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Table 2 Overview of included studies

From: Technology-based cognitive training and rehabilitation interventions for individuals with mild cognitive impairment: a systematic review

First author and year Study design Intervention and Technology Control Technology description Sessions/Duration Follow-up Cognitive outcome measures Other outcome measures Key findings
Cipriani, 2006 [29] Pre-post study Computer based-Cognitive Rehabilitation (cb-CR) programs NA TNP software: delivers individualized cognitive rehabilitation exercises in the following cognitive domains: attention, memory, perception, visuospatial cognition, language, and non-verbal intelligence 2 * 16 * 13–45 min sessions for 8 weeks 3 months MMSE
Attention: Visual search; Executive function: Trail Making test A and B; Behavioral Memory: RBMT; Psychomotor learning: digit symbol test; Verbal fluency: phonemic and semantic verbal fluency
Depression (GDS); Anxiety: STAI-X1, STAI-X2; ADL: AADL; QOL: SF-12 MCI: Only significantly improved in memory (RBMT)
Rozzini, 2007 [40] RCT TNP + ChEIs CG1: ChEIs
CG2: No treatment
TNP Software 20 * 1 h/session, five days/week for four weeks 1 yr MMSE
Memory: Short story recall; Executive function: Rey’s figure copy and recall, Raven’s colored matrices; Verbal fluency: Letter verbal fluency, Semantic verbal fluency
Mood: depression: GDS; anxiety, apathy Behavioral disturbances: NPI Activities of daily living: BADL IG: significant improvement in memory, abstract reasoning, and depression
CG1: no improvements on any cognition but benefit in depression
CG2: no improvement in any outcome measures
Talassi, 2007 [36] CCT TNP + OT + BT PR + OT + BT TNP Software 30–45 min/session, 4 days/week for 3 weeks Interven-tion end MMSE
Working memory: forward and backward digit span; Executive function: Rey’s figure copy; Verbal fluency: phonemic and semantic verbal fluency; CDT; Episodic Memory: episodic memory subset of RBMT; Verbal fluency: Phonemic and semantic verbal fluency; Attention: visual search, processing speed: digit symbol test
Mood: depression GDS; anxiety (Stai-Y1,Stai-Y2; ADL: BADL, IADL, PPT; MCI subjects in IG improved in executive function, visuospatial memory, anxiety, depression, and PPT but not IADL
MCI subjects in CG: no improvements
Barnes, 2009 [22] RCT cb-CT Passive computer activities Computer-based cognitive training software developed by Posit Science Corporation (San Francisco, CA), involving seven exercises including primary and working auditory memory tasks to improve processing speed and accuracy in the auditory cortex IG: 100 min/day five days/week for 6 weeks CG: 90 min/day, 5 days/week for 6 weeks Interven-tion end Global cognitive function: RBANS total score, 5 RBANS index score
Memory: CVLT-II
Language: COWAT, BNT
Executive function: California Trail Making Test
Attention: Design Fluency test; Working memory: Spatial Span test
Mood: depression (GDS) IG showed greater improvement on RBANS total scores but no significant between group difference.
Effect sizes for verbal learning and memory measures tended to favor IG.
Effect sizes for language and visuospatial function measures tended to favor CG (control group).
