Keywords
Emotion
Mild cognitive impairment
Meta-analysis
Submitted : 2026-02-08
Accepted : 2026-02-23
Published : 2026-03-10
Abstract
Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of dementia. Despite networked cognitive training has been demonstrated to enhance cognitive function in MCI, its effectiveness for negative emotions is still unknown. This review aimed to exam the influences of networked cognitive training on negative emotions and quality of life in people with MCI. Methods: Searches for eligible studies were conducted using PubMed, Web of Science, EMBASE, Cochrane Library, Psyc INFO, CNKI, Wanfang database, VIP database, and Sinomed. The retrieval time limit was set from their inception to 17 December 2025. The articles were reviewed and extracted by two researchers, and their quality was evaluated using the Cochrane risk-of-bias assessment tool. Subsequently, a meta-analysis was carried out utilizing RevMan 5.4 software. Results: The review comprised 13 randomized controlled trials with 626 individuals. The meta-analysis demonstrated that networked cognitive training significantly improved depression (SMD = -0.36; 95% CI [-0.73, -0.00]; p = .050), anxiety (SMD = -0.32; 95% CI [-0.57, -0.06]; p < .050), and quality of life (MD = 2.54; 95% CI [0.98, 4.10]; p < .001). In terms of the comparison of apathy, the effect of intervention was unclear. Conclusions: From these meta-analysis results, networked cognitive training may help patients for MCI with their anxiety, depression, and overall quality of life. However, because there are so few randomized controlled trials available, the evidence regarding apathy is still ambiguous. More thorough randomized controlled trials with larger samples are necessary to verify the significance of networked cognitive training on apathy and to consolidate the findings. Registered number on PROSPERO: CRD42024593710.
References
GBD 2019 Dementia Forecasting Collaborators, 2022, Estimation of the Global Prevalence of Dementia in 2019 and Forecasted Prevalence in 2050: An Analysis for the Global Burden of Disease Study 2019. Lancet Public Health, 7(2): e105–e125.
Petersen R, 2016, Mild Cognitive Impairment. Continuum (Minneapolis, Minn.), 22(2): 404–418.
Martin E, Velayudhan L, 2020, Neuropsychiatric Symptoms in Mild Cognitive Impairment: A Literature Review. Dementia and Geriatric Cognitive Disorders, 49(2): 146–155.
Ma L, 2020, Depression, Anxiety, and Apathy in Mild Cognitive Impairment: Current Perspectives. Frontiers in Aging Neuroscience, 12: 9.
Seibert M, Muhlbauer V, Holbrook J, et al., 2021, Efficacy and Safety of Pharmacotherapy for Alzheimer’s Disease and for Behavioral and Psychological Symptoms of Dementia in Older Patients with Moderate and Severe Functional Impairments: A Systematic Review of Controlled Trials. Alzheimer’s Research & Therapy, 13(1): 131.
Lin R, Yu D, Li P, et al., 2021, The Effectiveness of Non-Pharmacological Interventions Targeting Neuropsychiatric Symptoms Among Persons with Preclinical and Mild Dementia: A Systematic Review and Network Meta-Analysis. International Journal of Geriatric Psychiatry, 36(4): 479–492.
Xue D, Li P, Yu D, et al., 2023, Combined Exercise and Cognitive Interventions for Adults with Mild Cognitive Impairment and Dementia: A Systematic Review and Network Meta-Analysis. International Journal of Nursing Studies, 147: 104592.
Moyle W, 2019, The Promise of Technology in the Future of Dementia Care. Nature Reviews Neurology, 15(6): 353–359.
Liang J, Xu Y, Lin L, et al., 2018, Comparison of Multiple Interventions for Older Adults with Alzheimer Disease or Mild Cognitive Impairment: A PRISMA-Compliant Network Meta-Analysis. Medicine, 97(20): e10744.
Kang J, Kim N, Lee S, et al., 2021, Effect of Cognitive Training in Fully Immersive Virtual Reality on Visuospatial Function and Frontal-Occipital Functional Connectivity in Predementia: Randomized Controlled Trial. Journal of Medical Internet Research, 23(5): e24526.
