title: Cognitive Training Interventions for Patients with Alzheimer's Disease: A Systematic Review.
abstract: Cognitive training (CT) refers to guided cognitive exercises designed to improve specific cognitive functions, as well as enhance performance in untrained cognitive tasks. Positive effects of CT on cognitive functions in healthy elderly people and persons with mild cognitive impairment have been reported, but data regarding the effects of CT in patients with dementia is unclear.
  
  
  
  We systematically reviewed the current evidence from randomized controlled trials (RCTs) to find out if CT improves or stabilizes cognition and/or everyday functioning in patients with mild and moderate Alzheimer's disease.
  
  
  
  Altogether, 31 RCTs with CT as either the primary intervention or part of a broader cognitive or multi-component intervention were found. A positive effect was reported in 24 trials, mainly on global cognition and training-specific tasks, particularly when more intensive or more specific CT programs were used. Little evidence of improved everyday functioning was found.
  
  
  
  Despite some positive findings, the inaccurate definitions of CT, inadequate sample sizes, unclear randomization methods, incomplete datasets at follow-up and multiple testing may have inflated the results in many trials. Future high quality RCTs with appropriate classification and specification of cognitive interventions are necessary to confirm CT as an effective treatment option in Alzheimer's disease.
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.|Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Eeva-Liisa
authors.initials: EL
authors.lastname: Kallio
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.|Hospital, Rehabilitation, and Care Services, City of Helsinki, Helsinki, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Öhman
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Hietanen
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pitkälä
mesh_terms: D000544:Alzheimer Disease / Q000534:rehabilitation*; D003071:Cognition; D006801:Humans; D016032:Randomized Controlled Trials as Topic
keywords: Alzheimer’s disease; cognition; cognitive training; dementia; systematic review