Abstract
Objective
This systematic review and meta-analysis evaluates the evidence from randomized clinical
trials (RCTs) that designed brain gaming interventions to improve cognitive functions
of older adults with cognitive impairments, including mild cognitive impairments and
dementia.
Design
Systematic review and meta-analysis.
Setting and Participants
N/A.
Measures
N/A.
Methods
Data sources—relevant randomized control trials (RCTs) were identified by a systematic
search of databases including Medline, PubMed, PsycINFO, Embase, CINAHL, Web of Science,
and Cochrane. RCTs were selected first based on title and abstract review and then
on full-text review by independent reviewers using predefined eligibility criteria.
Risk of bias (RoB) was assessed using the Cochrane RoB tool and funnel plots. The
primary outcome variable was the composite score of global cognitive function.
Results
A total of 909 participants with mild cognitive impairment or dementia from 16 RCTs
were included in the systematic review. The study quality was modest, and the RoB
assessment showed bias in blinding the participants and personnel. Funnel plots showed
no evidence of publication bias. The meta-analysis of 14 RCTs revealed no superior
effect of brain gaming compared to other interventions on global cognitive function
(pooled standardized mean difference = 0.08, 95% confidence interval −0.24, 0.41,
P = .61, I2 = 77%). Likewise, no superior effects were found on the cognitive domains of memory,
executive function, visuospatial skills, and language.
Conclusion and Implications
The findings of this meta-analysis suggest that brain gaming compared with the control
intervention does not show significant improvement in standardized tests of cognitive
function. Because of considerable heterogeneity in sample size, gaming platform, cognitive
status, study design, assessment tools, and training prescription, we cannot confidently
refute the premise that brain gaming is an effective cognitive training approach for
older adults with cognitive impairments. Recommendations for future research are included.
Keywords
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Article info
Publication history
Published online: June 16, 2021
Footnotes
This study was conducted by the members of the Cognition in Aging Taskforce (previously called Applied Cognition Geriatric Taskforce) from the American Congress of Rehabilitation Medicine. This article was supported by a VA RR&D Career Development Award (RX001850-01 to S. L. Kletzel), the Swedish ALF Foundation of Umeå University and Västerbotten County Council, the Swedish Stroke Foundation (to X. Hu), and National Institute on Aging of the National Institutes of Health under Award Number (K01AG058785 to H. Devos). This work was also supported by National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (90SFGE0002 to S. Krishnan) and (H133G130200 and 90IF0055-01 P.C. Heyn). Any opinions contained in this document are those of the authors and do not necessarily represent the views of any of the above stated funding agencies.
The authors declare no conflicts of interest.
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