Finn, 2011 [25] RCT Computerized Cognitive Training Package No intervention Lumosity software on a computer contains four or five cognitive exercise that targeted four cognitive domains 30 sessions, 4–5 sessions/week Interven-tion end Executive function: IED; Attention: RVP
Subjective memory impairment: MFQ
Visual memory: PAL
Mood: Depression Anxiety and Stress Scale IG had significant improvement in visual attention but not processing speed, visual memory, nor mood
Rosen, 2011 [23] RCT cb-CT listening to audio books, reading online newspapers, and playing a visuospatial oriented computer game Computer-based cognitive training software developed by Posit Science Corporation IG: 24 sessions, 100 mins/day, 5 days/week
CG:24 sessions, 90 min/day, 5 days/week
Interven-tion end Global cognitive function: RBANS
Neuroimaging: fMRI
Not specified IG > CG: improvement in verbal memory and left hippocampal activation CG: declined in VM
Gagnon, 2012 [43] RCT Computer-based VP AC: Computer-based FP Computer-based divided attention dual-task training: VP: performing both tasks concurrently and varying allocation priorities across the series of blocks, feedbacks are provided; FP: perform both tasks concurrently and to allocate 50/50 attentional resources to each task, no feedbacks provided 6 * 1 h/session, 3 times/week for two weeks Interven-tion end Attention: dual task (digit span task, visual detection task); Executive subtest of TEA
Attention: Trail Making Test A; Executive function: Trail Making Test B;
QOL: Well-Being Scale
Divided attention: Divided Attention Questionnaire
VP showed significant advantage over FP in improving accuracy and reaction time
FP and VP both produced improvements on focused attention, speed of processing, and switching abilities
No reliable advantage for VP over FP
Herrera, 2012 [42] RCT Computer –based Memory and attention training Stimulating Cognitive activities Computer-based cognitive training that involved a memory task and an attention task 24 * 60 min/session twice/week for 12 weeks. 6 months MMSE-recall; Memory: the forward and backward digit span test, BEM-144 12-word-list recall, the 16-item free and cued reminding test, subscore recall of the MMSE, visual recognition subtest from the Doors and People memory battery, the DMS48 test; executive function: Rey–Osterrieth Complex Figure recall test N/A Significant improvement in memory, both episodic recall and recognition
Man, 2012 [13] CCT VR-based memory training program Therapist-led program VR: participants use either the joystick or the direction buttons of the keyboard to control the navigation action and give responses to a memory task 10 sessions, 30 min/session 2–3 times/week Interven-tion end Memory: MMQ; Episodic Memory: FOME ADL: Lawton IADL VR: significant improvement in total encoding, total recall, delayed recall and MMQ-strategy
Therapist-led: significant improvement in total recall, delayed recall and MMQ-contentment
VR > therapist in improving objective memory; Therapist > VR in subjective memory
Gonzalez-Palau, 2014 [33] Pre-post study LLM included CTC and PTC NA CTC: Gradior Software: a multi-domain cognitive training program including attention, perception, episodic memory and working memory tasks. Principles of feedback and difficulty adaptation are used
PTC: FFA: an innovative, low-cost game platform. Work our intensity gradually increases
CTC: 40/session, three times/week for 12 weeks
PTC: one-hour session of FFA, three times/week for 12 weeks
Interven-tion end Global cognitive function: The Mini Examen Cognitivo (MEC 35)
Memory: Logical Memory subtests of the WMS III
Attention: The Color Trail Test 1 and 2
Verbal learning and memory: HVLT-R
Mood: depression(GDS) For MCI subjects: Significant improvement in global cognitive function, verbal memory,episodic memory, and decrease in symptoms of depression.
Han, 2014 [30] Pre-post study Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training USMART Program NA USMART program app on IPad 24 face-to-face sessions Interven-tion end CERAD-K-N including: verbal fluency: the Categorical Fluency test, the Modified BNT; MMSE; memory: WLMT, WLRT, the Word List Recognition Test, CRT; visuospatial: Constructional Praxis Test; Attention: Trail Making Test A; executive function: Trail Making Test B N/A Significantly improved only in memory (WLMT); number of training sessions correlated with WLMT scores
Hughes, 2014 [45] RCT Interactive video games (Wii) Healthy aging education program Nintendo Wii gaming console for interactive video gaming (bowling, golf, tennis, and baseball) 24 * 90 min, 1 session/week for 24 weeks 1 year Global cognition: CAMCI; Processing speed/ Attention: Tracking A; Executive function: Tracking B; Subjective cognitive ability Mood/social functioning: CSRQ-25;
ADL: TIADL
IG: No significant improvement in any of the outcome measures. Medium effect size estimates were found for global cognition, subjective cognition, executive function, and gait speed
Fiatarone Singh, 2014 [26] RCT IG1: CT + Sham exercise
IG2: PRT + Sham cognitive intervention
IG3: CT + PRT
Sham exercise + Sham cognitive intervention COGPACK program: computer-based multimodal and multi-domain exercises targeting memory, executive function, attention, and speed of information processing, including 14 progressively more difficult exercises CG: 60 min
IG: 75 min PRT/CT groups, 100 min combined
2–3 days/week for 6 months
18 months Global cognition: ADAS-Cog
Executive Function: WAIS-III; Verbal fluency: COWAT, animal naming; Memory: BVRT-R, auditory Logical Memory I and II, subsets of WMS-III, List Learning subsection of ADAS-Cog; Attention: SDMT
ADL: B-IADL CT prevented memory decline only up until 6 months
PRT improved global and executive function until 18 months; PRT was better than CT + PRT in improving global and executive function
Manera, 2015 [32] Pre-post Study ‘Kitchen and Cooking’ Game NA Computerized Kitchen and Cooking’ serious game which challenges attention, executive function, and praxis 4 weeks Interven-tion end Attention: Trail Making Test A
Visual Memory: the Visual Association Test
Executive function: the Victoria Stroop Test
ADL: IADL, ADL Significant improvement in executive function. Improvement in MCI > AD. Longer time played correlated with better executive function
Styliadis, 2015 [34] CCT IG1: Long-Lasting Memories (LLM) Intervention: combined cognitive training (CT) and physical training (PT)
IG2: CT alone
IG3: PT alone
CG1: Active Control (AC) (documentaries viewing)
CG2: Passive Control
LLM training system CT and PT as follows: CT: Greek adaptation of Brain Fitness Software: 6 self-paced exercises focused on categories: Attention and Auditory Processing Speed.
