Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis of Effect Modifiers
Background:
New effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT) is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors.
Methods and Findings:
We systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I2 = 29.92%). There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model) for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29). Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38); verbal memory, g = 0.08 (95% CI 0.01 to 0.15); working memory (WM), g = 0.22 (95% CI 0.09 to 0.35); processing speed, g = 0.31 (95% CI 0.11 to 0.50); and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54). No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and only weak evidence for sessions less than 30 min. These results are limited to healthy older adults, and do not address the durability of training effects.
Conclusions:
CCT is modestly effective at improving cognitive performance in healthy older adults, but efficacy varies across cognitive domains and is largely determined by design choices. Unsupervised at-home training and training more than three times per week are specifically ineffective. Further research is required to enhance efficacy of the intervention.
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis of Effect Modifiers. PLoS Med 11(11): e32767. doi:10.1371/journal.pmed.1001756
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001756
Souhrn
Background:
New effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT) is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors.
Methods and Findings:
We systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I2 = 29.92%). There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model) for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29). Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38); verbal memory, g = 0.08 (95% CI 0.01 to 0.15); working memory (WM), g = 0.22 (95% CI 0.09 to 0.35); processing speed, g = 0.31 (95% CI 0.11 to 0.50); and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54). No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and only weak evidence for sessions less than 30 min. These results are limited to healthy older adults, and do not address the durability of training effects.
Conclusions:
CCT is modestly effective at improving cognitive performance in healthy older adults, but efficacy varies across cognitive domains and is largely determined by design choices. Unsupervised at-home training and training more than three times per week are specifically ineffective. Further research is required to enhance efficacy of the intervention.
Please see later in the article for the Editors' Summary
Zdroje
1. DearyIJ, CorleyJ, GowAJ, HarrisSE, HoulihanLM, et al. (2009) Age-associated cognitive decline. Br Med Bull 92: 135–152.
2. GrahamJE, RockwoodK, BeattieBL, EastwoodR, GauthierS, et al. (1997) Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 349: 1793–1796.
3. PlassmanBL, LangaKM, McCammonRJ, FisherGG, PotterGG, et al. (2011) Incidence of dementia and cognitive impairment, not dementia in the United States. Ann Neurol 70: 418–426.
4. UnverzagtFW, GaoS, BaiyewuO, OgunniyiAO, GurejeO, et al. (2001) Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology 57: 1655–1662.
5. ZhuCW, SanoM, FerrisSH, WhitehousePJ, PattersonMB, et al. (2013) Health-related resource use and costs in elderly adults with and without mild cognitive impairment. J Am Geriatr Soc 61: 396–402.
6. MarioniRE, ValenzuelaMJ, van den HoutA, BrayneC, MatthewsFE, et al. (2012) Active cognitive lifestyle is associated with positive cognitive health transitions and compression of morbidity from age sixty-five. PLoS ONE 7: e50940.
7. VergheseJ, LiptonRB, KatzMJ, HallCB, DerbyCA, et al. (2003) Leisure activities and the risk of dementia in the elderly. N Engl J Med 348: 2508–2516.
8. WilsonRS, Mendes De LeonCF, BarnesLL, SchneiderJA, BieniasJL, et al. (2002) Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 287: 742–748.
9. KueiderAM, ParisiJM, GrossAL, RebokGW (2012) Computerized cognitive training with older adults: a systematic review. PLoS ONE 7: e40588.
10. ClareL, WoodsRT, Moniz CookED, OrrellM, SpectorA (2003) Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database Syst Rev 2003: CD003260.
11. JakA, SeelyeA, JurickS (2013) Crosswords to computers: a critical review of popular approaches to cognitive enhancement. Neuropsychol Rev 23: 13–26.
12. Commercialising neuroscience: Brain sells. The Economist. Available: http://www.economist.com/news/business/21583260-cognitive-training-may-be-moneyspinner-despite-scientists-doubts-brain-sells. Accessed 11 November 2014.
