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A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults

Abstract

The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of “brain training” programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst “brain training” may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.

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Additional information and dataset provided as supplementary materials.

Notes

  1. Whilst companies refer to their products as “brain training”, there is limited evidence to suggest that such training actually elicits any brain changes (i.e., neuroplasticity); rather, the evidence used by these companies to market their products generally rely on cognitive or behavioral measures. Such products should instead be labelled cognitive training, or more specifically, game-based cognitive training, as “brain training” is generally unstructured and involves short mini-games—distinct from traditional cognitive training which is generally intensive, structured, and designed based on theory.

  2. Whilst the trim-and-fill method is a useful tool for detecting publication bias, the “adjusted” effect sizes reported should be interpreted cautiously as recent studies have indicated that this method overestimates the true effect size, thereby underestimating the impact of bias from potentially missing studies (Carter et al., 2019; Renkewitz & Keiner, 2019).

  3. Most commercial programs target multiple cognitive domains; therefore, near-transfer refers to measures similar to any of the domains trained, and far-transfer refers to outcome measures from untrained constructs. For example, if a training program targeted speed, memory, and visuospatial abilities, near-transfer would include outcomes tapping into any of these domains whereas far-transfer would include measures from domains that were not targeted by training such as attention, everyday functioning, fluid intelligence.

  4. Similar to previous meta-analyses, domains including three or fewer studies were not reported (e.g., Lampit et al., 2014).

  5. Overall mean and moderator effect sizes for older adults with MCI were not reported in this supplemental table due to the insufficient number of studies included in each planned analysis (ranging from 0 to 8 studies) – only four (out of ten) planned analyses included more than three studies.

  6. Only 5 out of 37 studies involving healthy older adults utilized a single-domain commercial training program (CogMed). No moderator analysis concerning single- versus multi-domain training was conducted as findings would reflect the efficacy of CogMed versus all other programs rather than provide evidence regarding single- versus multi-domain training.

  7. The Call-Back task is a naturalistic prospective memory task which requires participants to phone the researcher at a specific time (within an agreed upon period when the participant would be free).

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Funding

This work was supported by the Australian Government Research Training Program Scholarship.

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Correspondence to Lan Nguyen.

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Nguyen, L., Murphy, K. & Andrews, G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 32, 601–630 (2022). https://doi.org/10.1007/s11065-021-09515-2

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Keywords

  • Cognitive training
  • Brain training
  • Cognitive aging
  • Meta-analysis
  • Older adults
  • Transfer