Cognitive Interventions for Cognitively Healthy, Mildly Impaired, and Mixed Samples of Older Adults: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years). Interventions trained a single cognitive domain (e.g., memory) or were multi-domain training, and outcomes were assessed immediately post-intervention using standard neuropsychological tests. In total, 279 effects from 97 studies were pooled based on a random-effects model and expressed as Hedges’ g (unbiased). Overall, results indicated that cognitive interventions produce a small, but significant, improvement in the cognitive functioning of older adults, relative to active and passive control groups (g = 0.298, p < .001, 95% CI = 0.248–0.347). These results were confirmed using multi-level analyses adjusting for nesting of effect sizes within studies (g = 0.362, p < .001, 95% CI = 0.275, 0.449). Age, education, and cognitive status (healthy vs. MCI) were not significant moderators. Working memory interventions proved most effective (g = 0.479), though memory, processing speed, and multi-domain interventions also significantly improved cognition. Effects were larger for directly trained outcomes but were also significant for non-trained outcomes (i.e., “transfer effects”). Implications for future research and clinical practice are discussed. This project was pre-registered with PROSPERO (#42016038386).

[1]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[2]  Laura Fratiglioni,et al.  Relation of education and occupation-based socioeconomic status to incident Alzheimer's disease. , 2004, American journal of epidemiology.

[3]  K. Krishnan,et al.  A Brain-Computer Interface Based Cognitive Training System for Healthy Elderly: A Randomized Control Pilot Study for Usability and Preliminary Efficacy , 2013, PloS one.

[4]  Kp Suresh An overview of randomization techniques: An unbiased assessment of outcome in clinical research , 2011, Journal of human reproductive sciences.

[5]  M. Rosenberg,et al.  THE FILE‐DRAWER PROBLEM REVISITED: A GENERAL WEIGHTED METHOD FOR CALCULATING FAIL‐SAFE NUMBERS IN META‐ANALYSIS , 2005, Evolution; international journal of organic evolution.

[6]  Skye McDonald,et al.  Computerised cognitive training for older persons with mild cognitive impairment: A pilot study using a randomised controlled trial design , 2011 .

[7]  Mireille N. Rizkalla Cognitive training in the elderly: a randomized trial to evaluate the efficacy of a self-administered cognitive training program , 2018, Aging & mental health.

[8]  T. Vecchi,et al.  Self‐help memory training for healthy older adults in a residential care center: specific and transfer effects on performance and beliefs , 2015, International journal of geriatric psychiatry.

[9]  K. Sathian,et al.  Mnemonic strategy training improves memory for object location associations in both healthy elderly and patients with amnestic mild cognitive impairment: a randomized, single-blind study. , 2012, Neuropsychology.

[10]  G. Kinsella,et al.  Early intervention for mild cognitive impairment: a randomised controlled trial , 2009, Journal of Neurology, Neurosurgery, and Psychiatry.

[11]  Yvonne Brehmer,et al.  Working-memory training in younger and older adults: training gains, transfer, and maintenance , 2012, Front. Hum. Neurosci..

[12]  S. Willis,et al.  Reasoning Training in the ACTIVE Study , 2013, Journal of aging and health.

[13]  Camila Vieira Ligo Teixeira,et al.  Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI). , 2012, Archives of gerontology and geriatrics.

[14]  R. Petersen Mild cognitive impairment as a diagnostic entity , 2004, Journal of internal medicine.

[15]  Matthew Rizzo,et al.  The Accelerate Study: The Longitudinal Effect of Speed of Processing Training on Cognitive Performance of Older Adults , 2007 .

[16]  Y. Stern What is cognitive reserve? Theory and research application of the reserve concept , 2002, Journal of the International Neuropsychological Society.

[17]  Daniel Gopher,et al.  Space Fortress game training and executive control in older adults: A pilot intervention , 2011, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[18]  Mark W. Lipsey,et al.  Practical Meta-Analysis , 2000 .

[19]  S. Kemper,et al.  Interventions to reduce cognitive decline in aging. , 2010, Journal of psychosocial nursing and mental health services.

[20]  J. Morris The Clinical Dementia Rating (CDR) , 1993, Neurology.

