Systematic review of strengths and limitations of Randomized Controlled Trials for non-pharmacological interventions in mild cognitive impairment: Focus on Alzheimer's disease
Open accessAbstract
BACKGROUND: Non-pharmacological interventions may improve cognition and quality of life, reduce disruptive behaviors, slow progression from Mild Cognitive Impairment (MCI) to dementia, and delay institutionalization. It is important to look at their trial designs as well as outcomes to understand the state of the evidence supporting non-pharmacological interventions in Alzheimer's disease (AD). An analysis of trial design strengths and limitations may help researchers clarify treatment effect and design future studies of non-pharmacological interventions for MCI related to AD. METHODS: A systematic review of the methodology of Randomized Controlled Trials (RCTs) targeting physical activity, cognitive interventions, and socialization among subjects with MCI in AD reported until March 2014 was undertaken. The primary outcome was CONSORT 2010 reporting quality. Secondary outcomes were qualitative assessments of specific methodology problems. RESULTS: 23 RCT studies met criteria for this review. Eight focused on physical activity, fourteen on cognitive interventions, and one on the effects of socialization. Most studies found a benefit with the intervention compared to control. CONSORT reporting quality of physical activity interventions was higher than that of cognitive interventions. Reporting quality of recent studies was higher than older studies, particularly with respect to sample size, control characteristics, and methodology of intervention training and delivery. However, the heterogeneity of subjects identified as having MCI and variability in interventions and outcomes continued to limit generalizability. CONCLUSIONS: The role for non-pharmacological interventions targeting MCI is promising. Future studies of RCTs for non-pharmacological interventions targeting MCI related to AD may benefit by addressing design limitations.
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There is some evidence that cognitive training and physical interventions may improve cognitive abilities in individuals with MCI, but the effects on daily functioning are small.
“There is some evidence that cognitive training and physical interventions may improve cognitive abilities in individuals with MCI; however, the effects on daily functioning are small.”
From Psychotherapeutic interventions in individuals at risk for Alzheimer’s dementia: a systematic review (2022) · cites this paper as [31]
The Results sections on cognitive and physical activity interventions report cognitive benefits in some people with MCI, supporting the claim's cautious first half (page not provided). The Results discussion of functional improvement describes difficulties measuring subtle changes, while study summaries report some improvements in activities of daily living; the review does not establish that effects on daily functioning are small. (LLM, conf=0.85)
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- Authors
- Horr, T., Messinger-Rapport, B., & Pillai, J. A.
- Affiliations
- Cleveland Clinic Lerner College of Medicine (US)
- Corresponding author
- Pillai, Jagan A.
- ORCID
- Pillai, Jagan A.
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 19
- Issue
- 2
- Pages
- 141-153
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC12877530
- OpenAlex
- W2062745761
- Cited by
- 67
- References
- 91
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 11 · 2023: 7 · 2022: 8 · 2021: 4 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 5
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- mild cognitive impairment, Alzheimer's disease, non-pharmacological treatment, randomized controlled trials, trial design quality, physical activity interventions, cognitive intervention, socialization, dementia prevention, generalizability
- MeSH terms
- Alzheimer Disease, Cognition, Humans, Institutionalization, Quality of Life, Randomized Controlled Trials as Topic, Cognitive Dysfunction
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