Computerized cognitive interventions for preventing dementia in people with mild cognitive impairment: A systematic review with meta‐analyses

Abstract

BackgroundPeople with mild cognitive impairment (MCI) are faced with a higher risk of developing dementia, but with a “window of opportunity” for prevention and treatment. Computerized cognitive interventions (CCIs) might constitute a beneficial non‐pharmacological treatment approach. This systematic review evaluated evidence of CCIs performed individually with a computer, tablet‐PC, game consoles, virtual reality (VR), or augmented reality (AR) on cognition in community‐dwelling people with MCI.MethodA systematic review and meta‐analyses of randomized controlled trials (RCTs) was performed. The systematic literature search was conducted in MEDLINE, CINAHL, Embase, Cochrane CENTRAL, IEEE Xplore Digital Library, ISI Web of Knowledge, Scopus and PsycINFO, and included an additional search for gray literature. The search was completed by backward citation tracking. The methodological quality of the included RCTs was independently assessed by two reviewers. Comparable studies were pooled using the random‐effects model.ResultA total of 18 randomized controlled trials (RCTs) were identified. 12 RTCs were used for conducting meta‐analyses which showed significant effects of CCIs for people with MCI in memory (SMD 1.12, CI 95% [0.08, 2.16]), working memory (SMD 0.85, CI 95% [0.32, 1.38]), attention/concentration/processing speed (SMD 0.61, CI 95% [0.21, 1.02]), executive functioning (SMD 0.96, CI 95% [0.26, 1.66]), and language (SMD 1.63, CI 95% [0.20, 3.06]), but no significant improvement in global cognition. Pooling follow‐up evaluations was not possible, but one of two studies showed continuing significant differences for the intervention group after 6 months post intervention in memory and working memory. CCIs were conducted predominantly with computers, followed by tablet‐PCs, VR, AR, and mixed reality.ConclusionThis review demonstrated beneficial effects of CCIs on domain‐specific cognition in people with MCI. Therefore, CCIs might be a valuable treatment option to maintain cognition and prevent progression to dementia. However, further research is necessary, especially on CCIs applied with emerging technologies like VR or AR. Furthermore, various outcome measurements used in the studies were challenging for the pooling of study results, which highlights the need for a predefined set of important cognitive outcomes and tools for future RCTs.

Validity and Reliability Study of Online Cognitive Tracking Software (BEYNEX)

“…With the contribution of today's digital technology, many online applications have started to be used in the topics of cognitive stimulation, training, and rehabilitation. Research results of programs targeting training and rehabilitation are discussed in various review articles [14,15]. Most studies reported that users do not need to be technologically skilled to successfully complete or benefit from training.…”

Combining reinforcement learning and virtual reality in mild neurocognitive impairment: a new usability assessment on patients and caregivers

“…Beside assistive technology, which is useful to build a bridge between the individual's functioning and the requirements of their daily environment, new technologies rely on the use of wearable technologies, mobile technologies, serious games, and telerehabilitation (Di Lorito et al, 2021 ; Bacanoiu and Danoiu, 2022 ; Robinson and Moghaddam, 2022 ). Furthermore, virtual reality (VR) setups may be used (Moon and Han, 2022 ; Zuschnegg et al, 2022 ; Jang et al, 2023 ). Computer-mediated interventions can make up for some of the disadvantages of traditional approaches.…”

Effects of sensorimotor training on memory and brain plasticity in persons with amnestic mild cognitive impairment

“…However, the reported effect sizes of computerised training, domainspecific effects on memory, quality of life and long-term effects in people with MCI are still inconclusive ranging from no or little to large beneficial effects, sometimes with low-quality evidence. 17,18 Neuroplastic changes of the brain occur not only in early development but throughout the life-span and are related to injury as well as stimulation. 19 In the aging brain reduced brain plasticity with associated sensory and sensorimotor decline, noisy sensory processing, 20 changes in behaviour that accelerate cognitive decline, 21 disuse of sensorimotor capabilities and loss of modulatory brain functions can be observed.…”