[21]  Mike Martin,et al.  Plasticity of Verbal Fluency in Older Adults: A 90-Minute Telephone-Based Intervention , 2012, Gerontology.

[22]  D. Alfermann,et al.  Single versus combined cognitive and physical activity effects on fluid cognitive abilities of healthy older adults: a 4-month randomized controlled trial with follow-up. , 2014, Journal of aging and physical activity.

[23]  Leon Flicker,et al.  The PACE study: a randomized clinical trial of cognitive activity strategy training for older people with mild cognitive impairment. , 2015, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[24]  D. Terry,et al.  Functional Impairment in Mild Cognitive Impairment Evidenced Using Performance-Based Measurement , 2014, Journal of geriatric psychiatry and neurology.

[25]  L. Gluud Bias in clinical intervention research. , 2006, American journal of epidemiology.

[26]  Jeanine M. Parisi,et al.  Memory Training in the ACTIVE Study , 2013, Journal of aging and health.

[27]  Silvina Santana,et al.  Maintaining older brain functionality: A targeted review , 2015, Neuroscience & Biobehavioral Reviews.

[28]  Jin H. Yan,et al.  Visuospatial working memory training facilitates visually-aided explicit sequence learning. , 2015, Acta psychologica.

[29]  Tatia M.C. Lee,et al.  Effectiveness of cognitive training in Chinese older people with subjective cognitive complaints: a randomized placebo‐controlled trial , 2013, International journal of geriatric psychiatry.

[30]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[31]  C B Begg,et al.  Treatment allocation methods in clinical trials: a review. , 1985, Statistics in medicine.

[32]  J. Woo,et al.  Neural Plastic Effects of Cognitive Training on Aging Brain , 2015, Neural plasticity.

[33]  L. Nyberg,et al.  Executive process training in young and old adults , 2014, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[34]  Karlene K. Ball,et al.  Transfer of a Speed of Processing Intervention to Near and Far Cognitive Functions , 2002, Gerontology.

[35]  D. Magistro,et al.  The Effects of a Physical Activity Program and a Cognitive Training Program on the Long-Term Memory and Selective Attention of Older Adults: A Comparative Study , 2015 .

[36]  R. Dishman,et al.  Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis , 2016, Neuropsychology Review.

[37]  Monica Melby-Lervåg,et al.  Is working memory training effective? A meta-analytic review. , 2013, Developmental psychology.

[38]  M. Albert,et al.  Cognitive Training for Ethnic Minority Older Adults in the United States: A Review , 2018, The Gerontologist.

[39]  Nick C Fox,et al.  The Diagnosis of Mild Cognitive Impairment due to Alzheimer’s Disease: Recommendations from the National Institute on Aging-Alzheimer’s Association Workgroups on Diagnostic Guidelines for Alzheimer’s Disease , 2011 .

[40]  K. Sink,et al.  Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes: The Seniors Health and Activity Research Program Pilot (SHARP-P) Study, a randomized controlled trial , 2011, BMC geriatrics.

[41]  S. Salloway,et al.  Prediction of Functional Status from Neuropsychological Tests in Community-Dwelling Elderly Individuals , 2000, The Clinical neuropsychologist.

[42]  J. Ioannidis,et al.  Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials , 2011, BMJ : British Medical Journal.

[43]  L. Nyberg Cognitive Training in Healthy Aging , 2004 .

[44]  Erik von Elm,et al.  Different patterns of duplicate publication: an analysis of articles used in systematic reviews. , 2004, JAMA.

[45]  S. Belleville,et al.  Identifying training modalities to improve multitasking in older adults , 2014, AGE.

[46]  S. McDonald,et al.  Repetition-lag training to improve recollection memory in older people with amnestic mild cognitive impairment. A randomized controlled trial , 2015, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[47]  Paul B. Baltes,et al.  Intellectual Development in Adulthood: The Seattle Longitudinal Study , 1996 .

[48]  P. Baltes,et al.  On the locus of training gains in research on the plasticity of fluid intelligence in old age , 1988 .

[49]  M. Storandt,et al.  Memory-skills training, memory complaints, and depression in older adults. , 1985, Journal of gerontology.

[50]  E. Tucker-Drob,et al.  Neurocognitive functions and everyday functions change together in old age. , 2011, Neuropsychology.

