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Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors

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Abstract

The growing prevalence of neurodegenerative disorders associated with aging and cognitive decline has generated increasing cross-disciplinary interest in non-pharmacological interventions, such as computerized cognitive training (CCT), which may prevent or slow cognitive decline. However, inconsistent findings across meta-analytic reviews in the field suggest a lack of cross-disciplinary consensus and on-going debate regarding the benefits of CCT. We posit that a contributing factor is the lack of a theoretically-based taxonomy of constructs and representative tasks typically used. An integration of the Cattell-Horn-Carroll (CHC) taxonomy of broad and narrow cognitive factors and the Miyake unity-diversity theory of executive functions (EF) is proposed (CHC-M) as an attempt to clarify this issue through representing and integrating the disciplines contributing to CCT research. The present study assessed the utility of this taxonomy by reanalyzing the Lampit et al. (2014) meta-analysis of CCT in healthy older adults using the CHC-M framework. Results suggest that: 1) substantively different statistical effects are observed when CHC-M is applied to the Lampit et al. meta-analytic review, leading to importantly different interpretations of the data; 2) typically-used classification practices conflate Executive Function (EF) tasks with fluid reasoning (Gf) and retrieval fluency (Gr), and Attention with sensory perception; and 3) there is theoretical and practical advantage in differentiating attention and working-memory tasks into the narrow shifting, inhibition, and updating EF domains. Implications for clinical practice, particularly for our understanding of EF are discussed.

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Notes

  1. We use the qualifier ‘general’ for the broad short-term-memory (Gsm) factor to clearly distinguish it from the narrow short-term memory (STM) factor.

  2. Jewsbury and Bowden (2017) has presented evidence for the long-held view (see, Schneider and McGrew 2012) that Glr should be split into its constituent parts, Gl and Gr. Different abbreviations for the learning factor have been used. Carroll (1993) originally labeled it as Gy, more recently, it has been labeled as Gl. Consistent with Schneider and McGrew, we use the latter abbreviation.

  3. Studies where task methodology could not be disambiguated: Peretz, C., Korczyn, A.D., Shatil, E., Aharonson, V., Birnboim, S., & Giladi, N. (2011). A randomized double-blind prospective trial of cognitive stimulation, Neuroepidemiology, 36, 91–99, DOI: https://doi.org/10.1159/000323950; Shatil, E. (2013). 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, Frontiers in Aging Neuroscience, 5 (8), doi: https://doi.org/10.3389/fnagi.2013.00008.

  4. Q is the weighted sum of squared differences between individual study effects and the pooled effect across studies. We follow Bahar-Fuchs et al. (2013) and use a cut-off of p < .10 (dispersed on a χ2 distribution, with df = number of effects - 1) as an indicator of significant heterogeneity. The τ2 statistic the variance of the effect size parameters across the population of studies and it reflects the variance of the true effect sizes, while τ is the associated standard deviation.

  5. There are no formal broad or narrow factors considered specifically as Attention in the CHC-M taxonomy.

  6. We deemed four studies to be the minimum number for even speculative comparisons. Given there are differences between narrow factors within a broad domain, it seemed inappropriate to focus just on moderation of broad factors as a strategy to increase power (although these are reported in Online Resource 6).

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Acknowledgements

This research was supported under Australian Research Council’s Discovery Projects funding scheme (project DP140101147) to Damian Birney. Shannon Webb contributed to the conceptualization and writing, led the task classification, and conducted the meta-analysis; Vanessa Loh contributed to the original conceptualization, task classification and writing; Amit Lampit provided support related to the original meta-analysis and advice on the current meta-analysis; Joel Bateman contributed to task classification and writing; Damian Birney conceived the taxonomy project, led the theoretical aspects of the analyses and task classification, and was senior author. We wish to thank Kit Double for his support in earlier analyses and the anonymous reviewers for their feedback on earlier drafts. All required ethics approval was obtained through the University of Sydney human ethics review committees.

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This research was supported under Australian Research Council’s Discovery Projects funding scheme (project DP140101147). The views expressed herein are those of the authors and are not necessarily those of the Australian Research Council.

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Webb, S.L., Loh, V., Lampit, A. et al. Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors. Neuropsychol Rev 28, 232–250 (2018). https://doi.org/10.1007/s11065-018-9374-8

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