Cognitive training as a tool for maintaining brain reserves and cognitive functions during aging

Aim. To summarize current evidence on the effects of cognitive training (CoTr) on cognitive function and brain reserves in cognitively intact individuals and patients with mild cognitive impairment (MCI) during aging.

Material and  methods. The authors searched the PubMed, Google Scholar, and eLIBRARY.RU databases for publications from 2018 to 2025 using combinations of Russian and English keywords: “cognitive training,” “brain reserve,” “brain networks,” “virtual reality,” “connectivity,” “healthy,” and “mild cognitive impairment.” The review included full-text studies assessing the isolated effects of CoTr on cognitive function and/or neurobiological indicators reflecting brain reserve in healthy individuals and patients with MCI. A total of 69 publications were included in the final analysis.

Results. CoTr programs were typically standardized and predominantly computerized, administered 2–5 times per week over 4–12 weeks. Training effectiveness was assessed using validated neuropsychological measures and neuroimaging techniques. Most randomized controlled trials provided evidence of statistically significant positive effects of CoTr on cognitive performance and brain parameters, with more pronounced benefits observed in cognitively healthy individuals than in patients with MCI. Associations were identified between CoTr-induced cognitive improvements in middle-aged and older adults and changes in functional connectivity of neural networks, cortical thickness, and microstructural integrity of cerebral white matter.

Conclusion. Cognitive training is considered a promising strategy for maintaining cognitive health. However, heterogeneity of existing training protocols and limited durability of effects indicate the need for further development of standardized and available cognitive exercise programs.

1. Cherdak MA, Mkhitaryan EA, Sharashkina NV, Ostapenko VS, Isaev RI, Seyfedinova AB, Runikhina NK, Kotovskaya Yu.V., Tkacheva ON, Yakhno NN. Prevalence of cognitive impairment in older adults in the Russian Federation. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(4 vyp 2):5–11 (In Russ.). PMID: 38696145. doi: 10.17116/jnevro20241240425

2. Oberlin LE, Jaywant A, Wolff A, Gunning FM. Strategies to promote cognitive health in aging: recent evidence and innovations. Curr Psychiatry Rep. 2022;24(9):441–450. doi: 10.1007/s11920-022-01348-x

3. Prince JB, Davis HL, Tan J, Muller-Townsend K, Markovic S, Lewis DMG, Hastie B, Thompson MB, Drummond PD, Fujiyama H, Sohrabi HR. Cognitive and neuroscientifi c perspectives of healthy ageing. Neurosci Biobehav Rev. 2024;161:105649. doi: 10.1016/j.neubiorev.2024.105649

4. Basak C, Qin S, O'Connell MA. Diff erential eff ects of cognitive training modules in healthy aging and mild cognitive impairment: A comprehensive meta-analysis of randomized controlled trials. Psychol Aging. 2020;35(2):220–249. doi: 10.1037/pag0000442

5. Pellegrini-Laplagne M, Dupuy O, Sosner P, Bosquet L. Eff ect of simultaneous exercise and cognitive training on executive functions, barorefl ex sensitivity, and pre-frontal cortex oxygenation in healthy older adults: a pilot study. Geroscience. 2023;45(1):119–140. doi: 10.1007/s11357-022-00595-3

6. Gromova DO, Zakharov VV, Novikova MS. Modern approaches to the prevention of cognitive impairment. The concept of cognitive reserve. Pharmacology & Pharmacotherapy. 2020;1:55–64 (In Russ.). doi: 10.46393/2713-2129_2020_1_55

7. Pappalettera C, Carrarini C, Miraglia F, Vecchio F, Rossini PM. Cognitive resilience/reserve: Myth or reality? A review of defi nitions and measurement methods. Alzheimers Dement. 2024;20(5):3567–3586. doi: 10.1002/alz.13744

8. Krivanek TJ, Gale SA, McFeeley BM, Nicastri CM, Daff ner KR. Promoting successful cognitive aging: a ten-year update. J Alzheimers Dis. 2021;81(3):871–920. doi: 10.3233/JAD-201462

