Cognitive Training Program to Improve Working Memory in Older Adults with MCI

Hyer, L., Scott, C., Atkinson, M. M., Mullen, C. M., Lee, A., Johnson, A., & McKenzie, L. C. . (2016) Clinical Gerontologist .
DOI: 10.1080/07317115.2015.1120257

Abstract
Objective: Deficits in working memory (WM) are associated with age-related decline. We report findings from a clinical trial that examined the effectiveness of Cogmed, a computerized program that trains WM. We compare this program to a Sham condition in older adults with Mild Cognitive Impairment (MCI). Method: Older adults (N = 68) living in the community were assessed. Participants reported memory impairment and met criteria for MCI, either by poor delayed memory or poor performance in other cognitive areas. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Delayed Memory Index) and the Clinical Dementia Rating scale (CDR) were utilized. All presented with normal Mini Mental State Exams (MMSE) and activities of daily living (ADLs). Participants were randomized to Cogmed or a Sham computer program. Twenty-five sessions were completed over five to seven weeks. Pre, post, and follow-up measures included a battery of cognitive measures (three WM tests), a subjective memory scale, and a functional measure. Results: Both intervention groups improved over time. Cogmed significantly outperformed Sham on Span Board and exceeded in subjective memory reports at follow-up as assessed by the Cognitive Failures Questionnaire (CFQ). The Cogmed group demonstrated better performance on the Functional Activities Questionnaire (FAQ), a measure of adjustment and far transfer, at follow-up. Both groups, especially Cogmed, enjoyed the intervention. Conclusion: Results suggest that WM was enhanced in both groups of older adults with MCI. Cogmed was better on one core WM measure and had higher ratings of satisfaction. The Sham condition declined on adjustment.
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Comments

Aims: This study aimed to see if a computer-based training program called Cogmed could improve working memory in older adults with Mild Cognitive Impairment (MCI). Researchers wanted to find out if this training could help with memory and daily activities.

Findings: The results showed that both groups — those using Cogmed and a control group (Sham) — improved in some memory tasks. However, the Cogmed group performed better on measures closely related to working memory and reported feeling more satisfied with the training. Over time, the Cogmed group also maintained their skills better and showed improvements in daily functioning compared to the control group.

Strengths: The study involved real-world assessments and measured both cognitive abilities and everyday activities. Participants enjoyed the training, and many had no prior computer experience, yet they learned quickly. The involvement of caregivers and coaches helped keep participants motivated and engaged.

Limitations: The study had a small number of participants and no separate control group for comparison, so results might be influenced by placebo effects. Additionally, some participants were new to computers, which could have affected training outcomes. Additionally, effect sizes were not reported. 

REVIEWING

This study has been reviewed by Sharon Sanz-Simon , Kate Mahon .