13. GreenCS, StrobachT, SchubertT (2013) On methodological standards in training and transfer experiments. Psychol Res E-pub ahead of print. doi: 10.1007/s00426-013-0535-3
14. ValenzuelaM, SachdevP (2009) Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 17: 179–187.
15. PappKV, WalshSJ, SnyderPJ (2009) Immediate and delayed effects of cognitive interventions in healthy elderly: a review of current literature and future directions. Alzheimers Dement 5: 50–60.
16. MartinM, ClareL, AltgassenAM, CameronMH, ZehnderF (2011) Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane Database Syst Rev 2011: CD006220.
17. ReijndersJ, van HeugtenC, van BoxtelM (2013) Cognitive interventions in healthy older adults and people with mild cognitive impairment: a systematic review. Ageing Res Rev 12: 263–275.
18. KellyME, LoughreyD, LawlorBA, RobertsonIH, WalshC, et al. (2014) The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: a systematic review and meta-analysis. Ageing Res Rev 15: 28–43.
19. LiberatiA, AltmanDG, TetzlaffJ, MulrowC, GotzschePC, et al. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6: e1000100.
20. WardA, ArrighiHM, MichelsS, CedarbaumJM (2012) Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimers Dement 8: 14–21.
21. Strauss EH, Sherman EMS, Spreen OA, editors (2006) A compendium of neuropsychological tests: administration, norms and commentary. Oxford: Oxford University Press.
22. AngueraJA, BoccanfusoJ, RintoulJL, Al-HashimiO, FarajiF, et al. (2013) Video game training enhances cognitive control in older adults. Nature 501: 97–101.
23. MaillotP, PerrotA, HartleyA (2012) Effects of interactive physical-activity video-game training on physical and cognitive function in older adults. Psychol Aging 27: 589–600.
24. NouchiR, TakiY, TakeuchiH, HashizumeH, AkitsukiY, et al. (2012) Brain training game improves executive functions and processing speed in the elderly: a randomized controlled trial. PLoS ONE 7: e29676.
25. SmithGE, HousenP, YaffeK, RuffR, KennisonRF, et al. (2009) A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc 57: 594–603.
26. BavelierD, GreenCS, HanDH, RenshawPF, MerzenichMM, et al. (2011) Brains on video games. Nat Rev Neurosci 12: 763–768.
27. Higgins J, Green S, editors (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration.
28. MaherCG, SherringtonC, HerbertRD, MoseleyAM, ElkinsM (2003) Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 83: 713–721.
29. WykesT, HuddyV, CellardC, McGurkSR, CzoborP (2011) A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry 168: 472–485.
30. Gleser LJ, Olkin I (2009) Stochastically dependent effect sizes. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis, 2nd edition. New York: Russell Sage Foundation. pp. 357–376.
31. Borenstein M, Hedges L, Higgins JP, Rothstein HR (2009) Introduction to meta-analysis. Chichester: Wiley.
32. HigginsJP, ThompsonSG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21: 1539–1558.
33. HigginsJP, ThompsonSG, DeeksJJ, AltmanDG (2003) Measuring inconsistency in meta-analyses. BMJ 327: 557–560.
34. BorensteinM, HigginsJP (2013) Meta-analysis and subgroups. Prev Sci 14: 134–143.
35. SterneJA, SuttonAJ, IoannidisJP, TerrinN, JonesDR, et al. (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 343: d4002.
36. EggerM, Davey SmithG, SchneiderM, MinderC (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315: 629–634.
37. McDougallS, HouseB (2012) Brain training in older adults: evidence of transfer to memory span performance and pseudo-Matthew effects. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 19: 195–221.
38. SchmiedekF, LovdenM, LindenbergerU (2010) Hundred days of cognitive training enhance broad cognitive abilities in adulthood: findings from the COGITO study. Front Aging Neurosci 2: 27.
39. TheillN, SchumacherV, AdelsbergerR, MartinM, JanckeL (2013) Effects of simultaneously performed cognitive and physical training in older adults. BMC Neurosci 14: 103.
40. GajewskiPD, FalkensteinM (2012) Training-induced improvement of response selection and error detection in aging assessed by task switching: effects of cognitive, physical, and relaxation training. Front Hum Neurosci 6: 130.
