Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Search Strategy
- ①
- (P) people with a diagnosis of MCI or SMC;
- ②
- ③
- (P) when the inclusion standard was unclear and required discussion, we accepted the MCI and SMC status as defined by the authors of each trial. These could include diagnostic assessment and/or subjective memory complaints with reduced scores on cognitive tests such as the Mini Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA);
- ④
- (P) recruited and clinically classified as having MCI at time of performing the test were eligible for inclusion;
- ⑤
- (I) ICT interventions were included in a broad manner that could include PCs, desktops, laptops, handheld devices, and other types of wireless or cable-connected equipment [29];
- ⑥
- (O) studies which used cognitive function as a primary outcome.
- ①
- (P) not subject to MCI (mean age > 65 years);
- ②
- (P) who were diagnosed with a mood disorder, such as dementia or depression, and on drug treatment;
- ③
- (P) diagnosed with stroke, Parkinson’s disease, schizophrenia, epilepsy, and other neuropsychiatric disorders;
- ④
- (I) did not use ICT as a major intervention;
- ⑤
- (O) studies in which cognitive function, the primary outcome variable, could not be confirmed;
- ⑥
- Full text was unavailable;
- ⑦
- Not related to humans, protocols without research results, editorial comments, among others;
- ⑧
- Written in a language other than English or Korean;
- ⑨
- Published before 2010.
2.3. Data Collection
2.4. Risk-of-Bias Assessment
2.5. Data Synthesis
3. Results
3.1. Study Characteristics
3.2. Quality Evaluation of Selected Studies
3.3. Reporting Bias
3.4. Characteristics of the Training Sessions
3.5. Measurement Variables and Tools for Selected Studies
3.6. Data Synthesis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Category | Research Questions |
---|---|
Participants | Older adults |
Intervention | Information communication technology (ICT) |
Comparison | - |
Outcome | Cognition |
Time | - |
Setting | Community |
Study Design | Experimental study |
AND | OR | ||||||
Key Term | Added Terms | ||||||
MeSH | EMTREE | CINAHL SUBHEADINGS | KISS, RISS | ||||
Mild Cognitive Impairment (P1) | Cognitive Dysfunction [F03.615.250.700] | Cognitive defect | Cognition Disorders | Cognitive Impairment | Cognitive Impairment Mild Cognitive Impairment Mild Neurocognitive Disorder Cognitive Decline Mental Deterioration Cognition Disorder Cognitive Deficit Cognitive Disability | ||
Older adults (P2) | Aged [M01.060.116.100] | Aged | Aged | Elderly | Elderly Senium | ||
Training based on ICT (I) | Information Technology [L01.479] | Information technology | Information technology | ICT | Information and Communication Technology ICT Technology Self-Help Devices Device Telecare Electronic Game Computer Web-Based Robot | ||
Filter | Study with title, abstract which included above key terms Species: Human Year: 2010–2021 Study Design: RCT Language: English, Korean |
Study ID | Country /City | Setting | Design /Arms | Population, N (Exp., Cont.) | Mean Age (Exp., Cont.) | Percent Female (%) | Education | Inclusion Criteria | Exclusion Criteria |
---|---|---|---|---|---|---|---|---|---|
(1) Anderson–Hanley, 2018 | USA /New York | Comm. | RCT/3 | 111 (46, 45, 15) | 80.9 y, 75.4 y, 78.1 y | 57, 43, 50 | 14.9 y; 16.6 y; 15.7 y | MoCA < 26; MCI | ND; Functional limitations |
(2) de Souto Barreto 2021 | France /Toulouse | Comm. | RCT/2 | 120 (60, 60) | 75.2 y, 73.2 y | 31, 38 | College 61.7%, 66.7% | MMSE ≥ 24; Easy access to internet; SMC | Illness; Dementia; Parkinson; Depression; Dependency ≥ 1 ADL |
(3) Djabelkhir 2017 | France /Paris | Comm. | RCT/2 | 20 (10, 10) | 78.2 y, 75.2 y | 60, 70 | College 44.4%, 60.0% | MMSE > 24; SMC | PD and ND; Alcohol or other substance abuse; Sensory and/or motor deficits |
