Effect of cognitive training on daily function in older people without major neurocognitive disorder: A systematic review

Abstract

There is increasing interest in the effect of non-pharmacological treatments on preserving cognition and function in older adults without major neurocognitive disorder (dementia). However, its effect on everyday function in terms of instrumental activities of daily living (IADL) is unclear. We conducted a systematic review to examine whether cognitive training, independent of other interventions, can improve IADL function in older adults without major neurocognitive disorder. We searched multiple databases including MEDLINE, EMBASE, and PSYCINFO and found thirteen studies that met our inclusion criteria with 7130 participants in total. Six out of thirteen studies reported a significant change on validated IADL assessment. On subgroup analysis, five studies included older adults with normal cognition and one included mild cognitive impairment (MCI). Eleven out of twelve studies showed improvement in measures of cognition. None of the studies described changes in the ability to live independently. While variation in study protocol, outcome measurement, and effect size reporting precluded further inferential statistical analysis, our review found a sizable number of studies showing improvement in IADL. Cognitive training may have some benefit in improving IADL function in older adults without major neurocognitive disorder. Future long-term studies focusing on maintained IADL function and preserved independence are needed.