Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cognitive Training to Prevent Cognitive Decline

Ann Intern Med; ePub 2017 Dec 19; Butler, et al

Cognitive training improves cognitive performance in older adults with normal cognition, according to a recent review. The review summarized evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). Selection included 11 trials lasting at least 6 months and compared cognitive training with usual care, waitlist, information, or attention controls in adults without dementia. Other details include:

  • For healthy older adults, training improved cognitive performance in the domain trained but not in other domains.
  • Results for population with MCI suggested no effect of training on performance.
  • Evidence regarding prevention or delay of cognitive decline or dementia was insufficient.
  • No adverse events were reported.


Butler M, McCreedy E, Nelson VA, et al. Does cognitive training prevent cognitive decline?: A systematic review. [Published online ahead of print December 19, 2017]. Ann Intern Med. doi:10.7326/M17-1531.


An entire industry has developed around “brain training” as a way of delaying or preventing cognitive decline and dementia. This systematic review does not lend much credibility to the concept. It seems that for people who have normal cognitive capabilities, “training improved cognitive performance in the domain trained but not in other domains.” In other words, if you study math, you get better at math. If you train with puzzles, you get better at doing puzzles. There is no evidence that cognitive training delays general cognitive decline, and no evidence that cognitive training improves performance for people with mild cognitive impairment or slows progression from normal cognitive status to mild cognitive impairment or dementia. —Neil Skolnik, MD

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