期刊
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
卷 22, 期 11, 页码 2281-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2021.05.022
关键词
Brain gaming; dementia; Alzheimer's disease; mild cognitive impairment; cognitive training
资金
- VA RR&D Career Development Award [RX001850-01]
- Swedish ALF Foundation of Umea University
- Swedish ALF Foundation of Vasterbotten County Council
- Swedish Stroke Foundation
- National Institute on Aging of the National Institutes of Health [K01AG058785]
- National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) [90SFGE0002, H133G130200, 90IF0055-01]
- NIDILRR [90SFGE0002, 1004354] Funding Source: Federal RePORTER
This study conducted a systematic review and meta-analysis on the effects of brain gaming interventions for improving cognitive functions in older adults with cognitive impairments. The findings suggest that brain gaming did not show significant improvements in standardized cognitive tests compared to control interventions.
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, I-2 = 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. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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