Over the past 5 years, computerized cognitive training (CT) programs have made a huge splash in the digital wellness market. These programs, usually consisting of small computer games, have capitalized on recent research that shows a previously unrecognized degree of neuroplasticity, or cognitive flexibility, in the brain.

Currently, research is moderately supportive of CT. In a 2010 NIH state-of-the-science report, researchers reviewed nearly 3 dozen environmental, behavioral, and biological factors believed to prevent Alzheimer disease and cognitive decline.¹ Of these, they found evidence of preventative properties only for CT, which beat out other popular favorites, such as healthy diet and exercise.

The research on specific programs, however, is uneven. Moreover, there is an obvious profit motive for companies to make claims about their software that exceed the demonstrated benefits. Here I will explore the research to determine which computer software systems have the most empirical support. The empirical findings will be supplemented by my own clinical experiences using these programs with patients with cognitive deficits.

A look at supportive research

The Figure describes the supportive studies of 6 different brain training companies (some companies, such as Fit Brains and Nintendo Brain Age, do not claim empirically supported cognitive benefits and have been excluded). The first category, in red, shows the total number of studies; this could include studies funded and conducted by the company itself, or a conference poster that was not peer-reviewed. The second category, in blue, indicates how many of those studies were empirical and peer-reviewed and were published in a journal.

The last category shows only those that were both peer-reviewed and conducted completely free of financial conflicts of interest. These studies promise the most objective and rigorous empirical evidence. I will discuss the 3 companies with the most independent supportive research—Cogmed, Posit Science, and Attention Process Training—as well as Lumosity, because of its relative dominance in the market.

Cogmed

With more independent, peer-reviewed research support than any other product, Cogmed claims to improve focus, attention, planning abilities, and task completion. Its training program primarily uses spatial and auditory working-memory span tasks, which work to increase the amount of information you can hold in your head and manipulate.

Span tasks might include a player listening to a list of numbers and then reentering them backwards, or a visual task similar to the popular children’s game Simon Says. Treatment programs typically last 5 weeks. Cogmed is owned by Pearson, the largest education company in the world, which charges fees for clinicians to become licensed program facilitators.

While independent studies evaluating Cogmed generally indicate that subjects improve at brain games, it is unclear whether these improvements translate into real-world functionality. Critics have cited small test sample sizes and non-replicated results as evidence that Cogmed’s claims are unsupported by research.^2,3 Studies have also failed to show long-term, permanent gains, although with time this could change.

Perhaps most important, improving span is only one piece of working memory. The idea that improving span alone is sufficient to improve overall cognition in the face of other deficits in learning, memory, or executive function merits skepticism. Proponents of Cogmed research state that brain training shows promise, and that critics’ expectations are unrealistically high in these early stages of research.