García-Casal, J.A., Loizeau, A., Csipke, E., Franco-Martín, M., Perea-Bartolomé, M.V., & Orrell, M. (2016). Computer-based cognitive interventions for people living with dementia: A systematic literature review and meta-analysis. Aging & Mental Health. http://dx.doi.org/10.1080/13607863.2015.1132677
When this article was originally published online, the results about effects of the interventions on depression were incorrect in a number of places throughout the text.
The follow parts of the article have been corrected both online and in print.
The ‘Results’ and ‘Conclusion’ sections of the Abstract have now been corrected to:
Results: Twelve studies were identified. Their methodological quality was acceptable according to Downs and Black criteria, the weakest methodological area being the external validity. The meta-analyses indicated cognitive interventions lead to beneficial effects on cognition in PWD (SMD 0.69; 95% CI = 1.02–0.37; P < 0.0001; I2 = 29%), depression (SMD 0.47; 95% CI = 0.16–0.78; P = 0.003; I2 = 0%) and anxiety (SMD 0.55; 95% CI = 0.07–1.04; P < 0.03; I2 = 42%). They benefited significantly more from the computer-based cognitive interventions than from the non-computer-based interventions in cognition (SMD 0.48; 95% CI = 0.09–0.87; P = 0.02; I2 =2%).
Conclusion: Computer-based cognitive interventions have moderate effects in cognition and anxiety and small effects in depression in PWD. No significant effects were found on activities of daily living. They led to superior results compared to non-computer-based interventions in cognition. Further research is needed on cognitive recreation and cognitive stimulation. There is also a need for longer term follow-up to examine the potential retention of treatment effects, and for the design of specific outcome measures.
The ‘Effect of the cognitive interventions in depression and anxiety of PWD’ section of the main text has been corrected to:
Figure 4 presents the forest plots of change in depression of PWD after a computer-based cognitive intervention. The magnitude of the fixed effect sizes for depression (measured with GDS, CES-D Patient, MOSES Depression and EDC) were within the range of small effect sizes, indicating that people were less depressed after the intervention (SMD 0.47; 95% CI = 0.16–0.78; P = 0.003; I2 = 0%, fixed effect model). The total group of the pre-test and the post-test in the six studies was 84 (range 7–24).
The meta-analyses of changes on depression after cognitive interventions in case control studies pooled data from three studies with a total of 46 participants in the computer-based interventions and 26 participants in the non-computer-based interventions. The meta-analysis revealed no significant differences between both groups (SMD −0.02; 95% CI = −0.54–0.50; I = 0.95; I2 = 48%, fixed effect model; Figure 5).
Only two studies measured anxiety in participants. Figure 6 presents the forest plots of changes in anxiety after the computer-based cognitive interventions. The magnitude of the fixed effect sizes for anxiety (measured with STAI State) indicated that anxiety improved after cognitive interventions (SMD 0.55; 95% CI = 0.07–1.04; P < 0.03; I2 = 42%, fixed effect model). The total group of the pre-test and the post-test in the two studies was 34 (range 10--24). Only one study (Talassi et al., 2007) compared the reduction in anxiety of PWD receiving computer and non-computer interventions; thus, no meta-analysis could be conducted. That study did not find significant differences between both groups (Z = 0.38, P = 0.70).
The First Paragraph of the discussion has been corrected to:
In this review, we systematically searched for computer based cognitive interventions for people with dementia. We identified 12 studies that investigated the effectiveness of four types of interventions (CRC, CR, CS and CT). The meta-analyses indicated that computer-based cognitive interventions were associated with significant improvements in cognition, depression and anxiety. No benefits were found for activities of daily living. In studies comparing computer-based interventions with non-computer interventions, the meta-analysis suggested benefits to cognition in favour of the computer-based interventions. No between group differences were identified for depression, anxiety or activities of daily living.
Figures 4 and 5 have been replaced.
In this review, we systematically searched for computer based cognitive interventions for people with dementia. We identified 12 studies that investigated the effectiveness of four types of interventions (CRC, CR, CS and CT). The meta-analyses indicated that computer-based cognitive interventions were associated with significant improvements in cognition, depression and anxiety. No benefits were found for activities of daily living. In studies comparing computer-based interventions with non-computer interventions, the meta-analysis suggested benefits to cognition in favour of the computer-based interventions. No between group differences were identified for depression, anxiety or activities of daily living.
The Conclusion has been corrected to:
We can conclude that computer-based cognitive interventions have a moderate effect on cognition and anxiety and a small effect on depression in PWD. Computer-based cognitive interventions lead to better results than non-computer-based interventions in cognition. There is insufficient evidence to support that this interventions improve activities of daily living. Further research is needed on all four types of interventions, particularly in the overlooked areas of computer-based cognitive recreation, and in the undeveloped area of computer-based cognitive stimulation. There is also a need for longer term follow-up to examine the retention of treatment effects, and for the design of specific outcome measures. Most importantly, what we need are high-quality RCTs.