Use of the Internet as a prevention tool against cognitive decline in normal aging

Figures & data

Figure 1 Results of the systematic review.

Table 1 An overview of clinical studies focusing on the Internet and its role in the prevention of cognitive decline in healthy older adults

Study	Objective	Number of subjects	Period of intervention	Type of intervention	Findings
Almeida et al^Citation27 (CS)	To determine if older men who use computers have lower risk of developing dementia	5,506 Australian men aged 69–87 years	8.5 years	Use of computers, as well as emails, the Internet, word processors, and games	The results indicated that the risk of incident dementia is ~30%–40% lower among elderly computer users than nonusers. In addition, these results cannot be attributed to age, education, social isolation, depression, poor physical health, or prevalent cognitive impairment
Bozoki et al^Citation33 (RCTa)	To test the hypothesis that seniors aged 60–80 years can improve key aspects of cognitive ability with the aid of such games	60 older subjects (age 60–80 years); two intervention groups, no control group	6 weeks	Online cognitive training program	The findings showed no transference effects; the effect of size on cognition was relatively small; only improvements on games. Nevertheless, longer interventions or more intense games might significantly enhance cognitive functions
Corbett et al^Citation30 (RCT)	To assess the effect of the computerized training program on cognitive functions	2,192 older subjects; mean age 65 years; three groups: general CT, reasoning CT, and control	6 months	Online cognitive training program	The results indicate that general and reasoning packages gave benefit to IADL (P=0.008, P=0.011), reasoning (P<0.0001, P<0.0001), and VL (P=0.007, P=0.008) at 6 months; benefit in reasoning was evident from 6 weeks. The decline is age sensitive
Dodge et al^Citation28 (RCT)	To assess whether conversation-based cognitive stimulation, through personal computers, webcams, and a user-friendly interactive Internet interface had high adherence and a positive effect on cognitive functions among older adults without dementia	83 subjects participated (intervention: n=41, control: n=42); their mean age was 80.5 (6.8) years	6 weeks; daily 30-minute interactions	Internet-based conversation	The findings revealed that healthy older individuals had improved on a semantic fluency test (P=0.003) at the posttrial assessment and a phonemic fluency test (P=0.004) at the 18-week assessments. Among those with MCI, there was an improvement in their psychomotor speed
McAvinue et al^Citation53 (RCT)	To evaluate the efficacy of a working memory training scheme in improving memory in a group of older adults	36 healthy older subjects (age 64–79 years); 19 in the trainee group and 17 in the control group	A 5-week training period + a 6-month follow-up	Online cognitive training program	The findings show that the trainees improved far more than the controls from the pretraining to the posttraining assessment, F(1, 33) =10.35, P = 0.003, η^2 = 0.24, which was maintained at the 3-month follow-up. The results proved enhanced short-term memory, together with transfer of training gains to long-term episode memory tasks
Vermeij et al^Citation31 (PS)	To explore the transfer effects of core working memory training on the working memory domain and other cognitive domains	23 healthy older subjects (mean age 70.2±5.4 years); 18 MCI subjects (mean age 67.1±6.5 years)	25 training sessions (each 45 minutes) + a 3-month follow-up period	Online cognitive training program	The results proved that both groups had improved on the Digit Span and Spatial Span. In addition, there were gains on trained and untrained tasks within the WM domain, but no broad generalization to other cognitive domains
Walton et al^Citation32 (RCT)	To assess the effectiveness of online cognitive training program on the improvement of cognitive performance in healthy older adults	28 healthy older subjects (mean age 64.18 years); one cognitive trainee group and one active control group	28 days	Online cognitive training program	The results revealed that spatial working memory showed significant improvements in accuracy and measurable improvements in nonpracticed outcome measures in healthy older adults
Xavier et al^Citation26 (CS)	To investigate whether digital literacy might be associated with decreased cognitive decline in older adulthood	6,442 participants aged 50–89 years	8 years	Internet/email use	Digital literacy may help reduce cognitive decline among persons aged between 50 years and 89 years

Note:

a No control group.

Abbreviations: CS, cohort study; CT, cognitive training; IADL, instrumental activities of daily living; MCI, mild cognitive impairment; OS, observational study; PS, pilot study; RCT, randomized controlled trial; VL, verbal learning; WM, working memory.

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CorbettAOwenAHampshireAThe effect of an online cognitive training package in healthy older adults: an online randomized controlled trialJ Am Med Dir Assoc2015161199099726543007

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DodgeHHZhuJMattekNCWeb-enabled conversational interactions as a method to improve cognitive functions: results of a 6-week randomized controlled trialAlzheimers Dement201511112

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McAvinueLPGolemmeMCastorinaMAn evaluation of a working memory training scheme in older adultsFront Aging Neurosci201352023734126

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VermeijAClaassenJADautzenbergPLKesselsRPTransfer effects of online working-memory training in healthy older adults and mild cognitive impairmentAlzheimers Dement2014104311

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WaltonCKavanaghADowneyLALomasJCamfieldDAStoughCOnline cognitive training in healthy older adults: a preliminary study on the effects of single versus multi-domain trainingTranslat Neurosci201561319

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XavierAJd’OrsiEde OliveiraCMEnglish longitudinal study of aging: can Internet/e-mail use reduce cognitive decline?J Gerontol A Biol Sci Med Sci20146991117112125116923

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