(4) Gooding 2016 | USA /New York | Comm. | RCT/3 | 74 (31, 23, 20) | (total) 75.59 y | (total) 32 | (total)15.14 y | MMSE > 24; SMC; Normal independent functioning | - |
(5) Li 2019 | China/Shanghai | Comm. | RCT/2 | 141 (78, 63) | 69.5 y, 71.5 y | 33, 42 | 13.8 y, 13.5 y | MCI; GDR = 0.5 | Stroke; Parkinson; HIV; Mood problems; Poor vision or hearing |
(6) Liao 2019 | Taiwan /Taipei | Comm. | RCT/2 | 42 (21, 21) | 75.5 y, 73.1 y | 61, 75 | 9.3 y, 9.9 y | MMSE ≥ 24; MoCA < 26; SMC; ADLs | Dementia; Malignant tumors; ND or orthopedic disease; Education < 6 years |
(7) Oh 2021 | Korea /Cheongju | Comm. | RCT/2 | 24 (12, 12) | 77.8 y, 79.0 y | 56, 100 | 4.2 y, 3.7 y | CDR = 0.5 or GDS = 2 or MCI | Hearing or visual impairment; ND or musculoskeletal disorder; Depression; Stroke; Parkinson’s |
(8) Park 2018 | Korea /Wonju | Comm. | RCT/2 | 89 (39, 39) | 66.7 y, 67.6 y | 63, 44 | 8.54 y, 8.74 y | MMSE ≥ 24; SMC; IALD ≥ 8.2 | ND, PD; KGDS > 19; Auditory, visual, motor, or language impairments; Participation in CCT within 3 months |
(9) Phirom 2020 | Thailand /Chiang Mai | Comm. | RCT/2 | 40 (20, 20) | 70.2 y, 69.4 y | 85, 80 | 12.79 y, 11.20 y | Walk without a walking aid for at least 10 m; step unassisted in different directions | MMSE < 23; TGDS > 6/15 points; Health problems affecting stepping ability; Unstable health conditions |
(10) Poptsi 2019 | Greece | Comm. | RCT/5 | 100 (20, 20, 20, 20, 20) | 67.9 y, 70.1 y, 71.8 y, 65.7 y, 68.1 y | 64, 78, 50, 73, 71 | 12.14 y, 11.17 y, 9.70 y, 11.13 y, 10.36 y | aMCI; GDS stage 3; independent walking. | ND; Severe depression or anxiety; Uncontrolled hypertension or terminal illness; Cardiovascular disease; Mental illness; Pharmacological treatment; sensory deficits |
(11) Thapa 2020 | Korea /Busan | Comm. | RCT/2 | 68 (34, 34) | 72.6, 72.7 | 82, 71 | 9.3 y, 4 y | MCI | PD and ND; Dementia; Dizziness; Otolaryngological disease |
Study ID | Experimental Group | Control Group | Device | Setting | Training Dose per Session (min) | Time (Hours) | Duration (Weeks) | Frequency (Weeks) | Instructor |
---|---|---|---|---|---|---|---|---|---|
(1) | Aerobic and Cognitive Exercise Study (ACES) Exer-score (physical exercise interactive with a relatively effortful, high cognitive demand, videogame) | Exer-tour | Recumbent stationary bike, videogame | Individual | 20 | - | 12–16 | At least 2 | - |
(2) | Web multidomain platform focused on three lifestyles: nutritional advice, and exercise and cognitive training | Only the wrist-worn accelerometer, information about multidomain activities | Tablet/ a wrist-worn accelerometer | Individual | - | - | 24 | 2 | - |
(3) | Computerized cognitive stimulation (A web-based platform which provided several applications, i.e., appointment and event reminding, cognitive games, communication, entertainment, videos and library) | Computerized cognitive engagement | Android tablet-PC/iPad | Group (5–7 people) | 90 | 12 | 12 | 1 | Neuropsychologist |
(4) | Computerized Cognitive Training (Repeated drill-and-practice exercises involving memory, attention, and executive functions within domain-specific training modules) | Cognitive vitality training, active control (game, puzzle, sudoku) | Computer | Individual or group | 60 | 16 | 2 | - | |
(5) | Multi-model computerized cognitive training at home online (Visual working memory, 30-s memory, Episodic memory, Speed of calculation, Visual search, Alertness, Mental rotation, and Images re-arrangement task) | None | Computer | Individual | 40 | 72–96 | 24 | 3–4 | - |