[51]  Prabha Siddarth,et al.  Effect of a computerized brain exercise program on cognitive performance in older adults. , 2013, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[52]  J. Sterne,et al.  Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. , 2000, Journal of clinical epidemiology.

[53]  Arthur F Kramer,et al.  Achieving and maintaining cognitive vitality with aging. , 2002, Mayo Clinic proceedings.

[54]  Christian Chicherio,et al.  Individual differences in cognitive plasticity: an investigation of training curves in younger and older adults , 2014, Psychological research.

[55]  Matthias Kliegel,et al.  Working memory training and transfer in older adults: effects of age, baseline performance, and training gains. , 2014, Developmental psychology.

[56]  R. Rosenthal Meta-analytic procedures for social research , 1984 .

[57]  L. Clare Cognitive training and cognitive rehabilitation for people with early-stage dementia , 2003 .

[58]  R L Williams,et al.  A Note on Robust Variance Estimation for Cluster‐Correlated Data , 2000, Biometrics.

[59]  B. Carretti,et al.  Benefits of training visuospatial working memory in young-old and old-old. , 2014, Developmental psychology.

[60]  J. Yesavage,et al.  Mnemonic Training in Older Adults: Effects of Age, Length of Training, and Type of Cognitive Pretraining , 1999, International Psychogeriatrics.

[61]  Larry V Hedges,et al.  The power of statistical tests for moderators in meta-analysis. , 2004, Psychological methods.

[62]  V. Moro,et al.  Cognitive Stimulation of Executive Functions in Mild Cognitive Impairment , 2015, American journal of Alzheimer's disease and other dementias.

[63]  Training effects on Raven's progressive matrices in young, middle-aged, and elderly adults. , 1990 .

[64]  Ian H. Robertson,et al.  An Evaluation of a Working Memory Training Scheme in Older Adults , 2013, Front. Aging Neurosci..

[65]  B. Carretti,et al.  Benefits of training working memory in amnestic mild cognitive impairment: specific and transfer effects , 2012, International Psychogeriatrics.

[66]  Victoria Martínez,et al.  Introduction to Meta-Analysis , 2002 .

[67]  A. Karter,et al.  Racial/Ethnic Differences in Dementia Risk Among Older Type 2 Diabetic Patients: The Diabetes and Aging Study , 2014, Diabetes Care.

[68]  Cynthia Owsley,et al.  Timed Instrumental Activities of Daily Living Tasks: Relationship to Cognitive Function and Everyday Performance Assessments in Older Adults , 2002, Gerontology.

[69]  B. Alescio-Lautier,et al.  Positive effects of computer-based cognitive training in adults with mild cognitive impairment , 2012, Neuropsychologia.

[70]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[71]  Mike Martin,et al.  Memory training effects in old age as markers of plasticity: a meta-analysis. , 2009, Restorative neurology and neuroscience.

[72]  Ingram Olkin,et al.  Stochastically dependent effect sizes. , 1994 .

[73]  Eduard Kraft,et al.  Cognitive function, physical activity, and aging: Possible biological links and implications for multimodal interventions , 2012, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[74]  Michael Valenzuela,et al.  Cognitive Exercise and Its Role in Cognitive Function in Older Adults , 2010, Current psychiatry reports.

[75]  J. Morris,et al.  Current concepts in mild cognitive impairment. , 2001, Archives of neurology.

[76]  L. Whalley,et al.  A life-course approach to the aetiology of late-onset dementias , 2006, The Lancet Neurology.

[77]  J. Yesavage,et al.  Learning mnemonics: roles of aging and subtle cognitive impairment. , 1990, Psychology and aging.

[78]  C. Jack,et al.  Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment , 2004, Journal of internal medicine.

[79]  L. Bäckman,et al.  Multifactorial memory training with older adults: how to foster maintenance of improved performance. , 1989, Gerontology.

[80]  B. Rund,et al.  A cognitive training programme for schizophrenic patients , 1998, Schizophrenia Research.

[81]  Carrie Heeter,et al.  Effects of a computer-based cognitive exercise program on age-related cognitive decline. , 2013, Archives of gerontology and geriatrics.

[82]  S. Jaeggi,et al.  The malleability of working memory and visuospatial skills: a randomized controlled study in older adults. , 2014, Developmental psychology.

