Guangning Wang1, Menglu Zhao2, Fuguo Yang3, Ling Jie Cheng4, Ying Lau5. 1. Qingdao Municipal Hospital, Qingdao, Shandong, China. Electronic address: 13210098557@163.com. 2. Bachelor of Science, School of Nursing, Qingdao University, China. Electronic address: zmyhl94@163.com. 3. School of Nursing, Qingdao University, China. Electronic address: yfuguo@126.com. 4. Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore. Electronic address: chenglingjie@u.nus.edu. 5. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: nurly@u.nus.edu.
Abstract
BACKGROUND: Given that increasing aging is associated with a natural decline in cognitive function, identifying effective interventions that can help to prevent cognitive decline in older adults is a research priority. OBJECTIVE: To synthesize the best evidence to assess the effectiveness of game-based brain training in improving cognitive function and to evaluate the preferred design features of the intervention. METHODS: Twelve databases, trial registries, and gray literature resources were systematically searched for in randomized controlled trials. Meta-analysis and random-effects meta-regression were conducted using Comprehensive Meta-analysis Software 3.0. Overall effect was measured using Hedges's g and determined using Z-statistics. Cochran's Q test and I2 were used to investigate heterogeneity. The Grading of Recommendation, Assessment, Development, and Evaluation system was used to assess overall quality of evidence. RESULTS: Fifteen trials among 759 older adults were conducted. Meta-analysis revealed that game-based brain training significantly improved processing speed (g = 0.23), selective attention (g = 0.40), and short-term memory (g = 0.35) versus a control group. Our subgroup analyses emphasized that non-time pressure games, multiplayer, computer platform, provider support, sessions ≤ 3 times per week for ≤ 60 min. each comprised a preferable design. Meta-regression identified game design (β = 0.211, p = 0.008) that had statistically significant effects on processing speed. Egger's regression asymmetry test (p = 0.293) suggested no publication bias. CONCLUSIONS: Game-based brain training can be considered a supplementary intervention for improving cognitive functions in community-dwelling older adults. Future trials should use well-designed trials with large sample sizes.
BACKGROUND: Given that increasing aging is associated with a natural decline in cognitive function, identifying effective interventions that can help to prevent cognitive decline in older adults is a research priority. OBJECTIVE: To synthesize the best evidence to assess the effectiveness of game-based brain training in improving cognitive function and to evaluate the preferred design features of the intervention. METHODS: Twelve databases, trial registries, and gray literature resources were systematically searched for in randomized controlled trials. Meta-analysis and random-effects meta-regression were conducted using Comprehensive Meta-analysis Software 3.0. Overall effect was measured using Hedges's g and determined using Z-statistics. Cochran's Q test and I2 were used to investigate heterogeneity. The Grading of Recommendation, Assessment, Development, and Evaluation system was used to assess overall quality of evidence. RESULTS: Fifteen trials among 759 older adults were conducted. Meta-analysis revealed that game-based brain training significantly improved processing speed (g = 0.23), selective attention (g = 0.40), and short-term memory (g = 0.35) versus a control group. Our subgroup analyses emphasized that non-time pressure games, multiplayer, computer platform, provider support, sessions ≤ 3 times per week for ≤ 60 min. each comprised a preferable design. Meta-regression identified game design (β = 0.211, p = 0.008) that had statistically significant effects on processing speed. Egger's regression asymmetry test (p = 0.293) suggested no publication bias. CONCLUSIONS: Game-based brain training can be considered a supplementary intervention for improving cognitive functions in community-dwelling older adults. Future trials should use well-designed trials with large sample sizes.