9. Kang H, Ihara ES, Tompkins CJ, Lauber MS. Boosting cognitive training through social engagement: impacts on older adults with subjective cognitive decline. Sage Open Aging. 2025;11:30495334251366575. doi: 10.1177/30495334251366575

10. Zubritskaya EM, Prokopenko SV, Mozheyko E.Yu., Gurevich VA. Computer-based cognitive stimulation for posttraumatic cognitive impairment: a clinical case. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics.2020;12(6):131–136. (In Russ.). doi: 10.14412/2074-2711-2020-6-131-136

11. van Balkom TD, van den Heuvel OA, Berendse HW, van der Werf YD, Vriend C. The eff ects of cognitive training on brain network activity and connectivity in aging and neurodegenerative diseases: a systematic review. Neuropsychol Rev. 2020;30(2):267–286. doi: 10.1007/s11065-020-09440-w

12. Velichkovsky BM. Possibilities of cognitive training as a means of correcting age-related changes in cognitive control. Experimental psychology. 2009;2(4):67–91 (In Russ.). https://psyjournals.ru/journals/exppsy/archive/2009_n3/exppsy_2009_n3_24925.pdf

13. Turnbull A, Seitz A, Lin FV. Improving comparability across cognitive training trials for brain aging: A focus on interoperability. Alzheimers Dement (NY). 2023;9(3):e12405. doi: 10.1002/trc2.12405

14. Bellelli F. Cognitive interventions: symptomatic or diseasemodifying treatments in the brain? JAR Life. 2024;13:60–64. doi: 10.14283/jarlife.2024.8

15. Kotliar C, Olmos L, Koretzky M, Jauregui R, Delía T, Cingolani O. A new program for systematically enhancing cognitive reserve in healthy adults: A pilot randomized active-controlled clinical trial. PLoS One. 2025;20(10):e0331193. doi: 10.1371/journal.pone.0331193

16. Gozdas E, Avelar-Pereira B, Fingerhut H, Dacorro L, Jo B, Williams L, O'Hara R, Hosseini SM.H. Long-term cognitive training enhances fl uid cognition and brain connectivity in individuals with MCI. Transl Psychiatry. 2024;14(1):447. doi: 10.1038/s41398-024-03153-x

17. Kotov SV, Slyunkova EV, Borisova VA, Isakova EV. Eff ectiveness of brain — computer interfaces and cognitive training using computer technologies in restoring cognitive functions in patients after stroke. S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2022;122(12 vyp 2):67–75 (In Russ.). doi: 10.17116/jnevro202212212267

18. Nahas C, Gandit M, Monfort E. Engagement in computerized cognitive training instructions by older people. A within-subject design to evaluate comprehension and acceptability of serious games instructions. Front Aging Neurosci. 2025;6:1297704. doi: 10.3389/fragi.2025.1297704

19. Dziemian S, Appenzeller S, von Bastian CC, Jäncke L, Langer N. Working memory training eff ects on white matter integrity in young and older adults. Front Hum Neurosci. 2021;15:605213. doi: 10.3389/fnhum.2021.605213

20. Faraza S, Waldenmaier J, Dyrba M, Wolf D, Fischer FU, Knaepen K, Kollmann B, Tüscher O, Binder H, Mierau A, Riedel D, Fellgiebel A, Teipel S. Dorsolateral prefrontal functional connectivity predicts working memory training gains. Front Aging Neurosci. 2021;13:592261. doi: 10.3389/fnagi.2021.592261

21. Zheng L, Boogaart Z, McAvan A, Garren J, Doner S, Wilkes BJ, Groves W, Yuksel E, Cherep L, Ekstrom AD, Weisberg SM. Newly trained navigation and verbal memory skills elicit changes in task-related networks but not brain structure. bioRxiv. 2025. doi: 10.1101/2025.04.14.648747

