Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review.
Neuropsychol Rev
; 26(3): 252-270, 2016 09.
Article
en En
| MEDLINE
| ID: mdl-27613718
ABSTRACT
Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges' g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.
Palabras clave
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cognición
/
Función Ejecutiva
/
Aprendizaje
Tipo de estudio:
Guideline
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Neuropsychol Rev
Asunto de la revista:
NEUROLOGIA
/
PSICOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Australia