PT: FFA game platform incorporating Nintendo WII balance games
8 weeks
LLM group: Up to 10 h/week
PT group: Up to 5 h/week
CT group: Up to 5 h/week
AC group: Up to 5 h/week
Interven-tion end Electroencephalogram (EEG) measures of Cortical activity for delta, theta, beta 1 and beta 2 bands N/A A significant training effect was identified in the LLM group revealed by EEG measures but no training effects on the MMSE
Barban, 2016 [39] RCT Process-based-Cognitive Training (pb-CT) plus reminiscence therapy (RT) + rest Reminiscence therapy (RT) + pb-CT SOCIABLE software on a touch screen computer containing 27 games designed to improve function in 7 cognitive domains: attention, executive function, memory, logical reasoning, orientation, language, and constructional Praxis 24 * 1 h treatment sessions, 2 sessions/week for a about 3 months Interven-tion end MMSE
Memory: RAVLT; Executive function: Rey–Osterreith Complex Figure Test, Phonological Verbal Fluency Test; Executive function: Trail Making Test
IADL pb-CT: Significant training effects on memory in MCI subjects and the effect was maintained after reminiscence period; Significant training effect on MMSE was not maintained during reminiscence period; Medium effect sizes
Gooding, 2016 [35] CCT IG1: Computer based Cognitive Training (cb-CT)
IG2: Cognitive Vitality Training (CVT: cb-CT + Neuropsychological and Educational Approach to Remediation (NEAR)
Active Control Group (ACG) cb-CT: Brain Fitness: repeated drill-and-practice exercises involving memory, attention, and executive functions within domain-specific training modules that allow for adaptive training with titrated difficulty levels.
Same CT exercises delivered within a framework that allows for personalization, individual control, and contextualization of exercises
30 * 60 min/session, twice/week for 16 weeks 4 months Intellectual functioning: WRAT-3; mMMSE; Verbal learning and Memory: the BSRT, the WMS-R LM I and II subtests
Visual learning and memory: the WMS-R Visual Reproductions (VR) I and II subtests
Mood: depression (BDI-II) CVT and cb-CT groups had improvements in global cognition, verbal learning, and verbal memory; CVT and cb-CT had significantly greater improvements than ACG in global cognition, verbal memory, and verbal learning; No significant difference between cb-CT and CVT; Largest mood improvement in CVT, significant difference between CVT and ACG but not between CVT and cb-CT
Hyer, 2016 [28] RCT Computerized CT program Sham cognitive training Cogmed computer training program: Uses multiple rotating exercises daily that are designed to train working memory. 25 * 40 min /day for over 5 to 7 weeks 3 months Working Memory: WMS-III Span Board subtest, WAIS-III Letter Number Sequencing subtest; Attention: Trail Making Test Part A; Executive function: Trail Making Test Part B); Subjective memory: CFQ ADL: the Functional Activities Questionnaire Significant improvement of executive function, verbal and non-verbal working memory in both CG and IG; Significant improvement of subjective memory in IG but not CG.
