Clinical Question

Do cognitive interventions improve cognitive function in healthy older adults and older adults with mild cognitive impairments?

Evidence-Based Answer

Compared with no treatment, cognitive interventions improved cognitive performance in healthy older adults and older adults with mild cognitive impairments. However, there is inadequate evidence to determine which aspects of these interventions are effective. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Cognition may decline with increasing age. Mild cognitive impairment is defined as cognitive changes that are greater than expected for a person's age but not severe enough to meet criteria for dementia. Nonrandomized studies suggest that cognitive interventions may improve cognitive function in older adults. These interventions include activities such as problem-solving training, mnemonic training, and guided imagery.

The authors systematically reviewed literature from 1970 to 2007 that examined the effect of cognitive training on domains of cognitive functioning (i.e., memory, executive function, attention, and speed). Data from 24 randomized controlled trials with 2,229 participants were pooled according to measures of cognitive functioning, improvement, sustainability, and transfer of training effects. Time devoted to training ranged from six to 135 hours over a period of one day to one year. Studies included varying forms of individual and group-based interventions.

Adults with and without mild cognitive impairments who were randomized to receive cognitive training had statistically significant improvement in the areas of immediate and delayed verbal recall compared with persons who did not receive treatment. However, these improvements did not exceed those observed in persons randomized to active control groups, which included interventions such as discussion groups and physical training.

There are currently no guidelines specifically for cognitive training for adults older than 60 years. Although this review found improvement with different forms of active training, more research is needed to define optimal training design and the amount of training time needed.