[hmahncke]

>> Examples include the ACTIVE trial, commercial brain-training games (e.g., Neuroracer, Lumosity, and BrainHQ), and multidomain training programs (Binder et al., 2016; Buitenweg et al., 2017; Duyck & Op de Beeck, 2019). To date, none of these regimens have shown compelling evidence, or any evidence at all, of training-induced far transfer to either cognitive tests or real-life skills >>

ACTIVE showed that cognitive training slowed decline in instrumental activities of daily living [1], and that adaptive computerized speed training in particular reduced at-fault car crashes [2], reduced depressive symptoms [3], and most importantly reduced the incidence of dementia [4]. The NIH is spending tens of millions of dollars on follow-up trials to extend the results.

To dismiss ACTIVE in the brief paragraph is...startling.

>> We demonstrate that this optimism is due to the field neglecting the results of meta-analyses >>

A strong statement from a paper that doesn't seem to cover multiple positive meta-analyses of cognitive training [5, for example].

In my view, if you read a lot of papers in this field (and I do), the pattern is that negative articles generally focus on working memory training and effects on IQ or "generalized cognitive ability" (whatever that is); and positive articles generally focus on neurocognitive measures and real-world functional measures. One reasonable interpretation [and there are many!] is that programs focused on using working memory techniques to improve IQ are not generally effective, and programs using speed/attention training to improve specific aspects of cognitive and real-world performance are effective.

Meanwhile, out in the clinical world, cognitive training is now recommended by clinical guidelines from the American Academy of Neurology and the World Health Organization, and offered as a benefit by a dozen Medicare Advantage plans around the country.

Disclaimer: I work at BrainHQ, and have published in this field. Further disclaimer, a HN comment isn't an academic article.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055506/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057872/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657170/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700828/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050567/

[tgv]

ACTIVE doesn't have much to show for it, does it? Effect sizes are small, and some are almost absent, while there are differences in other factors between the groups with the same magnitude (drinking, cholesterol, diabetes, subject withdrawal, etc.). The calculation of the effect size is also dubious: it assumes the changes are linear and independent of the starting position, and the baseline is not within the group, although I can't see an easy way to get an objective one either.

As to the statistics: it's p-values all over, with all of the associated problems. The p-value for article [4] gets just below the 0.05 mark, but only for speed training. They also do two other comparisons, which are nowhere near significant. That is really suspicious, and there's no correction for multiple comparisons.

All in all, this short inspection doesn't convince me the OP article has it wrong.

[hmahncke]

For folks who dislike p-value reporting (and I'm one of them), we can focus on the effect sizes for speed of processing training in ACTIVE:

[1] 0.36 in slowing decline in functional abilities, equivalent to ~3 years of delayed decline [2] 48% reduction in at fault auto crash risk [3] 30% reduction in the risk of experiencing serious [0.5 s.d.] worsening of depressive symptoms [4] 29% reduction in dementia incidence [hazard ratio]

These are all clinically meaningful effect sizes.

Regarding the dementia incidence study, it's correct that two of the cognitive training interventions did not show effects, and speed of processing training did. In my view, a straightforward interpretation is that different types of cognitive training are different (much like different small molecule pharmaceuticals are different), and consequently they have different effects on endpoints like dementia incidence.

[kensai]

I don't disagree with you, generally, but if you had hit the first of the 5 quoted papers the OP linked, you would have seen that the effect size at least in a study was medium. Not small.

[tgv]

I did check [1]. That's where the differences between the four groups can be found. There are 12 effect sizes, only two or three medium (≥0.5). Some of the others are even negative. It's pretty suspicious that the type of training matters so much. It's as if it's training to the test.

But if this is what it is, then by all means, do cognitive training for the elderly: it can't do any harm. But there doesn't seem to be any point in further research.