Significant between group difference in working memory (Span Board) and in adjustment (FAQ)
Klados, 2016 [37] CCT Long Lasting Memories (LLM) Intervention (Cognitive Training (CT) + Physical Training (PT)) Active Control (AC): watching documentary and answering questionnaire Brain Fitness Software FitForAll CT: 1 h/day, 3–5 days/week for 8 weeks
PT: 1 h/day, 3–5 sessions/week for 8 weeks for 8 weeks
Interven-tion end Cortical Activity, Cortical Functional Connectivity: beta band Not specified IG showed beta band functional connectivity of MCI patients
Lin, 2016 [44] RCT VSOP MLA Software INSIGHT: online program designed by Posit Science, included five training tasks: eye for detail, peripheral challenge, visual sweeps, double decision, and target tracker 1 h/day
4 days/week for 6 weeks
Interven-tion end Processing speed: The Useful Field of View
Executive function: The EXAMINER
ADL: TIADL
Neuroimaging data: magnetic resonance imaging
IG > CG: improvement in trained (processing speed and attention) and untrained (working memory) cognitive domains, IADL, CEN and DMN
Vermeij, 2016 [31] Pre-post study WM training program NA Cogmed computer program 25 sessions, 45 min per session for 5 weeks 3 months Working memory: WAIS-III Digit Span forward and backward, WMS-III Spatial Span forward and backward; Verbal memory: Dutch equivalent of RAVLT; Figural Fluency: RFFT; Cognitive impairment: CFQ N/A IG: Significant improvement in trained verbal and visuospatial working memory tasks as well as executive function. Training gain was larger in the healthy elderly (HE) and was only maintained among HEs. Improvements in non-trained near-transfer tasks, maintained after 3 months follow-up
Bahar-Fuchs, 2017 [27] RCT home-based individually-tailored and adaptive cb-CT AC CogniFit Software: a computer-based program involving 33 tasks designed to train a broad range of cognitive abilities 2 sessions/day, 3 days/week, for 8–12 weeks 12 weeks Composite score global cognition
Memory: L’Hermitte Board, Logical Memory, RAVLT
Verbal fluency: SydBat
Processing speed: the Trails A and B tasks
Self-reported cognitive function
Mood MCI in IG: greater improvement in memory, learning, and global cognition.
No training effect in mood, self-reported memory
Training gains in MCI (including ADL) were consolidated over time large effect sizes of intervention at the follow-up assessments in learning, delayed memory, and global cognitive function, medium effect size in non-memory composite
Delbroek, 2017 [47] RCT VR dual task training with the BioRescue No intervention BioRescue Software: nine exercises to train balance, weight bearing, memory, attention and dual tasking. Led by a therapist, participants stand on a platform, adjustable difficulties based on performances Gradually increased from 18 min in week 1 to 30 min in week 5 Interven-tion end The Dutch version of MoCA Motivation: The Dutch version of IMI
emotions: OERS
IG significantly improved on balance, but not on global cognitive function or cognitive-motor dual tasking or gait performance
Hagovská, 2017 [12] RCT Cb-CT Classical group-based cognitive training CogniPlus program: on a computer, includes five sub-programs that involved activities that are similar to everyday activities, targets attention, working memory, long-term memory, planning of everyday activities, and visual-motor abilities. 20 *30 min, 2 sessions/week for 10 weeks 10 weeks Self-reported functional activities: FAQ Global cognition: ACE
Attention: The Stroop Test
QOL: Spitzer QOL index
Functional activities: The Functional Activities Questionnaire
IG demonstrated larger improvements in QoL and attention than CG.
