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

Abstract

Background: Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia, characterized by subjectivecognitive 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 platformsoffer 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.