(6) | VR-based physical and cognitive training (VR games was based on actual IADL, such as shopping, food preparation, handling finances, and transportation.) | Combined physical and cognitive training | VR (glasses on their heads and motor controllers in both hands) | Group (3–4 people) | 60 | 36 | 12 | 3 | Physiotherapists |
(7) | Nurse-led computer cognitive training | Therapist-led CCT | Computer | Individual | 30 | 12–20 | 4 | 3–5 | Nurses |
(8) | Using Nintendo Wii for improving functional performance | CCT | Nintendo Wii | Individual | 10 | 30 | 10 | 3 | - |
(9) | Interactive physical–cognitive game - Physical part: (1) Stepping on different targets and in different directions (2) Balancing - Cognitive part: (1) Executive function (2) Attention, (3) Memory | Educational material | Xbox 360 Kinect Sensor V2, LED projector, computer | Individual | 60 | 36 | 12 | 3 | Researchers |
(10) | (1) Paper and pencil group (PP/G) (2) Computer-based program of language tasks group (PC/G) (3) Oral group (OR/G) (Semantic expression of language, semantic comprehension of language and phonemic expression of language) | (4) Active control group: Unstructured session with discussion of current events (5) Control group: None | Computer | Group (5–10 people) | 60 | 48 | 24 | 2 | Expert Psychologists |
(11) | VR-based cognitive training (Juice making, Crow shooting, Find the fireworks number, Memory object at the house) + Educational program | Educational program | Oculus VR headset, two wireless hand controllers | Individual | 100 | 24 | 8 | 3 | - |
Study ID | Outcome Measurements and Results | |||||||
---|---|---|---|---|---|---|---|---|
Global Cognitive | Attention | Memory | Verbal Fluency | Executive Function | Visuospatial Ability | Motor Skill | Etc. | |
Tool(p) | ||||||||
(1) | MoCA(0.79) | Digit span (0.50) | Verbal Memory(0.047delay) | - | Stroop test (0.001), Color trails (0.32) | - | Get up and go (0.46) | MRI, Saliva, Protein |
(2) | MMSE(0.71) WAIS-R(0.09) | COWAT (0.15) | FCSRT (0.13) CNT (0.12) | - | - | - | SPPB (0.30); Gait speed (0.11) | GDS (0.21), MNA (0.61), HRQOL (0.04) |
(3) | MMSE(0.35) | Digit span (0.74) | - | Verbal fluency (0.4) | TMT-(0.23A,0.29B) | VST (0.46) | - | Anxiety (0.49), Depression (0.64), Self-esteem (0.76), CDS (0.80) |
(4) | MMSE(<0.001) | - | BSRT (<0.01) VR (0.52I,0.09II) LM-Ⅱ(0.01) | - | - | - | BDI (0.04) | |
(5) | MMSE(<0.05) ACER (<0.05memory,fluency,language) | - | AVLT immediate, (<0.120 min recall) | - | Stroop (<0.05index), STT (n.s.), SDS (n.s.) | CFT recall (n.s.) CFT copy (<0.05) | - | MRI |
(6) | MoCA(0.181) | CVVLT immediate (0.149immediate,0.115delay) | - | EXIT-25(0.724) | - | - | EEG, IADL (0.006) | |
(7) | MMSE(0.999) | Digit Span (0.594forward,0.729backward) | SVLT-E (0.030immediate) K-BNT (0.012) | - | K-CWST (0.375word,0.205color) | RCFT (0.231) | - | EEG; IADL (0.352) |
(8) | - | Digit Span (< 0.05) | RAVLT (n.s.) | - | TMT (n.s.), Stroop Color-Word Test (n.s.) | CFT (n.s.) WAIS-BDT (n.s.) | - | HRQOL (< 0.05) |
(9) | MoCA(0.001) | - | - | - | - | - | PPA (0.002), TUG (0.015single/0.025dual) | - |
(10) | MMSE(n.s.) | RAVLT 1 (n.s.) | RAVLT 2 (n.s.) PPT (n.s.) RBMT (n.s.) | FAS total (n.s.) BDAE (n.s.) | - | - | - | FRSSD (n.s.) |
(11) | MMSE(n.s.) | SDST (0.03) | - | - | TMT A(n.s.) TMT B(0.01) | - | Grip strength (n.s.), speed (0.02), 8 feet up and go (0.03) | EEG |
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Jung, A.-R.; Kim, D.; Park, E.-A. Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 11535. https://doi.org/10.3390/ijerph182111535
Jung A-R, Kim D, Park E-A. Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021; 18(21):11535. https://doi.org/10.3390/ijerph182111535
Chicago/Turabian StyleJung, Ae-Ri, Dasom Kim, and Eun-A Park. 2021. "Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 18, no. 21: 11535. https://doi.org/10.3390/ijerph182111535