41. Wild-WallN, FalkensteinM, GajewskiPD (2012) Neural correlates of changes in a visual search task due to cognitive training in seniors. Neural Plast 2012: 529057.
42. BarnesDE, Santos-ModesittW, PoelkeG, KramerAF, CastroC, et al. (2013) The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. JAMA Intern Med 173: 797–804.
43. ColzatoLS, van MuijdenJ, BandGP, HommelB (2011) Genetic modulation of training and transfer in older adults: BDNF ValMet polymorphism is associated with wider useful field of view. Front Psychol 2: 199.
44. DahlinE, NybergL, BackmanL, NeelyAS (2008) Plasticity of executive functioning in young and older adults: immediate training gains, transfer, and long-term maintenance. Psychol Aging 23: 720–730.
45. DustmanRE, EmmersonRY, SteinhausLA, ShearerDE, DustmanTJ (1992) The effects of videogame playing on neuropsychological performance of elderly individuals. J Gerontol 47: P168–P171.
46. MahnckeHW, ConnorBB, AppelmanJ, AhsanuddinON, HardyJL, et al. (2006) Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. Proc Natl Acad Sci U S A 103: 12523–12528.
47. EdwardsJD, WadleyVG, VanceDE, WoodK, RoenkerDL, et al. (2005) The impact of speed of processing training on cognitive and everyday performance. Aging Ment Health 9: 262–271.
48. GoldsteinJ, CajkoL, OosterbroekM, MichielsenM, Van HoutenO, et al. (1997) Video games and the elderly. Soc Behav Pers 25: 345–352.
49. LampitA, HallockH, MossR, KwokS, RosserM, et al. (2014) The timecourse of global cognitive gains from supervised computer-assisted cognitive training: a randomised, active-controlled trial in elderly with multiple dementia risk factors. J Prev Alzheimers Dis 1: 33–39.
50. LeeY, LeeC-R, HwangB (2012) Effects of computer-aided cognitive rehabilitation training and balance exercise on cognitive and visual perception ability of the elderly. J Phys Ther Sci 24: 885–887.
51. VanceD, DawsonJ, WadleyV, EdwardsJ, RoenkerD, et al. (2007) The accelerate study: the longitudinal effect of speed of processing training on cognitive performance of older adults. Rehabil Psychol 52: 89–96.
52. WolinskyFD, Vander WegMW, HowrenMB, JonesMP, MartinR, et al. (2011) Interim analyses from a randomised controlled trial to improve visual processing speed in older adults: the Iowa Healthy and Active Minds Study. BMJ Open 1: e000225.
53. BelchiorP, MarsiskeM, SiscoSM, YamA, BavelierD, et al. (2013) Video game training to improve selective visual attention in older adults. Comput Human Behav 29: 1318–1324.
54. BallK, BerchDB, HelmersKF, JobeJB, LeveckMD, et al. (2002) Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA 288: 2271–2281.
55. BerryAS, ZantoTP, ClappWC, HardyJL, DelahuntPB, et al. (2010) The influence of perceptual training on working memory in older adults. PLoS ONE 5: e11537.
56. BottiroliS, CavalliniE (2009) Can computer familiarity regulate the benefits of computer-based memory training in normal aging? A study with an Italian sample of older adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 16: 401–418.
57. Garcia-CampuzanoMT, Virues-OrtegaJ, SmithS, MoussaviZ (2013) Effect of cognitive training targeting associative memory in the elderly: a small randomized trial and a longitudinal evaluation. J Am Geriatr Soc 61: 2252–2254.
58. LiKZ, RoudaiaE, LussierM, BhererL, LerouxA, et al. (2010) Benefits of cognitive dual-task training on balance performance in healthy older adults. J Gerontol A Biol Sci Med Sci 65: 1344–1352.
59. LussierM, GagnonC, BhererL (2012) An investigation of response and stimulus modality transfer effects after dual-task training in younger and older. Front Hum Neurosci 6: 129.
60. MayasJ, ParmentierFBR, AndresP, BallesterosS (2014) Plasticity of attentional functions in older adults after non-action video game training: a randomized controlled trial. PLoS ONE 9: e92269.
