Systematic Review and Meta-Analysis of Digital Learning Tools for Cognitive Decline in Older Adults
DOI:
https://doi.org/10.64504/big.d.v3i4.1115Abstract
Background: Age-related cognitive decline represents a growing public health challenge, and digital learning tools have emerged as potentially scalable approaches for cognitive support in older adults. However, the overall effectiveness of these interventions and the factors associated with treatment response remain uncertain. This systematic review and meta-analysis aimed to evaluate the effects of digital learning tools on global cognitive function in adults aged 60 years and older and to explore potential moderators of intervention effects. Methods: Five electronic databases (PubMed, Embase, PsycINFO, Cochrane CENTRAL, and Web of Science) were searched for randomized controlled trials evaluating digital learning interventions in older adults with or without mild cognitive impairment (MCI). Random-effects models were used to synthesize standardized mean differences (SMDs) for global cognitive outcomes. Exploratory subgroup analyses examined intervention modality, participant cognitive status, intervention dosage, and risk of bias. The certainty of evidence was assessed using the GRADE framework. Results: Thirty-five randomized controlled trials involving 4,288 participants were included. Digital learning interventions were associated with improved global cognitive performance compared with control conditions (SMD = 0.48, 95% CI 0.35–0.61), although substantial heterogeneity was observed (I2 = 78%). Exploratory analyses indicated larger effect estimates for virtual reality-based interventions (SMD = 0.65) and serious games (SMD = 0.54) compared with computerized cognitive training (SMD = 0.39). Greater effects were also observed among participants with MCI (SMD = 0.56) and studies providing at least 24 hours of intervention exposure (SMD = 0.59). However, the certainty of evidence was rated as very low because of methodological limitations, substantial inconsistency, and potential small-study effects. Conclusion: Digital learning tools show potential for supporting cognitive performance in older adults, but current evidence remains insufficient to establish definitive effectiveness or identify optimal intervention characteristics. Future research should prioritize well-designed randomized trials with standardized outcomes, longer follow-up periods, transparent reporting, and evaluation of feasibility, accessibility, and real-world cognitive benefits.
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