15 February 2009

Review of structured cognitive interventions / brain training programs

Study questions effectiveness of $80 million per year ‘brain exercise’ products industry
e!Science: 11 February 2009
A new study from Lifespan evaluated the research to date on the impact of cognitive training on the healthy elderly population. Their review of all relevant randomized, controlled trials shows no evidence that structured cognitive interventions or "brain exercise" programs delay or slow progression of cognitive changes in healthy elderly. Such programs are now an $80 million per year industry. The study appeared in Alzheimer's & Dementia.

There is much research on the benefits of cognitive rehabilitation strategies among elderly who already experience mild cognitive impairment (MCI) or Alzheimer's disease, as well as on the positive impact of physical exercise. The researchers, however, wanted to evaluate current research that would focus on the impact of cognitive interventions in the healthy elderly population. With this in mind, they established three objectives for their study: to systematically review the available literature on cognitive training and the healthy elderly, to assess and compare the efficacy of different cognitive interventions and to provide recommendations for future research. … > full story

Other news coverage from The Scotsman : Guardian UK & BMJ Group

Comment from Alzheimer's Australia Research Officer, Michele Hawkins: There is increasing interest in cognitive training and a growing number of “brain-training” products are entering the market. Manufacturers claim, amongst other things, that these programs will delay or even reverse cognitive decline and dementia.

A team of researchers from the University of Connecticut and The Brown University, Providence, undertook a systematic review of randomized controlled trials of cognitive interventions in healthy elderly people, that is, trials in which healthy elderly people were given some form of brain training.

The team had several reasons for undertaking this research. These included the apparent effectiveness of cognitive rehabilitation in people with Alzheimer's disease; that bolstering skills that are eventually affected by disease would seem a valid pursuit; that it would be of value to find low-cost and non-invasive methods of preventing or staving off disease; that there is evidence that engaging in cognitively stimulating activities throughout life may provide protection against dementia; and that the population across the world is ageing.

After extensive searching, the team identified ten good-quality randomized controlled trials of cognitive interventions in the healthy elderly. This small number of trials suitable for analysis reflected the lack of consensus in the literature on what constitutes the most effective type of cognitive training; inadequate follow-up times to access long- or even medium-term benefit; a lack of suitable controls in trials; and narrow outcome measures. The important areas of changes in daily functioning, global cognitive skills, and progression to early Alzheimer’s disease were left either unmeasured or unreported.

The research team acknowledged that its review was limited by the small number of acceptable studies, the diversity in study approaches, and the methodologically limited literature. But in the studies that were suitable for review, the team found no evidence to support the notion that structured cognitive intervention programs (brain-training) delay or slow progression of Alzheimer’s disease in healthy elderly people.

The researchers concluded that more work is needed to overcome the limitations of previous research in this area. Furthermore, they made the important point that clear and unbiased reporting of the state of our knowledge and progress in research into this topic should be made available to the public. Such honest reporting would help people to make informed decisions about whether to invest time and money in cognitive intervention merchandise.

comment added: 7 March 2009

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