![]() Since no particular guidelines are given in the app regarding the frequency of the training sessions, we first analyzed the number of days needed to reach the 100 sessions for each CMG. Therefore, we investigated whether there was an impact of the time needed to perform all the sessions on the performance. Since training frequency was not imposed, the time to perform the 100 sessions may vary between subjects and type of CMG. Based on the results of one previous study 15, we hypothesized that the rate of improvement in CMG performance would be slower in the oldest subjects. Therefore, the main objective of our study is to add to the current knowledge by evaluating the efficacy of 100 sessions of CMG used in real-life (independently and without specific guidelines on training frequency) in older adults and how the effect may vary as a function of age. Currently, the literature in older adults supporting the benefits of Cognitive Mobile Games (CMG) when used in areal-life use context is still limited. Previous studies have suggested a beneficial effect of structured cognitive training using commercially available applications in healthy older adults 11, 12 however, those were not real-life use, but instead well-controlled studies with standardized training programs (i.e., number of sessions, duration, frequency). Processing speed training resulted in reduced dementia risk (hazard ratio 0.71 (95% CI 0.50–0.99), p = 0.049) compared to control, but memory and reasoning training generated no significant risk reduction (HR 0.79 (0.57–1.11), p = 0.18 and HR 0.79 (0.56–1.10), p = 0.16, respectively) 14. These results were confirmed in a 10-year longitudinal study following 2802 healthy older adults to assess the efficacy of three cognitive training programs (training memory, reasoning, or speed of processing) relative to a control condition. The results of these studies suggest that the use of cognitive games could be effective in training cognition if used prior to the onset of dementia. Finally, in people with MCI, the currently available evidence could not determine whether or not cognitive training would prevent clinical dementia or improve or maintain cognitive function 13. In cognitively healthy people aged 65 or older, there was some evidence from the included studies to suggest that 12 or more weeks of computerized cognitive training may improve cognition 10, Similar results were found in recent meta-analysis summarizing the efficacy of commercially available cognitive training in the healthy elderly 11, 12. Since its release, many studies have been carried out to evaluate the efficacy of cognitive training using commercial or specially-developed applications. Health-related apps make up an important part of this market, and numerous apps have been developed to ‘train’ cognition and challenge the brain, such as the ‘How Old Is Your Brain’ games developed by Dr Kawashima 9 in 2006 which pioneered the arrival of this type of application. In parallel to this rapid growth, the industry of mobile apps is exploding. Over the last decade, the accessibility and use of smartphones and mobile internet has quickly expanded around the globe. Non-pharmacological interventions such as physical exercise and cognitive interventions 7, 8 may offer an alternative to pharmacological intervention in delaying dementia-related functional decline. However, dementia is not considered a normal sequela of aging and prevention should be the key strategy to mitigate the identified risk factors 6. Age is the biggest risk factor for the development of dementia 4, and aging is associated with a decline of cognitive function 5. The economic cost has been estimated at €232 billion for European countries in 2015 and is expected to double by 2040 3. In addition to impacting the patient, dementia also has a significant impact on the family and society in general. As such, the WHO has suggested that preventing cognitive decline and dementia is a global mental health priority. Currently it is estimated that 50 million are living with dementia worldwide and nearly 10 million new cases occur every year, representing a serious public health problem 2. A significant decline in cognitive function, particularly memory, which is an early symptom of dementia, can lead to mild cognitive impairment (MCI). Clinically, normal healthy aging is associated with some progressive decline in cognitive domains, such as processing speed and executive function. According to the World Health Organization (WHO), the world population aged over 60 years will have doubled in number by 2050, with an estimated total of 2 billion people 1. ![]()
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