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What Is “Brain Training”?

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What Is “Brain Training”? “Train Your Brain” for Cognitive Gain? A Systematic Review and Meta- Analysis of Commercial Brain Training Programs Presented by Lan Nguyen Griffith University Cognitive Ageing 472,000+ People living with dementia in Australia (2021) Projection of dementia +227% prevalence rates (2021-58) dementia.org.au Projection of cognitive & brain training market value +356% (2020-25) USD 3.2billion to 11.4billion Growth of people aged 65+ in Australia “Brain Training” What is “brain training”? ▪ commercial apps/programs used on smart devices ▪ subscriptions can cost hundreds of dollars/year ▪ aim to improve cognition and daily functioning ▪ mini-games targeting different cognitive abilities Claims Made by the Industry Lumosity Brain HQ CogniFit “sharpen the skills you “improve [your] driving “strengthen the cognitive use every day” safety and confidence state of people who are behind the wheel” beginning to suffer cognitive pathology” Posit Science Personal Zen NeuroNation “think faster, focus better, “reduce stress and “used successfully in and remember more” anxiety within minutes” Dementia prevention as well as for stress and burnout prevention” -“Scientifically validated!” - “Results are proven!” “Brain Training” Studies Research Evaluating “brain training” ▪ pre-test → training → post-test ▪ assess variety of measures (affective, cognitive, neural) ▪ evaluate improvement on measures compared to control group How does “brain training” work? Founded on the premise that: training → neuroplasticity* → efficient cognitive processes = better performance & real-world functioning Current Meta-Analytic Investigation Aim: To evaluate the efficacy of commercial “brain training” programs in improving cognitive functioning for older adults with and without mild cognitive impairment (MCI). Rationale: A synthesis of the equivocal findings is needed. Researchers & general public need to be better informed. RQs: Are “brain training” programs effective in improving cognitive functioning in older adults? Systematic Literature Search ▪ Initial Google search to identify available commercial programs ▪ Systematic database search: o CINAHL o Embase o ProQuest o PsycINFO o PubMed o Scopus o Web of Science o Other sources (books, theses & dissertations database, etc.) Inclusion Criteria DESIGN PARTICIPANTS MEASURES ▪ pre-test—training—post- test design ▪ older adults (with or ▪ objective measures of without MCI) cognitive functioning ▪ commercial brain training (no other components) ▪ mean sample age at least ▪ subjective measures of 60 years cognitive/daily functioning ▪ control group needed Commercial Brain Training Programs Identified: 1. BrainGymmer 5. Dakim 2. BrainHQ 6. Lumosity 3. CogMed 7. MyBrainTrainer 4. CogniFit Data Analysis Effect of Brain Training ▪ Hedges’ g o Direction of effect (+) training > control (–) control > training o Magnitude of effect g = 0.20 (small effect) Planned Analyses g = 0.50 (moderate effect) Training efficacy (healthy & MCI) g = 0.80 (large effect) ▪ Corrected for publication bias ▪ attention ▪ memory ▪ everyday functioning ▪ processing speed ▪ executive functioning ▪ visuospatial ability ▪ fluid intelligence Results – Healthy Older Adults PROCESSING SPEED MEMORY EXECUTIVE FUNCTIONING Sig. small training effect Sig. small training effect but Sig. small training effect but ✓ 18 studies nonsig. adjusting for bias nonsig. adjusting for bias ✓ g = 0.18, p = .045 ‒ 25 studies ‒ 28 studies ‒ g = 0.26, p < .001 ‒ g = 0.19, p < .001 ‒ gadjusted = 0.07, p > .05 ‒ gadjusted = 0.11, p > .05 EVERYDAY FUNCTIONING FLUID INTELLIGENCE OTHER DOMAINS Objective nonsig. No training effect (nonsig.) No training effect (nonsig.) x 7 studies x 7 studies x Attention (13) x g = 0.12, p = 064 x g = -0.06, p = .578 x Language (3) Subjective sig. small effect x Visuospatial ability (7) ✓ 10 studies ✓ g = 0.22, p = .001 Healthy Older Adults— Everyday Functioning (objective) Effect size of individual studies Line of “no effect” Average effect size Healthy Older Adults— Everyday Functioning (subjective) Results – Older Adults with MCI MEMORY EXECUTIVE FUNCTIONING OTHER DOMAINS No training effect (nonsig.) No training effect (nonsig.) Insufficient studies for analysis x 5 studies x 5 studies x Attention x g = 0.33, p = .058 x g = 0.04, p = .749 x Everyday functioning x Fluid Intelligence x Language x Processing speed x Visuospatial ability Summary of Findings HEALTHY MCI ATTENTION ns — EVERYDAY FUNCTIONING (OBJECTIVE) ns — EVERYDAY FUNCTIONING (SUBJECTIVE) sig — EXECUTIVE FUNCTIONING sigx ns FLUID INTELLIGENCE ns — MEMORY sigx ns PROCESSING SPEED sig — VISUOSPATIAL ABILITY ns — Note: sigx = nonsignificant when adjusting for publication bias Limitations & Future Directions ➢ Publication bias ➢ Very few studies involving older adults with MCI ➢ Very few studies examining ‘real-world’ outcomes ➢ Programs could be better adapted to improve everyday functioning Note: “Brain training” does not represent all cognitive training or cognitive remediation interventions. Conclusion ▪ Currently no compelling evidence to substantiate brain training companies’ claims. ▪ May confer some benefits but more evidence is needed. “Brain training” – and any other intervention – is not a silver bullet. A balance of healthy cognitive, physical, and social activities is important for maintaining a healthy and active lifestyle. Thank you.
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