Long-Term Effects of Mobile-Based Metamemory Cognitive Training in Older Adults With Mild Cognitive Impairment: 15-Month Prospective Single-Arm Longitudinal Study.

BACKGROUND

Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia, characterized by subjective cognitive decline and objective memory impairment. Cognitive training has consistently shown short-term benefits for individuals with MCI, but evidence on the long-term effectiveness is extremely limited. Given the progressive nature of MCI and the need for sustainable strategies to delay cognitive decline, research on the long-term impact of cognitive training is necessary and timely. Mobile-based platforms offer a promising solution by enhancing accessibility and adherence, but their durability of effect over extended periods remains underexplored.

OBJECTIVE

This study aimed to evaluate the long-term effects of a mobile-based cognitive training app on the cognitive function of older adults with MCI.

METHODS

In total, 28 older adults with MCI used Cogthera, a mobile cognitive training app based on metamemory training. Participants completed 2 training sessions daily for 3 months, and 9 (32%) continued for an additional 12 months. Cognitive function and quality of life were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale 14 and EQ-5D-5L.

RESULTS

Cognitive function improved over 15 months, as measured by Alzheimer's Disease Assessment Scale-Cognitive Subscale (F2,35.56=7.08; P=.003). EQ-5D-5L scores increased at 3 months but did not show sustained change at 15 months (F2,42.14=3.40; P=.04). Greater cognitive improvements were associated with younger age, higher functional status, and lower baseline cognitive function.

CONCLUSIONS

This study showed that long-term use of a mobile-based metamemory cognitive training app was associated with cognitive improvements over 15 months. Although limited by the small sample size and the absence of a control group, these findings suggest potential for mobile cognitive training as a sustainable intervention that warrants validation in larger trials.