Web-based cognitive training and cognitive stimulation are intended to help improve the memory performance of patients with mild to severe dementia. But how helpful are computer-supported training programs that those affected can use independently and without the support of caregivers and relatives? To what extent is the benefit scientifically proven?
The Institute for Quality and Efficiency in Health Care (IQWiG) investigated this on behalf of the Federal Ministry of Health (BMG) in a so-called evidence report. These research findings have been incorporated into the updated S3 guideline „Dementia,“ which was published by the German Society of Neurology (DGN) and the German Association for Psychiatry, Psychotherapy and Psychosomatic Medicine (DGPPN) in November 2023.
Fundamentally, cognitive training is an addition to dementia treatment, the researchers acknowledge. However, due to the IQWiG study results, the editors of the S3 Guideline „Dementias“ clearly reject the use of online programs: „We do not recommend the use of self-administered, computer-based cognitive training programs for people with dementia.“
„The IQWiG Evidence Report is a prime example of how scientific findings can be translated into concrete recommendations for treating people with dementia.“
Anne Keefer, digiDEM Bavaria Scientist
Compared to standard therapies in dementia treatment, the training programs showed no definite medical benefit for those affected.
Furthermore, the evidence for an improvement in cognitive performance is „very low,“ and the trustworthiness of the evidence itself is „very low.“ The assessments covered the impact on cognition, memory performance, attention, and executive functions. One of the stimulations examined involved, for instance, a daily one-hour training session over a period of six weeks. In another study, participants trained for one hour every two weeks for 15 weeks.
IQWiG analyzed a total of six randomized controlled trials (RCTs). These are considered the scientific gold standard for reliably demonstrating the effectiveness of medical treatments. In the studies, patients with mild Alzheimer's dementia were treated with a web-based cognitive training program. The age of the participants ranged from 67.5 to 78.2 years.
Tip for practice: Other scientific reviews have shown that cognitive stimulation and cognitive training can have a positive effect on the memory performance of people with dementia. However, self-administered, computer-based cognitive training programs do not show this effect, which is why other training modalities, such as memory training groups, should be preferred.
Here you can access the IQWiG evidence report.