[83]  Elizabeth M Zelinski,et al.  Cognitive benefits of computer games for older adults. , 2009, Gerontechnology : international journal on the fundamental aspects of technology to serve the ageing society.

[84]  Lixia Yang,et al.  Plasticity of inhibition in older adults: retest practice and transfer effects. , 2012, Psychology and aging.

[85]  J. Ioannidis,et al.  The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration , 2009, BMJ : British Medical Journal.

[86]  A. Vita,et al.  Non-pharmacological interventions in early schizophrenia: focus on cognitive remediation , 2015 .

[87]  D J Madden,et al.  Four to ten milliseconds per year: age-related slowing of visual word identification. , 1992, Journal of gerontology.

[88]  S. Hynes Internet, home-based cognitive and strategy training with older adults: a study to assess gains to daily life , 2016, Aging Clinical and Experimental Research.

[89]  M. Falkenstein,et al.  Training-Induced Improvement of Response Selection and Error Detection in Aging Assessed by Task Switching: Effects of Cognitive, Physical, and Relaxation Training , 2012, Front. Hum. Neurosci..

[90]  H R Dinse,et al.  Treating the aging brain: cortical reorganization and behavior. , 2005, Acta neurochirurgica. Supplement.

[91]  H. Hendrie,et al.  Does targeted cognitive training reduce educational disparities in cognitive function among cognitively normal older adults? , 2016, International journal of geriatric psychiatry.

[92]  Kristine Yaffe,et al.  A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity‐based Adaptive Cognitive Training (IMPACT) Study , 2009, Journal of the American Geriatrics Society.

[93]  Peter Fuhr,et al.  Cognitive training in Parkinson disease , 2014, Neurology.

[94]  P. Baltes,et al.  Modification of response speed deficits and intellectual performance in the elderly. , 1973, Human development.

[95]  Sharona M. Atkins,et al.  Memory enhancement in healthy older adults using a brain plasticity-based training program: A randomized, controlled study , 2006, Proceedings of the National Academy of Sciences.

[96]  Cristina Buiza,et al.  A randomized, two‐year study of the efficacy of cognitive intervention on elderly people: the Donostia Longitudinal Study , 2008, International journal of geriatric psychiatry.

[97]  R. Barker,et al.  Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines , 2012, Movement disorders : official journal of the Movement Disorder Society.

[98]  K Warner Schaie,et al.  The Seattle Longitudinal Study: Relationship Between Personality and Cognition , 2004, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[99]  Quincy M. Samus,et al.  Memory training interventions for older adults: A meta-analysis , 2012, Aging & mental health.

[100]  C. Bottino,et al.  Cognitive intervention in amnestic Mild Cognitive Impairment: A systematic review , 2012, Neuroscience & Biobehavioral Reviews.

[101]  F. Scogin,et al.  The efficacy of self-taught memory training for community-dwelling older adults , 1992 .

[102]  S. Willis,et al.  In-Home Cognitive Training with Older Married Couples: Individual Versus Collaborative Learning , 2006, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[103]  B. Hayslip Alternative mechanisms for improvements in fluid ability performance among older adults. , 1989, Psychology and aging.

[104]  M. Gatz,et al.  Relationship Between Education and Dementia: An Updated Systematic Review , 2011, Alzheimer disease and associated disorders.

[105]  I. Robertson,et al.  The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: A systematic review and meta-analysis , 2014, Ageing Research Reviews.

[106]  Ashley R. Morgan,et al.  A cognitive training intervention improves modality-specific attention in a randomized controlled trial of healthy older adults , 2011, Neurobiology of Aging.

[107]  William C. Mann,et al.  Video game training to improve selective visual attention in older adults , 2013, Comput. Hum. Behav..

[108]  M. Kliegel,et al.  Benefits in tasks related to everyday life competences after a working memory training in older adults , 2017, International journal of geriatric psychiatry.

[109]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[110]  Kevin J Black,et al.  The cognitive correlates of functional status: a review from the Committee on Research of the American Neuropsychiatric Association. , 2007, The Journal of neuropsychiatry and clinical neurosciences.

[111]  Camarin E. Rolle,et al.  Video game training enhances cognitive control in older adults , 2013, Nature.

