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Meta-Analysis
. 2016 Sep;26(3):225-251.
doi: 10.1007/s11065-016-9330-4. Epub 2016 Sep 8.

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

M J Chandler  1 , A C Parks  2 , M Marsiske  3 , L J Rotblatt  3 , G E Smith  3
Affiliations
Meta-Analysis

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

M J Chandler et al. Neuropsychol Rev. 2016 Sep.

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.

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

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Figures

Fig. 1
Fig. 1
Cumulative growth of controlled trials of cognitive interventions in MCI over time. To fully illustrate the total number of studies in this area, studies that included no generalization outcome measure (i.e., controlled trials of cognitive interventions in MCI that only provided cognitive measures or fMRI outcomes) that were excluded from the general review are shown in this figure as “Non-gen outcome”
Fig. 2
Fig. 2
PRISMA Flow Diagram. Flow diagram illustrating the process of inclusion/exclusion of studies
See this image and copyright information in PMC

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