22. Dalhuisen I, Schutte C, Bramson B, Roelofs K, van Eijndhoven P, Tendolkar I. Studying additive eff ects of combining rTMS with cognitive control training: a pilot investigation. Front Hum Neurosci. 2023;17:1201344. doi: 10.3389/fnhum.2023.1201344

23. Li R, Qu P, Hu X, Li X, Zeng H, Gao B, Sun Z. Assessing acute eff ects of two motor-cognitive training modalities on cognitive functions, postural control, and gait stability in older adults: a randomized crossover study. PeerJ. 2024;12:e18306. doi: 10.7717/peerj.18306

24. Šimko P, Pupíková M, Gajdoš M, Rektorová I.. Cognitive aftereff ects of acute tDCS coupled with cognitive training: an fMRI study in healthy seniors. Neural Plast. 2021; 2021:6664479. doi: 10.1155/2021/6664479

25. Weller S, Derntl B, Plewnia C. Sex matters for the enhancement of cognitive training with transcranial direct current stimulation (tDCS). Biol Sex Diff er. 2023;14(1):78. doi: 10.1186/s13293023-00561-4

26. Kuzyukova AA, Zagainova A.Yu., Mokeev IN, Dobyarkova VV, Yurova Yu.A. Repetitive transcranial magnetic stimulation and cognitive training in the cognitive rehabilitation of patients who have suff ered an ischemic stroke. Russian Journal of Environmental and Rehabilitation Medicine. 2024;1:9–18 (In Russ.). EDN BTJBNI.

27. Kazinka R, Roediger D, Xuan L, Yu L, Mueller BA, Camchong J, Opitz A, MacDonald A. 3rd, Lim KO. tDCS-enhanced cognitive training improves attention and alters connectivity in control and somatomotor networks: A triple blind study. Neuroimage. 2024;298:120792. doi: 10.1016/j.neuroimage.2024.120792.

28. Marusic U, Verghese J, Mahoney JR. Does Cognitive training improve mobility, enhance cognition, and promote neural activation? Front Aging Neurosci. 2022;14:845825. doi: 10.3389/fnagi.2022.845825

29. Gómez-Soria I, Iguacel I, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Zaldívar JN.C., Calatayud E. Cognitive stimulation and cognitive results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr. 2023;104:104807. doi: 10.1016/j.archger.2022.104807

30. Liu T, Spector A, Mograbi DC, Cheung G, Wong GH.Y. Changes in default mode network connectivity in resting-state fMRI in people with mild dementia receiving cognitive stimulation therapy. Brain Sci. 2021;11(9):1137. doi: 10.3390/brainsci11091137

31. Zhitkova Yu.V., Gasparian АА, Sarvarova AF, Korobova DA, Galyavova FI, Baynazarova AI, Khamidullina АМ, Domanskaya EV. Results from the open-label, single-center, clinical study assessing the efficacy and safety of a group cognitive stimulation therapy in Russian-speaking patients with the moderate dementia stage of Alzheimer's disease. Meditsinskiy Sovet. 2024;18(3):43– 50 (In Russ.). doi: 10.21518/ms2024-044

32. Marchenko EV, Issar AD. Use of mobile applications for memory and attention training in extreme profi le specialists (fi refi ghters as an example). National Psychological Journal. 2024;19(4):176–188 (In Russ.). https://doi.org/10.11621/npj.2024.0412

33. Georgopoulou EN, Nousia A, Siokas V, Martzoukou M, Zoupa E, Messinis L, Dardiotis E, Nasios G. Computer-based cognitive training vs. paper-and-pencil training for language and cognitive defi cits in Greek patients with mild Alzheimer's disease: a preliminary study. Healthcare (Basel). 2023;11(3):443. doi: 10.3390/healthcare11030443

34. Savchits DO, Prokopenko SV, Subocheva SA. Modern technologies of contactless computer control and their application in rehabilitation. Doctor.Ru. 2025;24(6):69–78 (in Russ.). doi: 10.31550/1727-2378-2025-24-6-69-78

