Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

Abstract

Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.

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Research reported in this manuscript was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER-1306-01,897). The statements in this publication are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.

Appendix

Appendix

Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present

  1. 1.

    mild cognitive impairment/ or (mci or amci or mci-a or predement* or pre-dement* or pre-AD or (mild adj2 cogniti* adj2 (decline or impair* or deficit* or deteriorate* or disorder*)) or ((prelude or preclinical or pre-clinical or prodromal or precursor) adj2 (dement* or Alzheimer* or AD))).tw

  1. 2.

    rh.fs or cognitive therapy/ or ((cogniti* or behavi* or memory or attention or information or neuropsychological or rehearsal* or mnemonic) adj3 (intervention* or rehab* or program* or strategy* or train* or retrain* or treatment* or therapy or therapies or stimulat* or technique*)).tw

  1. 3.

    1 AND 2

  1. 4.

    limit 3 to (addresses or autobiography or bibliography or biography or case reports or classical article or comment or dictionary or directory or editorial or historical article or in vitro or interactive tutorial or interview or legal cases or legislation or letter or news or newspaper article or patient education handout or periodical index or portraits or technical report)

  1. 5.

    3 NOT 4

  1. 6.

    (infant* OR infancy OR newborn* OR baby* OR babies OR neonat* OR preterm* OR prematur* OR postmatur* OR child* OR schoolchild* OR school age* OR preschool* OR kid or kids OR toddler* OR adoles* OR teen* OR boy* OR girl* OR minors* OR pubert* OR pubescen* OR prepubescen* OR paediatric* OR paediatric* OR peadiatric* OR nursery school* OR kindergar* OR primary school* OR secondary school* OR elementary school* OR high school* OR highschool* or youth).tw

  1. 7.

    5 NOT 6

  1. 8.

    7 not (exp neoplasms/ or epilepsy/ or (schizophren* or cancer* or neoplas* or epilep*)).tw.

  1. 9.

    (treatment outcome/ or treatment failure/ or quality of life/ or activities of daily living/ or mental recall/ or (outcome* or efficac* or effectiv* or benefit* or ( (daily adj2 activit*) or (self* adj care*1))).tw. or ((pre* or post*) adj interven*).tw)

  1. 10.

    8 AND 9

PsychInfo 1967 to October Week 3 2015

  1. 1.

    (mci or amci or mci-a or predement* or pre-dement* or pre-AD or (mild adj2 cogniti* adj2 (decline or impair* or deficit* or deteriorate* or disorder*)) or ((prelude or preclinical or pre-clinical or prodromal or precursor) adj2 (dement* or Alzheimer* or AD))).tw

  1. 2.

    exp. cognitive techniques/ or exp. neuropsychological rehabilitation/ or ((cogniti* or behavi* or memory or attention or information or neuropsychological or rehearsal* or mnemonic) adj3 (intervention* or rehab* or program* or strategy* or train* or retrain* or treatment* or therapy or therapies or stimulat* or technique*)).tw.

  1. 3.

    1 AND 2

  1. 4.

    3 NOT (infant* or infancy or newborn* or baby* or babies or neonat* or preterm* or prematur* or postmatur* or child* or schoolchild* or school age* or preschool* or kid or kids or toddler* or adoles* or teen* or boy* or girl* or minors* or pubert* or pubescen* or prepubescen* or paediatric* or paediatric* or peadiatric* or nursery school* or kindergar* or primary school* or secondary school* or elementary school* or high school* or highschool* or youth).tw.

  1. 5.

    limit 4 to (bibliography or “column/opinion” or “comment/reply” or editorial or encyclopedia entry or letter or obituary or poetry or publication information or reprint or review-book or review-media or review-software & other or reviews)

  1. 6.

    4 NOT 5

  1. 7.

    6 AND (treatment outcomes/ or treatment effectiveness evaluation/ or exp. quality of life/ or exp. activities of daily living/ or exp. recall learning/ or (outcome* or efficac* or effectiv* or benefit* or ((daily adj2 activit*) or (self* adj care*1))).tw or ((pre* or post*) adj interven*).tw.)

  1. 8.

    7 not (exp neoplasms/ or epilepsy/ or (schizophren* or cancer* or neoplas* or epilep*)).tw.

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Chandler, M.J., Parks, A.C., Marsiske, M. et al. Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 26, 225–251 (2016). https://doi.org/10.1007/s11065-016-9330-4

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Keywords

  • Mild Cognitive Impairment
  • Cognitive intervention
  • Activities of daily living
  • Quality of life; systematic review; meta-analysis