The Effects of Computerized Cognitive Training on Memory Performance in Adults with Mild Cognitive Impairment or Dementia. A Systematic Review and Meta‐analysis

Background Memory impairment is a predominant symptom in people with mild cognitive impairment (MCI) and dementia. Computerized cognitive training (CCT) has been proposed as a promising non‐pharmaceutical intervention to slow down the deterioration of cognitive functions. While previous studies have reported the benefits of CCT on global cognition, few have focused specifically on memory outcomes. Therefore, the aim of this study is to investigate the benefits of CCT on memory outcomes in adults with MCI or dementia. Method A literature search was conducted via the PubMed, Medline, Embase and PsycINFO databases from inception to Sept 2022. Inclusion criteria included: (1) participants with MCI or dementia, (2) CCT as one of the interventions, (3) randomized trials with a non‐CCT comparison group, and (4) studies that reported changes in memory‐related neuropsychological scores before and after the intervention. The outcomes were measures of verbal memory, visual memory and working memory. With the heterogeneous definitions of CCT, the standardized mean differences (SMD) were pooled using a random‐effects model. Result Thirty‐nine clinical trials with 2,010 participants with MCI or dementia were included. The mean age ranged from 44 to 83, and the percentage of males ranged from 21% to 73%. Participants with MCI that received CCT demonstrated significantly better performance in verbal memory (SMD = 0.69, 95% CI = 0.41 to 0.90), visual memory (SMD = 0.49, 95% CI = 0.14 to 0.84) and working memory (SMD = 0.42, 95% CI = 0.12 to 0.72) than the control groups. In the sub‐group analyses of different control groups, those MCI patients who received CCT demonstrated better verbal memory performance than the usual care and the active control groups, but comparable results as the paper‐and‐pencil cognitive training group. For the studies that include dementia participants, CCT effects were not significantly better than the control groups. Conclusion Computerized cognitive training conferred significant benefits in preserving memory function in people with MCI, while the benefits were not statistically significant in patients with dementia. This study also supports that computerized cognitive training can be enhanced by using mobile devices, gamification and immersive technologies.