61. O'BrienJL, EdwardsJD, MaxfieldND, PerontoCL, WilliamsVA, et al. (2013) Cognitive training and selective attention in the aging brain: an electrophysiological study. Clin Neurophysiol 124: 2198–2208.
62. PengH, WenJ, WangD, GaoY (2012) The impact of processing speed training on working memory in old adults. J Adult Dev 19: 150–157.
63. van MuijdenJ, BandGP, HommelB (2012) Online games training aging brains: limited transfer to cognitive control functions. Front Hum Neurosci 6: 221.
64. AckermanPL, KanferR, CalderwoodC (2010) Use it or lose it? Wii brain exercise practice and reading for domain knowledge. Psychol Aging 25: 753–766.
65. AndersonS, White-SchwochT, Parbery-ClarkA, KrausN (2013) Reversal of age-related neural timing delays with training. Proc Natl Acad Sci U S A 110: 4357–4362.
66. BasakC, BootWR, VossMW, KramerAF (2008) Can training in a real-time strategy video game attenuate cognitive decline in older adults? Psychol Aging 23: 765–777.
67. BootWR, ChampionM, BlakelyDP, WrightT, SoudersDJ, et al. (2013) Video games as a means to reduce age-related cognitive decline: attitudes, compliance, and effectiveness. Front Psychol 4: 31.
68. BozokiA, RadovanovicM, WinnB, HeeterC, AnthonyJC (2013) Effects of a computer-based cognitive exercise program on age-related cognitive decline. Arch Gerontol Geriatr 57: 1–7.
69. EdwardsJD, WadleyVG, MyersRS, RoenkerDL, CissellGM, et al. (2002) Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology 48: 329–340.
70. EdwardsJD, ValdesEG, PerontoC, Castora-BinkleyM, AlwerdtJ, et al. (2013) The efficacy of InSight cognitive training to improve useful field of view performance: a brief report. J Gerontol B Psychol Sci Soc Sci E-pub ahead of print. doi:10.1093/geronb/gbt113
71. LegaultC, JenningsJM, KatulaJA, DagenbachD, GaussoinSA, et al. (2011) Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes: the Seniors Health and Activity Research Program Pilot (SHARP-P) study, a randomized controlled trial. BMC Geriatr 11: 27.
72. MillerKJ, DyeRV, KimJ, JenningsJL, O'TooleE, et al. (2013) Effect of a computerized brain exercise program on cognitive performance in older adults. Am J Geriatr Psychiatry 21: 655–663.
73. RasmussonDX, RebokGW, BylsmaFW, BrandtJ (1999) Effects of three types of memory training in normal elderly. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 6: 56–66.
74. RichmondLL, MorrisonAB, CheinJM, OlsonIR (2011) Working memory training and transfer in older adults. Psychol Aging 26: 813–822.
75. ShatilE (2013) Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults. Front Aging Neurosci 5: 8.
76. SternY, BlumenHM, RichLW, RichardsA, HerzbergG, et al. (2011) Space Fortress game training and executive control in older adults: a pilot intervention. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 18: 653–677.
77. BrehmerY, WesterbergH, BackmanL (2012) Working-memory training in younger and older adults: training gains, transfer, and maintenance. Front Hum Neurosci 6: 63.
78. BurkiCN, LudwigC, ChicherioC, de RibaupierreA (2014) Individual differences in cognitive plasticity: an investigation of training curves in younger and older adults. Psychol Res E-pub ahead of print. doi:10.1007/s00426-014-0559-3
79. BuschkuehlM, JaeggiSM, HutchisonS, Perrig-ChielloP, DappC, et al. (2008) Impact of working memory training on memory performance in old-old adults. Psychol Aging 23: 743–753.
80. CasuttG, TheillN, MartinM, KellerM, JanckeL (2014) The drive-wise project: driving simulator training increases real driving performance in healthy older drivers. Front Aging Neurosci 6: 85.
81. HeinzelS, SchulteS, OnkenJ, DuongQL, RiemerTG, et al. (2014) Working memory training improvements and gains in non-trained cognitive tasks in young and older adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 21: 146–173.
82. McAvinueLP, GolemmeM, CastorinaM, TattiE, PigniFM, et al. (2013) An evaluation of a working memory training scheme in older adults. Front Aging Neurosci 5: 20.