The transfer to functional activities was the same between groups
Mansbach, 2017 [38] CCT cb-CR No intervention Memory Match online cognitive rehabilitation module: designed to improve attention and visual memory, requires the participant to visually pair “matching pictures” by remembering their location 9*30 min/session Interven-tion end Global cognitive functioning: BCAT
AD8 Dementia Screening
Interview, KPT
Attitudes about their cognitive abilities: SRI
Mood: depression: GDS-SF
IG > CG in global cognition at post-intervention assessment
Savulich, 2017 [41] RCT CT No intervention Game Show on iPad: a novel learning and memory game, target to improve episodic memory 8 sessions, 1 h/session Interven-tion end for 4 weeks MMSE;
Episodic memory and new learning: CANTAB PAL; Visual/spatial abilities: BVMT-R; Processing speed: CANTAB CRT
GDS-SF
Anxiety and depression: HADS; Apathy: AES
IG > CG: significantly better performance in episodic memory, visuospatial abilities, MMSE, and less apathy
  1. Pb-CT = Process-based cognitive training, Cb-CR = computer-based cognitive rehabilitation, Cb-CT = computer-based cognitive training, TNP = Neuropsychological Training, WLMT = memory Word List Memory Test, USMART = Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training, MSS = Memory Support System, PT = Physical training, CT = cognitive training, LLM = long lasting memories, CCT = clinical controlled trials, or, computerized cognitive training, WM = working memory, ACG = Active Control Group, CVT = Cognitive Vitality Training, NEAR: motivational therapeutic milieu based on Neuropsychological and Educational Approach to Remediation (NEAR) model, FFA = FitForAll, PRT = Progress resistance training, VR = virtual reality, PR = Physical rehabilitation, OT = Occupational therapy, BT = Behavioral training, ChEIs = cholinesterase inhibitors, VP = Variable Priority, FP = Fixed Priority, VSOP = Vision-based speed-of-processing, MLA = mental leisure activities, TIADL = The Timed Instrumental Activities of Daily Living, QOL-AD = The Quality of Life-AD, PTC = physical training component, CAMCI = The Computerized Assessment of Mild Cognitive Impairment, CSRQ-25 = Cognitive Self-Report Questionnaire-25, RAVLT = the Rey Auditory Verbal Learning Test, AADL = advanced activity of daily living, RBMT = Rivermead behavioral memory test, RBMT = Rivermead behavioral memory test, CERAD-K-N the Korean version of the CERAD Neuropsychological Assessment Battery, DRS-2 = Dementia Rating Scale-2, E-Cog = The Everyday Cognition, WAIS-III = Wechsler Adult Intelligence Scale-Third Edition, WMS-III = Wechsler Memory Scale-Third Edition, CFQ = Cognitive Failures Questionnaire, RFFT = the Ruff Figural Fluency Test, SCWT the Stroop Color-Word Task, IADL = Instrumental Activities of Daily Living scale, ADL = the Independence in Activity of Daily Living index, WRAT-3 = Wide Range Achievement Test–3rd Edition, BSRT = Buschke Selective Reminding Test, MFQ = Memory Functioning Questionnaire, IED = Intra−/extra-dimensional set shifting, RVP = a mea Rapid visual information processing, MFQ = Memory Functioning Questionnaire, PAL Paired-associates learning, SDMT = Symbol Digit Modalities Test, BVRT-R = Benton Visual Retention Test-Revised 5th Edition, B-IADL Bayer Activities of Daily Living, ADAS-Cog = Alzheimer’s Disease Assessment Scale-cognitive subscale, MoCA = the Montreal Cognitive Assessment, IMI = Intrinsic Motivation Inventory, OERS = Observed Emotion Rating Scale, NPI = Neuropsychiatric Inventory, BADL = Basic Activities Daily Living, CDT = clock-drawing test, PPT = physical performance test, TEA = Test of Everyday Attention, GDS = Geriatric Depression Scale, GAI = Geriatric Anxiety Scale, AES = Apathy Evaluation Scale, MMQ Multifactorial Memory Questionnaire, FOME = Fuld Object Memory Evaluation, CVLT-II = California Verbal Learning Test – II, COWAT = Controlled Oral Word Association Test, BNT = Boston Naming Test, BCAT = The Brief Cognitive Assessment Tool, FAQ = Functional Activities Questionnaire, ACE = Addenbrooke’s Cognitive Examination, EXAMINER = Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research, BCAT = The Brief Cognitive Assessment Tool, SRI = self-rating inventory of Cognitive Ability, KPT = Kitchen Picture Test of Practical Judgment, GDS-SF = Geriatric Depression Scale-Short Form, CANTAB PAL = Cambridge Neuropsychological Test Automated Battery Paired Associates Learning, BVMT-R = Brief Visuospatial Memory Test-Revised, CANTAB CRT = Cambridge Neuropsychological Test Automated Battery Choice Reaction Time, AES = Apathy Evaluation Scale, HADS = Hospital Anxiety and Depression Scale, CEN = central executive network, WLRT = Word List Recall Test, MN = mode network, CRT = Constructional Recall Test, VTA = Visual Association Test