35. Irazoki E, Contreras-Somoza LM, Toribio-Guzmán JM, JenaroRío C, van der Roest H, Franco-Martín MA. Technologies for cognitive training and cognitive rehabilitation for people with mild cognitive impairment and dementia. a systematic review. Front Psychol. 2020;11:648. doi: 10.3389/fpsyg.2020.00648

36. Hu M, Wu X, Shu X, Hu H, Chen Q, Peng L, Feng H. Eff ects of computerised cognitive training on cognitive impairment: a meta-analysis. J Neurol. 2021;268(5):1680–1688. doi: 10.1007/s00415-019-09522-7

37. Robledo-Castro C, Castillo-Ossa L.F, Corchado JM. Artifi cial cognitive systems applied in executive function stimulation and rehabilitation programs: a systematic review. Arab J Sci Eng. 2023;48(2):2399–2427. doi: 10.1007/s13369-022-07292-5

38. Fischer FU, Kollmann B, Wolf D, Sebastian A, Knaepen K, Riedel D, Mierau A, Ruffi ni N, Endres K, Winter J, Strüder HK, Bischof GN, Faraza S, Baier B, Binder H, Drzezga A, Teipel S, Fellgiebel A, Tüscher O.. Cognitive training gain transfer in cognitively healthy aging: per protocol results of the German AgeGain study. Front Aging Neurosci. 2025;17:1587395. doi: 10.3389/fnagi.2025.1587395

39. Baragash RS, Aldowah H, Ghazal S. Virtual and augmented reality applications to improve older adults' quality of life: A systematic mapping review and future directions. Digit Health. 2022;8:20552076221132099. doi: 10.1177/20552076221132099

40. Šlosar L, Voelcker-Rehage C, Paravlić AH, Abazovic E, de Bruin ED, Marusic U. Combining physical and virtual worlds for motor-cognitive training interventions: Position paper with guidelines on technology classifi cation in movement-related research. Front Psychol. 2022;13:1009052. doi: 10.3389/fpsyg.2022.1009052

41. Jeung S, Hilton C, Berg T, Gehrke L, Gramann K. Virtual reality for spatial navigation. Curr Top Behav Neurosci. 2023;65:103– 129. doi: 10.1007/7854_2022_403

42. Moulaei K, Sharifi H, Bahaadinbeigy K, Dinari F. Effi cacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis. BMC Psychiatry. 2024;24(1):116. doi: 10.1186/s12888-024-05563-z

43. Na S, Lee SK, Lee TK, Hong D, Lee ES. The eff ectiveness of VR-based cognitive training program for mild cognitive impairment: a pilot study. Dement Neurocogn Disord. 2025;24(3):174–186. doi: 10.12779/dnd.2025.24.3.174

44. Kim DR, Moon E, Shin MJ, Yang YA, Park JH. Eff ect of individual virtual reality cognitive training programs on cognitive function and depression in middle-aged women: randomized controlled trial. JMIR Ment Health. 2023;10:e48912. doi: 10.2196/48912

45. Georgiev DD, Georgieva I, Gong Z, Nanjappan V, Georgiev GV. Virtual reality for neurorehabilitation and cognitive enhancement. Brain Sci. 2021;11(2):221. doi: 10.3390/brainsci11020221

46. Bentham C, De Marco M, Venneri A.. The modulatory eff ect of cerebrovascular burden in response to cognitive stimulation in healthy ageing and mild cognitive impairment. Neural Plast. 2019;2019:2305318. doi: 10.1155/2019/2305318

47. Boutzoukas EM, O'Shea A, Kraft JN, Hardcastle C, Evangelista ND, Hausman HK, Albizu A, Van Etten EJ, Bharadwaj PK, Smith SG, Song H, Porges EC, Hishaw A, DeKosky ST, Wu SS, Marsiske M, Alexander GE, Cohen R, Woods AJ. Higher white matter hyperintensity load adversely aff ects pre-post proximal cognitive training performance in healthy older adults. Geroscience. 2022;44(3):1441–1455. doi: 10.1007/s11357-02200538-y