[112]  B. Carretti,et al.  Gains in language comprehension relating to working memory training in healthy older adults , 2013, International journal of geriatric psychiatry.

[113]  Norbert Kathmann,et al.  Working memory training improvements and gains in non-trained cognitive tasks in young and older adults , 2014, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[114]  M. Linzer,et al.  Randomization in clinical trials. , 1987, Annals of internal medicine.

[115]  Brennan R. Payne,et al.  The effects of verbal working memory training on language comprehension in older adulthood , 2014 .

[116]  L. Bäckman,et al.  MAINTENANCE OF GAINS FOLLOWING MULTIFACTORIAL AND UNIFACTORIAL MEMORY TRAINING IN LATE ADULTHOOD , 1993 .

[117]  G. Smith,et al.  The memory support system for mild cognitive impairment: randomized trial of a cognitive rehabilitation intervention , 2013, International journal of geriatric psychiatry.

[118]  Hauke R. Heekeren,et al.  Training-induced changes in subsequent-memory effects: No major differences among children, younger adults, and older adults , 2016, NeuroImage.

[119]  Arthur F Kramer,et al.  The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. , 2013, JAMA internal medicine.

[120]  Anita Liberalesso Neri,et al.  Treino de memória episódica com ênfase em categorização para idosos sem demência e depressão , 2010 .

[121]  E. Kraft,et al.  Neuroplasticity in Aging: Implications for Behavioral and Lifestyle Combined Interventions , 2014 .

[122]  M. Storandt,et al.  The effects of memory skills training and incentives on free recall in older learners. , 1990, Journal of gerontology.

[123]  V. Moro,et al.  Cognitive Stimulation in a-MCI , 2012, American journal of Alzheimer's disease and other dementias.

[124]  R. Petersen,et al.  Mild Cognitive Impairment: An Overview , 2008, CNS Spectrums.

[125]  R D Hill,et al.  Stories as a mnemonic aid for older learners. , 1991, Psychology and aging.

[126]  B. Ska,et al.  Working memory training and poetry-based stimulation programs: are there differences in cognitive outcome in healthy older adults? , 2014, NeuroRehabilitation.

[127]  Lars Bäckman,et al.  Forgetting Numbers in Old Age: Strategy and Learning Speed Matter , 2005, Gerontology.

[128]  K. Chamari,et al.  Improvement of cognitive function by mental and/or individualized aerobic training in healthy elderly subjects. , 2002, International journal of sports medicine.

[129]  E. M. Hudak The Effects of Cognitive Stimulation and Computerized Memory Training among Older Adults Residing in Indepedent-Living Facilities , 2012 .

[130]  D L Roenker,et al.  The impact of speed of processing training on cognitive and everyday performance , 2005, Aging & mental health.

[131]  D. Young,et al.  Effectiveness of cognitive training for Chinese elderly in Hong Kong , 2013, Clinical interventions in aging.

[132]  Mônica Sanches Yassuda,et al.  Memory training (MT) in mild cognitive impairment (MCI) generates change in cognitive performance. , 2013, Archives of gerontology and geriatrics.

[133]  G. McDougall,et al.  The SeniorWISE study: improving everyday memory in older adults. , 2010, Archives of psychiatric nursing.

[134]  Luc Goossens,et al.  Improving memory performance in the aged through mnemonic training: a meta-analytic study. , 1992, Psychology and aging.

[135]  M. Simard,et al.  Cognitive Stimulation Programs in Healthy Elderly: A Review , 2011, International journal of Alzheimer's disease.

[136]  Mike Martin,et al.  Cognition-based interventions for healthy older people and people with mild cognitive impairment. , 2011, The Cochrane database of systematic reviews.

[137]  D. Devanand,et al.  Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline , 2016, Neuropsychological rehabilitation.

[138]  Meghan B. Mitchell,et al.  Activities of Daily Living Are Associated With Older Adult Cognitive Status , 2013, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[139]  Denise C Park,et al.  Improving Cognitive Function in Older Adults: Nontraditional Approaches. , 2007, The journals of gerontology. Series B, Psychological sciences and social sciences.

[140]  A. Lampit,et al.  Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis of Effect Modifiers , 2014, PLoS medicine.

[141]  L. Hedges Distribution Theory for Glass's Estimator of Effect size and Related Estimators , 1981 .

