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Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review
Butler M, McCreedy E, Nelson VA, Desai P, Ratner E, Fink HA, Hemmy LS, McCarten JR et al.. Annals of internal medicine, 2017-12-19
Topic: Risk, prevention and care in population studies
Background Structured activities to stimulate brain function-that is, cognitive training exercises-are promoted to slow or prevent cognitive decline, including dementia, but their effectiveness is highly debated. Purpose To summarize evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). Data sources Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and PsycINFO through July 2017, supplemented by hand-searches. Study selection Trials (published in English) lasting at least 6 months that compared cognitive training with usual care, waitlist, information, or attention controls in adults without dementia. Data extraction Single-reviewer extraction of study characteristics confirmed by a second reviewer; dual-reviewer risk-of-bias assessment; consensus determination of strength of evidence. Only studies with low or medium risk of bias were analyzed. Data synthesis Of 11 trials with low or medium risk of bias, 6 enrolled healthy adults with normal cognition and 5 enrolled adults with MCI. Trainings for healthy older adults were mostly computer based; those for adults with MCI were mostly held in group sessions. The MCI trials used attention controls more often than trials with healthy populations. For healthy older adults, training improved cognitive performance in the domain trained but not in other domains (moderate-strength evidence). Results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence). Evidence for prevention of cognitive decline or dementia was insufficient. Adverse events were not reported. Limitation Heterogeneous interventions and outcome measures; outcomes that mostly assessed test performance rather than global function or dementia diagnosis; potential publication bias. Conclusion In older adults with normal cognition, training improves cognitive performance in the domain trained. Evidence regarding prevention or delay of cognitive decline or dementia is insufficient. Primary funding source Agency for Healthcare Research and Quality.
Key findings
- Results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence).
Why it matters
This review of trials lasting at least six months found that cognitive training did not improve performance in people with mild cognitive impairment. For healthy older adults, training improved some cognitive measures, but the evidence on preventing dementia is limited.
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Study details
- Evidence strengthLow
How this study scored 67/100
Published in a leading specialty journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of internal medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question (from PubMed type “Systematic Review”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 233 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.3 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 4 / 6 | Cited 12.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 12 other studies in this library |
| Still being cited | 3 / 4 | Cited 74 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Robert L Kane: h-index 106 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Minnesota: institution h-index 1,568 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29255842) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 67 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Butler, M., McCreedy, E., Nelson, V. A., Desai, P., Ratner, E., Fink, H. A., et al. (2018). Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review. Annals of internal medicine. https://doi.org/10.7326/m17-1531
Vancouver
Butler M, McCreedy E, Nelson VA, Desai P, Ratner E, Fink HA, et al. Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review. Annals of internal medicine. 2018. doi:10.7326/m17-1531. PMID: 29255842.
BibTeX
@article{butler2018-29255842,
author = {Butler, M. and McCreedy, E. and Nelson, V. A. and Desai, P. and Ratner, E. and Fink, H. A. and Hemmy, L. S. and McCarten, JR. and others},
title = {{Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review}},
journal = {Annals of internal medicine},
year = {2018},
doi = {10.7326/m17-1531},
pmid = {29255842},
url = {https://doi.org/10.7326/m17-1531}
}
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