Computer-Based Cognitive Programs for Improvement of Memory, Processing Speed and Executive Function during Age-Related Cognitive Decline: A Meta-Analysis

<div><p>Background</p><p>Several studies have assessed the effects of computer-based cognitive programs (CCP) in the management of age-related cognitive decline, but the role of CCP remains controversial. Therefore, this systematic review evaluated the evidence on the efficacy of CCP for age-related cognitive decline in healthy older adults.</p><p>Methods</p><p>Six electronic databases (through October 2014) were searched. The risk of bias was assessed using the Cochrane Collaboration tool. The standardized mean difference (SMD) and 95% confidence intervals (CI) of a random-effects model were calculated. The heterogeneity was assessed using the Cochran Q statistic and quantified with the <i>I²</i> index.</p><p>Results</p><p>Twelve studies were included in the current review and were considered as moderate to high methodological quality. The aggregated results indicate that CCP improves memory performance (SMD, 0.31; 95% CI 0.16 to 0.45; p < 0.0001) and processing speed (SMD, 0.50; 95% CI 0.14 to 0.87; p = 0.007) but not executive function (SMD, -0.12; 95% CI -0.33 to 0.09; p = 0.27). Furthermore, there were long-term gains in memory performance (SMD, 0.59; 95% CI 0.13 to 1.05; p = 0.01).</p><p>Conclusion</p><p>CCP may be a valid complementary and alternative therapy for age-related cognitive decline, especially for memory performance and processing speed. However, more studies with longer follow-ups are warranted to confirm the current findings.</p></div

Forest plot of the effect of computer-based cognitive programs in processing speed.

<p>Forest plot of the effect of computer-based cognitive programs in processing speed.</p

Flow diagram of study selection.

<p>RCTs: randomized controlled trials.</p

Funnel plot for memory, processing speed, and executive function.

<p>Funnel plot for memory, processing speed, and executive function.</p

Characteristics of included studies.

<p>Abbreviations: wk = week; MON = Monitoring (simple reaction time); IDN = Identification (visual-motor reaction time); WMS-III = Wechsler memory scale III.</p><p>Characteristics of included studies.</p

Forest plot of the effect of computer-based cognitive programs in memory performance.

<p>Forest plot of the effect of computer-based cognitive programs in memory performance.</p

Risk of bias.

<p>Red (-): high risk of bias; Yellow (?): unclear risk of bias; Green (+): low risk of bias.</p

Forest plot of the long-term effect of computer-based cognitive programs in memory performance.

<p>Forest plot of the long-term effect of computer-based cognitive programs in memory performance.</p