The Effect of Cognitive Rehabilitation on Daily Functioning of Patients With Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Clinical Trials

Frontiers in Neurology

Ren, S., Pan, F., et al. (2024).

Frontiers in Neurology, 15, 1371298.

This systematic review with meta-analysis compares daily functioning outcomes of cognitive rehabilitation to other cognitive interventions in adults with Alzheimer's disease.

No funding received

From database inception to June 2023

Randomized or non-randomized controlled designs. Excludes letters, reviews, case reports, editorial comments, conference abstracts, and unpublished articles.

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Compared to controls, cognitive rehabilitation (CR) demonstrated statistically significant moderate-to-large impacts on quality of life (WMD=2.87; <em>p=0.007</em>) and occupational performance levels (WPM=1.53;&nbsp;<em>p=0.007</em>) in individuals with Alzheimer's disease. Other domains (i.e., neuropsychiatric status, caregiver burden, independent performance on daily living, behavioral memory, attention, and verbal fluency) showed no significant difference between CR and control interventions. Subgroup analysis found the following:<br /> <ul> <li>For follow-up periods of less than 6 months, quality of life showed no significant difference between CR and control groups; however, occupational performance levels showed significant improvement with CR (WMD=1.54;&nbsp;<em>p</em>=0.03).</li> <li>For follow-ups longer than 6 months, CR demonstrated greater improvements in quality of life (WMD=2.90; <em>p</em>=0.01); meanwhile, occupational performance levels showed no difference for CR and control groups.</li> </ul> Limitations of this review included the small number of included studies, heterogeneity among the included studies, the presence of random assignment bias, and the possible exclusion of relevant non-English studies. Additional research is needed to investigate the long-term effects of cognitive intervention strategies.