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Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials
Li Z, He H, Chen Y, Guan Q.. Age and ageing, 2024-01-01
Topic: Risk, prevention and care in population studies
Background Limited understanding exists regarding the influences of engagement, persistence and adherence on the efficacy of cognitive training for age-related cognitive decline and neurodegenerative cognitive impairment. Methods This study conducted a meta-analysis of randomised controlled trials (RCTs). We systematically searched MEDLINE, PubMed, Web of Science, Embase and CINAHL databases from 1 January 2012 to 13 June 2023, and included RCTs assessing the effects of cognitive training in older adults, both with and without cognitive impairment. Hedges' g with a 95% confidence interval (CI) was used to synthesise cognitive training effect sizes on various neuropsychological tests. Subgroup analyses were conducted based on variables including engagement, persistence, adherence and cognitive conditions of normal cognition, mild cognitive impairment (MCI) or neurodegenerative dementia. Results This meta-analysis included 55 RCTs with 4,455 participants with cognitive conditions spanning normal cognition, MCI and neurodegenerative dementia. The mean age of participants was 73.9 (range: 65.7-84.5) years. Overall, cognitive training showed a significant cross-domain effect (Hedges' g = 0.286, 95% CI: 0.224-0.348). Training effects are significant when engagement or persistence rates exceed 60% or when adherence rates exceed 80%. Higher levels of persistence are required to achieve significant training effects in memory, visuospatial ability and reasoning than in executive function and attention and language. Higher persistence is also required for older adults with normal cognition to achieve significant training gains compared to those with cognitive impairment. Conclusions This systematic review highlights the critical roles of engagement, persistence and adherence in augmenting the efficacy of cognitive training.
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APA 7th
Li, Z., He, H., Chen, Y., & Guan, Q. (2024). Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Age and ageing. https://doi.org/10.1093/ageing/afad247
Vancouver
Li Z, He H, Chen Y, Guan Q. Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Age and ageing. 2024. doi:10.1093/ageing/afad247. PMID: 38266127.
BibTeX
@article{li2024-38266127,
author = {Li, Z. and He, H. and Chen, Y. and Guan, Q.},
title = {{Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials}},
journal = {Age and ageing},
year = {2024},
doi = {10.1093/ageing/afad247},
pmid = {38266127},
url = {https://doi.org/10.1093/ageing/afad247}
}
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Key findings
- Results This meta-analysis included 55 RCTs with 4,455 participants with cognitive conditions spanning normal cognition, MCI and neurodegenerative dementia.
- Overall, cognitive training showed a significant cross-domain effect (Hedges' g = 0.286, 95% CI: 0.224-0.348).
- Training effects are significant when engagement or persistence rates exceed 60% or when adherence rates exceed 80%.
- Higher levels of persistence are required to achieve significant training effects in memory, visuospatial ability and reasoning than in executive function and attention and language.
- Higher persistence is also required for older adults with normal cognition to achieve significant training gains compared to those with cognitive impairment.
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Study details
- Study designsystematic review
- Participants55
- Evidence strengthHigh
How this study scored 76/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 44 of the 58 points we could judge it on, which is 76 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and ageing) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 55 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38266127) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 44 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 44 of the 58 points we could judge it on is 76 out of 100. |
| Total | 76 / 100 | — |
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