHMRC Career Development Fellow. Ms. Chadwick is a former employee of Synaptikon. Dr. Valenzuela receives in-kind research support in the form of no-cost software from BrainTrain and Synaptikon for projects unrelated to this study; he is also an NHMRC Career Development Fellow. Dr. Lampit is supported by an NHMRC/ARC Dementia Research Development Fellowship. Ms. Hill reports no financial relationships with commercial interests.

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