Long-term effects of mobile-based metamemory cognitive training in older adults with mild cognitive impairment: A 15-month prospective single-arm study (Preprint)

BACKGROUND Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia, characterized by subjective cognitive decline and objective memory impairment. Cognitive training has consistently shown short-term benefits for individuals with MCI, but evidence on the long-term effectiveness is extremely limited. Given the progressive nature of MCI and the need for sustainable strategies to delay cognitive decline, research on the long-term impact of cognitive training is necessary and timely. Mobile-based platforms offer a promising solution by enhancing accessibility and adherence, but their durability of effect over extended periods remains underexplored. OBJECTIVE This study aimed to evaluate the long-term effects of a mobile-based cognitive training application on cognitive function of older adults with MCI. METHODS Twenty-eight older adults with MCI used Cogthera, a mobile cognitive training application based on metamemory training. Participants completed two training sessions daily for 3 months and nine continued for an additional 12 months. Cognitive function and quality of life were assessed using Alzheimer’s Disease Assessment Scale-cognitive subscale 14 (ADAS-cog 14) and EuroQol-5 Dimensions-5 Level (EQ-5D-5L). RESULTS Cognitive function improved significantly over 15 months, as measured by ADAS-cog 14 (F(2, 35.56)=7.08, P=.003). The quality of life also improved significantly, as reflected by EQ-5D-5L (F(2, 42.14)=3.40, P=.04). Greater cognitive improvements were significantly predicted by younger age, higher functional status, and lower baseline cognitive function. CONCLUSIONS This study showed that long-term use of a mobile-based metamemory cognitive training application led to meaningful improvements in both cognitive function and quality of life in older adults with MCI. These results support the potential of mobile application use as a scalable and accessible approach for delivering sustained cognitive interventions in MCI populations.