48. Alvares Pereira G, Silva Nunes MV, Alzola P, Contador I. Cognitive reserve and brain maintenance in aging and dementia: an integrative review. Appl Neuropsychol Adult. 2022;29(6):1615– 1625. doi: 10.1080/23279095.2021.1872079

49. Pettigrew C, Soldan A. Defi ning cognitive reserve and implications for cognitive aging. Curr Neurol Neurosci Rep. 2019;19(1):1–22. doi: 10.1007/s11910-019-0917-z

50. Peckham AD. Why don't cognitive training programs transfer to real life?: three possible explanations and recommendations for future research. Behav Ther (N Y N Y). 2021;44(7):357–360. https://pubmed.ncbi.nlm.nih.gov/35813267/

51. Ledreux A, Håkansson K, Carlsson R, Kidane M, Columbo L, Terjestam Y, Ryan E, Tusch E, Winblad B, Daff ner K, Granholm AC, Mohammed AK.H. Diff erential eff ects of physical exercise, cognitive training, and mindfulness practice on serum BDNF levels in healthy older adults: a randomized controlled intervention study. J Alzheimers Dis. 2019;71(4):1245–1261. doi: 10.3233/JAD-190756

52. Delrieu J, Voisin T, Saint-Aubert L, Carrie I, Cantet C, Vellas B,. Payoux P, Andrieu S. The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial. Alzheimers Res Ther. 2020;12(1):134. doi: 10.1186/s13195-020-00683-6

53. Gu N, Li H, Cao X, Li T, Jiang L, Zhang H, Zhao B, Luo C, Li C. Diff erent modulatory eff ects of cognitive training and aerobic exercise on resting state functional connectivity of entorhinal cortex in community-dwelling older adults. Front Aging Neurosci. 2021;13:655245. doi: 10.3389/fnagi.2021.655245

54. Mikos A, Malagurski B, Liem F, Mérillat S, Jäncke L. Objectlocation memory training in older adults leads to greater deactivation of the dorsal default mode network. Front Hum Neurosci. 2021;15:623766. doi: 10.3389/fnhum.2021.623766

55. Li X, Sawamura D, Hamaguchi H, Urushibata Y, Feiweier T, Ogawa K, Tha KK. Microscopic fractional anisotropy detects cognitive training-induced microstructural brain changes. Tomography. 2022;8(1):33–44. doi: 10.3390/tomography8010004

56. Zhang T, Gao Y, Li Y, Wu L, Lin X, Hou Y, He W, Zhu Y, Jiang J, Xie Y, Fang P. Neural plasticity induced by working memory training: insights from cortical microstructure and transcriptional profi les. CNS Neurosci Ther. 2025;31(8):e70479. doi: 10.1111/cns.70479

57. Hardcastle C, Hausman HK, Kraft JN, Albizu A, O'Shea A, Boutzoukas E.M, Evangelista ND, Langer K, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander GE, Woods AJ. Proximal improvement and higher-order resting state network change after multidomain cognitive training intervention in healthy older adults. Geroscience. 2022;44(2):1011–1027. doi: 10.1007/s11357-022-00535-1

58. Yildirim Z, Delen F, Berron D, Baumeister H, Ziegler G, Schütze H, Glanz W, Dobisch L, Peters O, Freiesleben SD, Schneider LS, Priller J, Spruth EJ, Schneider A, Fliessbach K, Wiltfang J, Schott BH, Meiberth D, Buerger K, Janowitz D, Perneczky R, Rauchmann BS, Teipel S, Kilimann I, Laske C, Munk MH, Spottke A, Roy N, Heneka M, Brosseron F, Wagner M, Roeske S, Ramirez A, Ewers M, Dechent P, Hetzer S, Scheffl er K, Kleineidam L, Wolfsgruber S, Yakupov R, Schmid M, Berger M, Gurvit H, Jessen F, Duzel E. Brain reserve contributes to distinguishing preclinical Alzheimer's stages 1 and 2. Alzheimers Res Ther. 2023;15(1):43. doi: 10.1186/s13195-023-01187-9

