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The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews

Haywood, Darren, Henneghan, Ashley M., Chan, Alexandre, Chan, Raymond J., Dhillon, Haryana M., Lustberg, Maryam B., Vardy, Janette L., O’Connor, Moira, Elvidge, Norah, Dauer, Evan, Franco-Rocha, Oscar Y., Vasan, Shradha, Murray, James, Crichton, Megan, Wilding, Helen, Rossell, Susan L., Hart, Nicolas H.·2025·Supportive Care in Cancer
DOI 10.1007/s00520-025-09212-3
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Abstract

Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind–body, and multi-modal/complex interventions. This umbrella review provides a critical overview to inform guidelines and current practice, identify the most promising interventions, and uncover gaps in the research literature. Methods: This umbrella review of systematic reviews was pre-registered on Open Science Framework and PROSPERO. Six databases were searched. Systematic reviews (SR) assessing any non-pharmacological interventions to improve cognition in cancer (any type) were included. The overview followed gold-standard guidelines and recommendations. The results were narratively synthesised, and descriptive statistics and effect size ranges were calculated. Results: Sixty-four ( n = 64) SRs were included. Results were synthesised into four non-pharmacological domains. Cognitive training/rehabilitation had the strongest evidence for efficacy. Physical activity/exercise showed promising efficacy; however, the variability of findings was considerable. Mind–body and psychological/behavioural therapy interventions were limited, but there was evidence for short-term effectiveness. Multi-modal/complex interventions showed potential for improving cognition in cancer but were poorly defined. Conclusions: Overall, non-pharmacological interventions demonstrated efficacy for improving cognition in cancer. There were limited intervention characteristics within domains which were consistently related to efficacy. Three key recommendations are provided for future research: (1) adopt harmonisation and reporting guidelines; (2) develop definitional guidelines of cognitive domains for CRCI research; and (3) assess intervention and participant characteristics associated with positive versus null/negative findings.

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Metadata

Authors
Haywood, D., Henneghan, A. M., Chan, A., Chan, R. J., Dhillon, H. M., Lustberg, M. B., Vardy, J. L., O’Connor, M., Elvidge, N., Dauer, E., Franco-Rocha, O. Y., Vasan, S., Murray, J., Crichton, M., Wilding, H., Rossell, S. L., & Hart, N. H.
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2025-02
Volume
33
Issue
2
ISSN
  • 0941-4355
  • 1433-7339
DOI
10.1007/s00520-025-09212-3
Cited by
16
References
7
Language
en
Licence
Funders
  • Multinational Association of Supportive Care in Cancer
  • University of Technology Sydney

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