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Abstract
Objectives To determine the effect of computerised cognitive training (CCT) on improving cognitive function for older adults with mild cognitive impairment (MCI).
Design Systematic review and meta-analysis.
Data sources PubMed, Embase, Web of Science and the Cochrane Library were searched through January 2018.
Eligibility criteria Randomised controlled trials comparing CCT with control conditions in those with MCI aged 55+ were included.
Data extraction and synthesis Two independent reviewers extracted data and assessed the risk of bias. Effect sizes (Hedges’ g and 95% CIs) were calculated and random-effects meta-analyses were performed where three or more studies investigated a comparable intervention and outcome. Heterogeneity was quantified using the I2 statistic.
Results 18 studies met the inclusion criteria and were included in the analyses, involving 690 participants. Meta-analysis revealed small to moderate positive treatment effects compared with control interventions in four domains as follows: global cognitive function (g=0.23, 95% CI 0.03 to 0.44), memory (g=0.30, 95% CI 0.11 to 0.50), working memory (g=0.39, 95% CI 0.12 to 0.66) and executive function (g=0.20, 95% CI −0.03 to 0.43). Statistical significance was reached in all domains apart from executive function.
Conclusions This meta-analysis provides evidence that CCT improves cognitive function in older people with MCI. However, the long-term transfer of these improvements and the potential to reduce dementia prevalence remains unknown. Various methodological issues such as heterogeneity in outcome measures, interventions and MCI symptoms and lack of intention-to-treat analyses limit the quality of the literature and represent areas for future research.
- mild cognitive training (MCI)
- computerised
- cognitive training
- cognitive outcomes
- meta-analysis
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Footnotes
Contributors HZ, RB, JH, RLG, HW, XY and RH all contributed to the conception and design of the review. HZ, BH, JC and JH read and screened abstracts and titles of potentially relevant studies. HZ, RB and JH read the retained papers and were responsible for extracting data and rating their quality independently. HZ drafted the paper with all the authors critically reviewing it and suggesting amendments prior to submission. All the authors had access to all the data in the study and can take responsibility for the integrity of the reported findings.
Funding We acknowledge the funding provided by Beijing Municipal Science and Technology Commission (no Z161100000516001, D171100008217007). HZ is supported by the China Scholarship Council (CSC) (no 201706010329) to be a visiting PhD student at University College London, UK. RB is supported by an NIHR Academic Clinical Fellowship. JH, RLG and RH are supported by the NIHR UCLH BRC.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Details of excluded papers are available from the first author on request.
Patient consent for publication Not required.