59. Nichols ES, Erez J, Stojanoski B, Lyons KM, Witt ST, Mace CA, Khalid S, Owen AM. Longitudinal white matter changes associated with cognitive training. Hum Brain Mapp. 2021;42(14):4722–4739. DOI:10.1002/hbm.25580

60. Nęcka E, Gruszka A, Hampshire A, Sarzyńska-Wawer J, Anicai AE, Orzechowski J, Nowak M, Wójcik N, Sandrone S, Soreq E. The eff ects of working memory training on brain activity. Brain Sci. 2021;11(2):155. doi: 10.3390/brainsci11020155

61. Bråthen AC.S., Sørensen Ø, de Lange AG, Mowinckel AM, Fjell AM, Walhovd KB. Cognitive and hippocampal changes weeks and years after memory training. Sci Rep. 2022;12(1):7877. doi: 10.1038/s41598-022-11636-4

62. Butler M, McCreedy E, Nelson VA, Desai P, Ratner E, Fink HA, Hemmy LS, McCarten JR, Barclay TR, Brasure M, Davila H, Kane RL. Does cognitive training prevent cognitive decline? A systematic review. Ann Intern Med. 2018;168(1):63–68. DOI:10.7326/M17-1531

63. Yang FG, Liu TY, Liu CH, Murakami S, Nakai T. Verbal training induces enhanced functional connectivity in Japanese healthy elderly population. Front Hum Neurosci. 2022;16:786853. doi: 10.3389/fnhum.2022.786853

64. Ripp I, Emch M, Wu Q, Lizarraga A, Udale R, von Bastian CC, Koch K, Yakushev I. Adaptive working memory training does not produce transfer eff ects in cognition and neuroimaging. Transl Psychiatry. 2022;12(1):512. doi: 10.1038/s41398-02202272-7

65. Wu Q, Ripp I, Emch M, Koch K. Cortical and subcortical responsiveness to intensive adaptive working memory training: an MRI surface-based analysis. Hum Brain Mapp. 2021;42(9):2907–2920. doi: 10.1002/hbm.25412

66. Hsu CC, Wu YH, Lee KS, Shih PC, Liu TY, Wei JC, Chu WM, Nakai T, Yang FG. Verbal training can improve neurocognitive and reading performance by increasing white matter integrity and grey matter volume. Exp Gerontol. 2024;198:112625. doi: 10.1016/j.exger.2024.112625

67. Zhao X, Ji C, Zhang C, Huang C, Zhou Y, Wang L. Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial. BMC Psychiatry. 2023;23(1):418. doi: 10.1186/s12888-023-04917-3

68. Simon SS, Hampstead BM, Nucci MP, Duran FL.S., Fonseca LM, Martin MD.G.M, Ávila R, Porto FH.G., Brucki SM.D., Martins CB, Tascone LS, Amaro E.Jr., Busatto GF, Bottino CM.C. Cognitive and brain activity changes after mnemonic strategy training in amnestic mild cognitive impairment: evidence from a randomized controlled trial. Front Aging Neurosci. 2018;10:342. doi: 10.3389/fnagi.2018.00342

69. Bray NW, Pieruccini-Faria F, Witt ST, Bartha R, Doherty TJ, Nagamatsu LS, Almeida QJ, Liu-Ambrose T, Middleton LE, Bherer L, Montero-Odasso M. . Combining exercise with cognitive training and vitamin D3 to improve functional brain connectivity in older adults with mild cognitive impairment (MCI): results from the SYNERGIC trial. Geroscience. 2023;45(3):1967–1985. doi: 10.1007/s11357-023-00805-6