[142]  George W Rebok,et al.  Effects of cognitive training interventions with older adults: a randomized controlled trial. , 2002, JAMA.

[143]  Evelyn Shatil,et al.  Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults , 2013, Front. Aging Neurosci..

[144]  Yasuyuki Taki,et al.  Brain Training Game Improves Executive Functions and Processing Speed in the Elderly: A Randomized Controlled Trial , 2012, PloS one.

[145]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[146]  Harald Hampel,et al.  Cognitive intervention in Alzheimer disease , 2010, Nature Reviews Neurology.

[147]  L. Hedges,et al.  Statistical Methods for Meta-Analysis , 1987 .

[148]  J. Goh Functional Dedifferentiation and Altered Connectivity in Older Adults: Neural Accounts of Cognitive Aging. , 2011, Aging and disease.

[149]  A. Spector,et al.  A review of the effectiveness of memory interventions in mild cognitive impairment (MCI) , 2010, International Psychogeriatrics.

[150]  M. Couture,et al.  Psychological distress in older adults with low functional independence: a multidimensional perspective. , 2005, Archives of gerontology and geriatrics.

[151]  D. Hall Designing Clinical Trials for Assessing the Effectiveness of Interventions for Tinnitus , 2017, Trends in hearing.

[152]  Heinz-Martin Süß,et al.  Experimental Evaluation of Near- and Far-Transfer Effects of an Adaptive Multicomponent Working Memory Training , 2015 .

[153]  J. Yesavage,et al.  Mental status as a predictor of response to memory training in older adults , 1989 .

[154]  E. Glisky Changes in Cognitive Function in Human Aging , 2007 .

[155]  Denise C. Park,et al.  Neuroplasticity and cognitive aging: the scaffolding theory of aging and cognition. , 2009, Restorative neurology and neuroscience.

[156]  T. Ordonez,et al.  Effects of cognitive training based on metamemory and mental images , 2010, Dementia & neuropsychologia.

[157]  Lars Nyberg,et al.  Plasticity of executive functioning in young and older adults: immediate training gains, transfer, and long-term maintenance. , 2008, Psychology and aging.

[158]  R. Papa,et al.  The Effects of Cognitive Training for Elderly: Results from My Mind Project , 2016, Rejuvenation research.

[159]  Ingrid R Olson,et al.  Working memory training and transfer in older adults. , 2011, Psychology and aging.

[160]  Bob Woods,et al.  Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: a review , 2013, Alzheimer's Research & Therapy.

[161]  Martin van Boxtel,et al.  Cognitive interventions in healthy older adults and people with mild cognitive impairment: A systematic review , 2013, Ageing Research Reviews.

[162]  J. Jolles,et al.  Interaction effects of education and health status on cognitive change: A 6-year follow-up of the Maastricht Aging Study , 2009, Aging & Mental Health.

[163]  J. Dunlosky,et al.  Training monitoring skills improves older adults' self-paced associative learning. , 2003, Psychology and aging.

[164]  H. Brodaty,et al.  The Timecourse of Global Cognitive Gains from Supervised Computer-Assisted Cognitive Training: A Randomised, Active-Controlled Trial in Elderly with Multiple Dementia Risk Factors. , 2014, The journal of prevention of Alzheimer's disease.

[165]  Jerome A. Yesavage,et al.  Which older adults maintain benefit from cognitive training? Use of signal detection methods to identify long-term treatment gains , 2012, International Psychogeriatrics.

[166]  J P Matts,et al.  Randomization in clinical trials: conclusions and recommendations. , 1988, Controlled clinical trials.

[167]  C. Caltagirone,et al.  A pilot study on the effect of cognitive training on BDNF serum levels in individuals with Parkinson’s disease , 2015, Front. Hum. Neurosci..

[168]  Peter J. Snyder,et al.  Immediate and delayed effects of cognitive interventions in healthy elderly: A review of current literature and future directions , 2009, Alzheimer's & Dementia.

[169]  Yue Gao,et al.  The Training Effect of Working Memory Based on Central Executive System Intervention in Older Adults: A Randomized Controlled Study , 2014 .

[170]  Elizabeth M Zelinski,et al.  Far transfer in cognitive training of older adults. , 2009, Restorative neurology and neuroscience.

