Computerized Brain Training: What Works & What Doesn’t

Hot on the heels of the Stanford Center on Longevity and Max Planck Center for Human Development’s recommendations concerning computer-based cognitive training, a group of researchers at the University of Sydney Brain & Mind Research Institute conducted a meta-analysis of existing research on computerized cognitive training. In addition to examining the domains in which such training has been shown to have an impact, their summary also focused on which factors may contribute to computerized training’s efficacy.

This meta-analysis focused on high quality studies of computerized cognitive training. Only peer-reviewed, randomized controlled trials that included a control group—the gold standard for research—were included. Additionally, in all studies reviewed, participants’ average ages were greater than 60, and they had no major cognitive impairments. Finally, the training in the studies needed to involve at least four hours of computerized cognitive training, although many studies involved much more than this. Overall, the researchers found and reviewed 51 studies that met these criteria. These studies encompassed 4,885 total participants, and there was considerable variation in the type of cognitive training done across studies. Sixty-three percent of the studies involved group training, where participants did the training in a supervised setting such as a senior center. The remaining 37 percent involved computerized cognitive training done at home.

Overall, the authors found that computerized cognitive training programs are “effective at enhancing cognitive function in healthy older adults, but small effect sizes are to be expected.” They reported that the average improvement for training programs conducted in a group setting was equivalent to approximately a one point improvement on the Mini-Mental State Examination (which uses a 30-point scale). However, the authors also found that statistically significant effects were only seen for some areas of cognition, and that some design features of computerized training programs were associated with statistically significant outcomes, while others were not.

The cognitive areas in which these researchers found computerized cognitive training to be effective were nonverbal memory, working memory, processing speed, and visuospatial skills. They found that taken together, the studies included in this meta-analysis did not show a statistically significant improvement in attention, executive functions, or verbal memory.

The researchers’ meta-analysis also revealed features of the various computerized training programs that contributed to achieving statistically significant outcomes. In particular, the researchers found that group-based classes were much more effective than at-home training; taken together, the at-home training that was evaluated did not yield statistically significant results. They noted that this could be the result of less supervision of participants to ensure adherence to the training program, lower amounts of encouragement or motivational support, and less availability of IT help. Outside of factors specific to the training program, the researchers also noted that the general social interaction involved in group settings could have provided cognitive benefits that at-home training could not offer.

Somewhat surprisingly, the researchers discovered that those training programs that met more than three times per week did not show statistically significant results, while statistically significant results were found for those that met once a week, and for those that met two to three times per week. The researchers suggest that beyond three times a week there may be other cognitive factors such as fatigue that may interfere with the cognitive gains seen in participants who meet less often.

Less surprisingly, the researchers also found consistent evidence for the likely inefficacy of training sessions lasting less than 30 minutes. This is in line with other research that shows that synaptic plasticity in the brain is more likely after 30 to 60 minutes of stimulation.

The findings of this meta-analysis can be applied to those seeking the most effective he computerized cognitive training, as well as for those who evaluate and design such programs.  For home-based training, additional research is needed to determine the reasons why it is not showing statistically significant results.

Source:

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

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