Park J, Liao Y, Kim D, et al., 2020, Feasibility and Tolerability of a Culture-Based Virtual Reality Training Program in Patients with Mild Cognitive Impairment: A Randomized Controlled Pilot Study. International Journal of Environmental Research and Public Health, 17(9): 3030.
Sasaninezhad M, Moradi A, Farahimanesh S, et al., 2024, Enhancing Cognitive Flexibility and Working Memory in Individuals with Mild Cognitive Impairment: Exploring the Impact of Virtual Reality on Daily Life Activities. Geriatric Nursing, 56: 32–39.
Cipriani G, Bianchetti A, Trabucchi M, 2006, Outcomes of a Computer-Based Cognitive Rehabilitation Program on Alzheimer’s Disease Patients Compared with Those on Patients Affected by Mild Cognitive Impairment. Archives of Gerontology and Geriatrics, 43(3): 327–335.
Ho K, Cheung P, Cheng T, et al., 2022, Virtual Reality Intervention for Managing Apathy in People with Cognitive Impairment: Systematic Review. JMIR Aging, 5(2): e35224.
Hagovská M, Dzvoník O, Olekszyová Z, 2017, Comparison of Two Cognitive Training Programs with Effects on Functional Activities and Quality of Life. Research in Gerontological Nursing, 10(4): 172–180.
Domenicucci R, Ferrandes F, Sarlo M, et al., 2022, Efficacy of ICT-Based Interventions in Improving Psychological Outcomes Among Older Adults with MCI and Dementia: A Systematic Review and Meta-Analysis. Ageing Research Reviews, 82: 101781.
Sterne J, Savović J, Page M, et al., 2019, RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials. BMJ (Clinical Research Ed.), 366: l4898.
Borenstein M, Higgins J, Hedges L, et al., 2017, Basics of Meta-Analysis: I² Is Not an Absolute Measure of Heterogeneity. Research Synthesis Methods, 8(1): 5–18.
Cohen J, 1992, Statistical Power Analysis. Current Directions in Psychological Science, 1(3): 98–101.
Lee E, Kim B, Kim H, et al., 2020, Four-Week Home-Based Robot Cognitive Intervention for Patients with Mild Cognitive Impairment: A Pilot Randomized Controlled Trial. Dementia and Neurocognitive Disorders, 19(3): 96–107.
Baik J, Min J, Ko S, et al., 2024, Effects of Home-Based Computerized Cognitive Training in Community-Dwelling Adults with Mild Cognitive Impairment. IEEE Journal of Translational Engineering in Health and Medicine, 12: 97–105.
Yuting L, 2021, Development and Evaluation of a Remote Creative Expressive Program for Patients with Mild Cognitive Impairment, thesis, Fujian Medical University.
Meizhen H, 2022, Research on the Effects and Mechanisms of Immersive Virtual Reality-Based Cognitive Training Intervention for Mild Cognitive Impairment Patients in the Community, thesis, Fujian Medical University.
Savulich G, Piercy T, Fox C, et al., 2017, Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment. International Journal of Neuropsychopharmacology, 20(8): 624–633.
Goumopoulos C, Skikos G, Frounta M, 2023, Feasibility and Effects of Cognitive Training with the COGNIPLAT Game Platform in Elderly with Mild Cognitive Impairment: Pilot Randomized Controlled Trial. Games for Health Journal, 12(5): 414–425.
Buele J, Avilés-Castillo F, Del-Valle-Soto C, et al., 2024, Effects of a Dual Intervention (Motor and Virtual Reality-Based Cognitive) on Cognition in Patients with Mild Cognitive Impairment: A Single-Blind Randomized Controlled Trial. Journal of NeuroEngineering and Rehabilitation, 21(1): 149.
Park E, Jung A, Lee K, 2021, The Humanoid Robot Sil-Bot in a Cognitive Training Program for Community-Dwelling Elderly People with Mild Cognitive Impairment During the COVID-19 Pandemic: A Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 18(15): 8198.
