Efficacy of Nonpharmacological Interventions in Cognitive Impairment: Systematic Review And Network Meta-Analysis
American Journal of Geriatric Psychiatry
Venegas-Sanabria, L. C., Cavero-Redondo, I., et al. (2024).
American Journal of Geriatric Psychiatry, Advance online publication. https://doi.org/10.1016/j.jagp.2024.06.012.
<div>This systematic review and meta-analysis investigates the effects of nonpharmacological interventions on on global cognition for individuals with dementia or mild cognitive impairment. Only those interventions within the scope of speech-language pathology will be included in this summary.</div>
No funding received
From database inception to July 2023
<div>Two-arm or multi-arm randomized-controlled trials published in English or Spanish</div>
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<div>For individuals with mild cognitive impairment, computerized cognitive training significantly improved global cognition as compared to the following:</div>
<div>
<ul>
<li>usual care (SMD = 0.6) and</li>
<li>other physical exercise (SMD = 0.9).</li>
</ul>
<div>There were no significant differences between computerized cognitive training and occupational therapy, multicomponent physical exercise, physical-cognitive exercise, aerobic exercise, tai-chi, music therapy, conventional cognitive training, strength exercises, or mind-body exercises.</div>
<div> </div>
<div>Limitations to this study include lack of investigation of cognitive outcomes besides global cognition, high total heterogeneity and high pairwise comparison heterogeneity, and lack of consideration of long-term effects.</div>
</div>
<div>
<div>For individuals with mild cognitive impairment, conventional cognitive training significantly improved global cognition as compared to usual care (SMD = 0.4). There were no significant differences between conventional cognitive training and occupational therapy, multicomponent physical exercise, combined physical and cognitive exercise, aerobic exercise, tai-chi, music therapy, computerized cognitive training, strength exercises, mind-body exercises, or other physical exercise.</div>
<div> </div>
<div>Limitations to this study include lack of investigation of cognitive outcomes besides global cognition, high total heterogeneity and high pairwise comparison heterogeneity, and lack of consideration of long-term effects.</div>
</div>
<div>For individuals with dementia, computerized cognitive training:</div>
<div>
<ul>
<li>significantly improved global cognition as compared to usual care (SMD = 0.8).</li>
<li>was not significantly different from conventional cognitive training, other physical exercise, occupational therapy, tai-chi, aerobic exercise, multicomponent physical exercise, reminiscence therapy, music therapy, strength exercises, or mind-body exercises.</li>
</ul>
<div>Additionally, combined treatments of physical and cognitive exercise significantly improved global cognition as compared to computerized cognitive training (SMD = 0.9).</div>
<div> </div>
<div>Limitations to this study include lack of investigation of cognitive outcomes besides global cognition, high total heterogeneity and high pairwise comparison heterogeneity, and lack of consideration of long-term effects.</div>
</div>
<div>
<div>For individuals with dementia, conventional cognitive training:</div>
<div>
<ul>
<li>significantly improved global cognition as compared to usual care (SMD = 0.5).</li>
<li>was not significantly different from computerized cognitive training, other physical exercise, occupational therapy, tai-chi, aerobic exercise, multicomponent physical exercise, reminiscence therapy, music therapy, strength exercises, or mind-body exercises.</li>
</ul>
<div>Additionally, combined treatments of physical and cognitive exercise significantly improved global cognition as compared to conventional cognitive training (SMD = 1.1).</div>
<div> </div>
<div>Limitations to this study include lack of investigation of cognitive outcomes besides global cognition, high total heterogeneity and high pairwise comparison heterogeneity, and lack of consideration of long-term effects.</div>
</div>
</div>
<div>For individuals with dementia, reminiscence therapy was not significantly different from computerized cognitive training, conventional cognitive training, other physical exercise, occupational therapy, tai-chi, aerobic exercise, multicomponent physical exercise, music therapy, strength exercises, mind-body exercises, or usual care. Additionally, combined treatments of physical and cognitive exercise significantly improved global cognition as compared to reminiscence therapy (SMD = 1.4).</div>
<div> </div>
<div>Limitations to this study include lack of investigation of cognitive outcomes besides global cognition, high total heterogeneity and high pairwise comparison heterogeneity, and lack of consideration of long-term effects.</div>