[171]  Lesley A Ross,et al.  The impact of speed of processing training on cognitive and everyday functions. , 2007, The journals of gerontology. Series B, Psychological sciences and social sciences.

[172]  Robert E Kass,et al.  An Implementation of Bayesian Adaptive Regression Splines (BARS) in C with S and R Wrappers. , 2008, Journal of statistical software.

[173]  Paul Verhaeghen Older Adults Making Working Memory Work : A Meta-Analysis of Executive-Control and Working Memory Training in , 2014 .

[174]  Kathy E. Johnson,et al.  The cognitive reserve hypothesis: a longitudinal examination of age-associated declines in reasoning and processing speed. , 2009, Developmental Psychology.

[175]  E Kalbe,et al.  [Cognitive Training in Parkinson's Disease - A New Therapy Option?]. , 2016, Fortschritte der Neurologie-Psychiatrie.

[176]  G. Rebok Mental Capital and Wellbeing: Making the most of ourselves in the 21st century State-of-Science Review: SR-E22 Cognitive Training: Infl uence on Neuropsychological and Brain Function in Later Life , 2008 .

[177]  Erika Borella,et al.  Working memory training in older adults: evidence of transfer and maintenance effects. , 2010, Psychology and aging.

[178]  Mun Sang Kim,et al.  Structural Brain Changes after Traditional and Robot-Assisted Multi-Domain Cognitive Training in Community-Dwelling Healthy Elderly , 2015, PloS one.

[179]  U. Lindenberger,et al.  Life-span plasticity of the brain and cognition: From questions to evidence and back , 2013, Neuroscience & Biobehavioral Reviews.

[180]  Yaakov Stern,et al.  A study of the efficacy of a comprehensive memory enhancement program in healthy elderly persons , 1998, Psychiatry Research.

[181]  L. Bäckman,et al.  Effects of multifactorial memory training in old age: generalizability across tasks and individuals. , 1995, The journals of gerontology. Series B, Psychological sciences and social sciences.

[182]  Tania B. Huedo-Medina,et al.  Assessing heterogeneity in meta-analysis: Q statistic or I2 index? , 2006, Psychological methods.

[183]  Susan M. Barnett,et al.  When and where do we apply what we learn? A taxonomy for far transfer. , 2002, Psychological bulletin.

[184]  Wolfgang Viechtbauer,et al.  Conducting Meta-Analyses in R with the metafor Package , 2010 .

[185]  G. Band,et al.  Online games training aging brains: limited transfer to cognitive control functions , 2011, Front. Hum. Neurosci..

[186]  Susan Whitfield-Gabrieli,et al.  Cognitive training changes hippocampal function in mild cognitive impairment: a pilot study. , 2011, Journal of Alzheimer's disease : JAD.

[187]  Gordon Winocur,et al.  Cognitive rehabilitation in the elderly: Effects on memory , 2006, Journal of the International Neuropsychological Society.

[188]  S. Heidrich,et al.  Training effects on Raven's progressive matrices in young, middle-aged, and elderly adults. , 1990, Psychology and aging.

[189]  R. Peterson,et al.  Mild cognitive impairment: Transition from aging to Alzheimer's disease , 2000, Neurobiology of Aging.

[190]  R. Allegri,et al.  Efficacy of a cognitive intervention program in patients with mild cognitive impairment , 2013, International Psychogeriatrics.

[191]  Francesco Bellotti,et al.  Novel Television-Based Cognitive Training Improves Working Memory and Executive Function , 2014, PloS one.

[192]  R. Dishman,et al.  Personality and physical activity: A systematic review and meta-analysis. , 2015 .

[193]  A. Newman,et al.  Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study , 2013, BMJ.

[194]  J. Virués-Ortega,et al.  Effect of Cognitive Training Targeting Associative Memory in the Elderly: A Small Randomized Trial and a Longitudinal Evaluation , 2013, Journal of the American Geriatrics Society.

[195]  J. M. L. Postigo,et al.  Efficacy of a Group Memory Training Method for Older Adults Based on Visualization and Association Techniques: A Randomized, Controlled Trial with a Placebo Group , 2010 .

[196]  K. Warner Schaie,et al.  Can decline in adult intellectual functioning be reversed , 1986 .