83. SandbergP, RonnlundM, NybergL, Stigsdotter NeelyA (2014) Executive process training in young and old adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 21: 577–605.
84. ShatilE, MikuleckaJ, BellottiF, BuresV (2014) Novel television-based cognitive training improves working memory and executive function. PLoS ONE 9: e101472.
85. von BastianCC, LangerN, JanckeL, OberauerK (2013) Effects of working memory training in young and old adults. Mem Cognit 41: 611–624.
86. SimpsonT, CamfieldD, PipingasA, MacphersonH, StoughC (2012) Improved processing speed: online computer-based cognitive training in older adults. Educ Gerontol 38: 445–458.
87. PeretzC, KorczynAD, ShatilE, AharonsonV, BirnboimS, et al. (2011) Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation. Neuroepidemiology 36: 91–99.
88. WangMY, ChangCY, SuSY (2011) What's cooking?—cognitive training of executive function in the elderly. Front Psychol 2: 228.
89. ColcombeS, KramerAF (2003) Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 14: 125–130.
90. GrossAL, ParisiJM, SpiraAP, KueiderAM, KoJY, et al. (2012) Memory training interventions for older adults: a meta-analysis. Aging Ment Health 16: 722–734.
91. Melby-LervågM, HulmeC (2013) Is working memory training effective? A meta-analytic review. Dev Psychol 49: 270–291.
92. KivipeltoM, SolomonA, AhtiluotoS, NganduT, LehtisaloJ, et al. (2013) The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): study design and progress. Alzheimers Dement 9: 657–665.
93. AnsteyKJ, BurnsRA, BirrellCL, SteelD, KielyKM, et al. (2010) Estimates of probable dementia prevalence from population-based surveys compared with dementia prevalence estimates based on meta-analyses. BMC Neurol 10: 62.
94. VerhaeghenP, MarcoenA, GoossensL (1992) Improving memory performance in the aged through mnemonic training: a meta-analytic study. Psychol Aging 7: 242–251.
95. LuscherC, NicollRA, MalenkaRC, MullerD (2000) Synaptic plasticity and dynamic modulation of the postsynaptic membrane. Nat Neurosci 3: 545–550.
96. HoltzerR, ShumanM, MahoneyJR, LiptonR, VergheseJ (2011) Cognitive fatigue defined in the context of attention networks. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 18: 108–128.
97. WangZ, ZhouR, ShahP (2014) Spaced cognitive training promotes training transfer. Front Hum Neurosci 8: 217.
98. PennerIK, VogtA, StcklinM, GschwindL, OpwisK, et al. (2012) Computerised working memory training in healthy adults: a comparison of two different training schedules. Neuropsychol Rehabil 22: 716–733.
99. GatesNJ, SachdevPS, Fiatarone SinghMA, ValenzuelaM (2011) Cognitive and memory training in adults at risk of dementia: a systematic review. BMC Geriatr 11: 55.
100. Bahar-FuchsA, ClareL, WoodsB (2013) Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database Syst Rev 6: CD003260.
101. JaeggiSM, BuschkuehlM, JonidesJ, ShahP (2011) Short- and long-term benefits of cognitive training. Proc Natl Acad Sci U S A 108: 10081–10086.
Štítky
Interné lekárstvoČlánok vyšiel v časopise
PLOS Medicine
2014 Číslo 11
- Parazitičtí červi v terapii Crohnovy choroby a dalších zánětlivých autoimunitních onemocnění
- Pleiotropní účinky statinů na kardiovaskulární systém
- Statiny indukovaná myopatie: Jak na diferenciální diagnostiku?
- Zástava srdce u pacienta se střelnými ranami – kazuistika
- Statinová intolerance
Najčítanejšie v tomto čísle
- Act II of the Sunshine Act
- Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis of Effect Modifiers
- What Could Computerized Brain Training Learn from Evidence-Based Medicine?
- Sublingual Misoprostol versus Intramuscular Oxytocin for Prevention of Postpartum Hemorrhage in Uganda: A Double-Blind Randomized Non-Inferiority Trial