Yiwen D, 2023, The Effect of Virtual Supermarket Cognitive Assessment and Training System on the Elderly with Mild Cognitive Impairment, thesis, Jilin University.
Manenti R, Gobbi E, Baglio F, et al., 2020, Effectiveness of an Innovative Cognitive Treatment and Telerehabilitation on Subjects with Mild Cognitive Impairment: A Multicenter Randomized Active-Controlled Study. Frontiers in Aging Neuroscience, 12: 585988.
Zhicheng S, Ming W, Yongyang L, et al., 2024, Effect of Virtual Reality Training on Rehabilitation Therapy in Patients with Mild Cognitive Impairment in Nursing Home. Practical Geriatrics, 38(1): 34–39.
Chae H, Lee S, 2023, Effectiveness of Online-Based Cognitive Intervention in Community-Dwelling Older Adults with Cognitive Dysfunction: A Systematic Review and Meta-Analysis. International Journal of Geriatric Psychiatry, 38(1): e5853.
Rayner G, Jackson G, Wilson S, 2016, Cognition-Related Brain Networks Underpin the Symptoms of Unipolar Depression: Evidence from a Systematic Review. Neuroscience and Biobehavioral Reviews, 61: 53–65.
Breukelaar I, Antees C, Grieve S, et al., 2017, Cognitive Control Network Anatomy Correlates with Neurocognitive Behavior: A Longitudinal Study. Human Brain Mapping, 38(2): 631–643.
Ten Brinke L, Davis J, Barha C, et al., 2017, Effects of Computerized Cognitive Training on Neuroimaging Outcomes in Older Adults: A Systematic Review. BMC Geriatrics, 17(1): 139.
Clark D, Beck A, 2010, Cognitive Theory and Therapy of Anxiety and Depression: Convergence with Neurobiological Findings. Trends in Cognitive Sciences, 14(9): 418–424.
Insel T, Cuthbert B, Garvey M, et al., 2010, Research Domain Criteria (RDoC): Toward a New Classification Framework for Research on Mental Disorders. American Journal of Psychiatry, 167(7): 748–751.
Karbach J, Verhaeghen P, 2014, Making Working Memory Work: A Meta-Analysis of Executive-Control and Working Memory Training in Older Adults. Psychological Science, 25(11): 2027–2037.
Wang Y, Bian W, Wei J, et al., 2023, Anxiety-Reducing Effects of Working Memory Training: A Systematic Review and Meta-Analysis. Journal of Affective Disorders, 331: 269–278.
Massimo L, Kales H, Kolanowski A, 2018, State of the Science: Apathy as a Model for Investigating Behavioral and Psychological Symptoms in Dementia. Journal of the American Geriatrics Society, 66(Suppl 1): S4–S12.
Robert P, Manera V, Derreumaux A, et al., 2020, Efficacy of a Web App for Cognitive Training (MeMo) Regarding Cognitive and Behavioral Performance in People with Neurocognitive Disorders: Randomized Controlled Trial. Journal of Medical Internet Research, 22(3): e17167.
Roberts R, Knopman D, Mielke M, et al., 2014, Higher Risk of Progression to Dementia in Mild Cognitive Impairment Cases Who Revert to Normal. Neurology, 82(4): 317–325.
Gladis M, Gosch E, Dishuk N, et al., 1999, Quality of Life: Expanding the Scope of Clinical Significance. Journal of Consulting and Clinical Psychology, 67(3): 320–331.
Siying T, Suai L, Mengrao L, et al., 2024, Qualitative Research on Emotional Experience of Mild Cognitive Impairment Patients Participating in Cognitive Intervention Based on Virtual Reality Technology. Chinese Journal of Nursing, 59(5): 569–575.
Wingham J, Adie K, Turner D, et al., 2015, Participant and Caregiver Experience of the Nintendo Wii Sports After Stroke: Qualitative Study of the Trial of Wii in Stroke (TWIST). Clinical Rehabilitation, 29(3): 295–305.