Efficacy of Computerized Cognitive Training on Mild Cognitive Impairment: A Systematic Review and Network Meta-Analysis (Preprint)

BACKGROUND Mild Cognitive Impairment (MCI) often precedes Alzheimer’s disease (AD) and represents a critical intervention period. Computerized Cognitive Training (CCT) is a promising non-pharmacological intervention to enhance cognitive reserve and delay cognitive decline in older adults with MCI. Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of CCT on cognitive function in patients with MCI and explore factors influencing its effectiveness. OBJECTIVE Objective:This systematic review and meta-analysis aims to evaluate the efficacy of Computerized Cognitive Training(CCT)on cognitive function in patients with Mild Cognitive Impairment(MCI)and identify factors influencing its effectiveness. METHODS A comprehensive literature search was conducted from January 1, 2000, to December 31, 2023, across six databases. The inclusion criteria specified studies on patients with MCI with computerized interventions, providing sufficient data for effect size calculation. Non-computerized interventions and studies lacking the necessary data were excluded. Data were analyzed using Comprehensive Meta-Analysis Version 3.3 software, with heterogeneity and publication bias assessed using standard statistical methods. In addition, a network meta-analysis using the Onlinemeta tool was conducted to compare the relative efficacy of different digital interventions, such as computerized training, virtual reality, and musical therapy, which highlighted digital and behavioral interventions as the most likely to be ranked highest in effectiveness. RESULTS A total of 24 studies involving 1657 participants were included. The meta-analysis revealed a significant positive effect of CCT on global cognitive function in patients with MCI (effect size=0.652, P<0.05). Heterogeneity was high (Q=86.422, I²=73.386, P<0.05), indicating variability among the studies. Subgroup and meta-regression analyses identified multi-domain training, offline delivery, sessions under 60 minutes, frequency of more than three times per week, and less than 12 weeks’ durations as factors contributing to CCT effectiveness. Conclusion: Cognitive training programs on computers show the best results when they involve multiple areas of training, with each session lasting no more than 60 minutes, occurring minimum three times a week, and for no more than 12 weeks. CONCLUSIONS Digital interventions can effectively delay cognitive decline in older adults with MCI , both in terms of cognition (such as attention and memory) and emotion, The intervention effects are moderated by various variables,CCT demonstrates optimal intervention outcomes when employing multi-domain training, with sessions lasting under 60 minutes, conducted at least three times per week, and sustained for less than 12 weeks, with offline digital cognitive training showing superior effects. CLINICALTRIAL The protocol was registered with PROSPERO (CRD420250632971).