Efficacy of non-pharmacological intervention on cognitive function of elderly patients with mild cognitive impairment: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Ziqi ¹ ,  YUN Jie ² , LI Wanlin ¹ , HE Siying ¹ , HE Ling ¹

1. College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, P. R. China;
2. Department of Hospital Infection, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, P. R. China;

Corresponding author：

YUN Jie, Email: 836762774@qq.com

Keywords：

Mild cognitive impairment; Non-pharmacological intervention; Network meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.202302074

Video：

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Objective To evaluate the efficacy of different non-pharmacological interventions on cognitive function in elderly patients with mild cognitive impairment by the network meta-analysis. Methods The PubMed, Embase, Cochrane Library, CINAHL, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The network meta-analysis was then performed by using Stata 16.0 and Open BUGS 3.2.3 software. Results A total of 43 RCTs involving 2 986 patients were included, which involved 8 non-drug intervention methods. The best probability ranking results of the network meta-analysis showed that on the simple mental state scale (MMSE) scores: rTMS > acupressure > acupuncture therapy > exercise therapy > cognitive training > multicomponent intervention > VR > conventional care > health education, and on the Montreal cognitive assessment scale (MoCA) scores: VR > exercise therapy > rTMS > acupuncture therapy > acupressure > cognitive training > health education > conventional care. Conclusion Current evidence shows that rTMS, acupressure, VR, exercise therapy and acupuncture may be effective interventions to improve cognitive function in elderly patients with mild cognitive impairment. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： ZHOU Ziqi, YUN Jie, LI Wanlin, HE Siying, HE Ling. Efficacy of non-pharmacological intervention on cognitive function of elderly patients with mild cognitive impairment: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(11): 1305-1312. doi: 10.7507/1672-2531.202302074 Copy

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1. Karssemeijer EGA, Aaronson JA, Bossers WJ, et al. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: a meta-analysis. Ageing Res Rev, 2017, 40: 75-83.
2. Garand L, Dew MA, Eazor LR, et al. Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment. Int J Geriatr Psychiatry, 2005, 20(6): 512-522.
3. Petersen RC, Lopez O, Armstrong MJ, et al. Author response: practice guideline update summary: mild cognitive impairment: report of the guideline development, dissemination, and implementation subcommittee of the American academy of neurology. Neurology, 2018, 91(8): 373-374.
4. B L, T W, Hn Z, et al. The prevalence of hyperuricemia in China: a meta-analysis. BMC Public Health, 2011, 11: 832.
5. 石义容. 社区轻度认知损害患者知-信-行调查及健康教育的研究. 武汉: 湖北中医药大学, 2017.
6. Couture M, Giguère-Rancourt A, Simard M. The impact of cognitive interventions on cognitive symptoms in idiopathic Parkinson's disease: a systematic review. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 2019, 26(5): 637-659.
7. Dong Y, Lee WY, Basri NA, et al. The Montreal cognitive assessment is superior to the mini-mental state examination in detecting patients at higher risk of dementia. Int Psychogeriatr, 2012, 24(11): 1749-1755.
8. 贾建平, 王荫华, 李焰生, 等. 中国痴呆与认知障碍诊治指南(二): 痴呆分型及诊断标准. 中华医学杂志, 2011, 91(10): 651-655.
9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington (DC): American psychiatric association, 2013.
10. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
11. Bisbe M, Fuente-Vidal A, López E, et al. Comparative cognitive effects of choreographed exercise and multimodal physical therapy in older adults with amnestic mild cognitive impairment: randomized clinical trial. J Alzheimers Dis, 2020, 73(2): 769-783.
12. Hong SG, Kim JH, Jun TW. Effects of 12-week resistance exercise on electroencephalogram patterns and cognitive function in the elderly with mild cognitive impairment: a randomized controlled trial. Clin J Sport Med, 2018, 28(6): 500-508.
13. Lam LC, Chan WM, Kwok TC, et al. Effectiveness of Tai Chi in maintenance of cognitive and functional abilities in mild cognitive impairment: a randomised controlled trial. Hong Kong Med J, 2014, 20(3 Suppl 3): 20-23.
14. Li L, Liu M, Zeng H, et al. Multi-component exercise training improves the physical and cognitive function of the elderly with mild cognitive impairment: a six-month randomized controlled trial. Ann Palliat Med, 2021, 10(8): 8919-8929.
15. Song D, Yu DSF. Effects of a moderate-intensity aerobic exercise programme on the cognitive function and quality of life of community-dwelling elderly people with mild cognitive impairment: a randomised controlled trial. Int J Nurs Stud, 2019, 93: 97-105.
16. Suzuki T, Shimada H, Makizako H, et al. A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment. PLoS One, 2013, 8(4): e61483.
17. Yang SY, Lee HC, Huang CM, et al. Efficacy of Tai Chi-style multi-component exercise on frontal-related cognition and physical health in elderly with amnestic mild cognitive impairment. Front Aging, 2021, 2: 636390.
18. 吴含, 朱奕, 王石艳, 等. 有氧运动操对轻度认知障碍的影响. 中华物理医学与康复杂志, 2016, 38(2): 113-117.
19. Buschert VC, Friese U, Teipel SJ, et al. Effects of a newly developed cognitive intervention in amnestic mild cognitive impairment and mild Alzheimer's disease: a pilot study. J Alzheimers Dis, 2011, 25(4): 679-694.
20. Carcelén-Fraile MDC, Llera-DelaTorre AM, Aibar-Almazán A, et al. Cognitive stimulation as alternative treatment to improve psychological disorders in patients with mild cognitive impairment. J Clin Med, 2022, 11(14): 3947.
21. Diaz Baquero AA, Franco-Martín MA, Parra Vidales E, et al. The effectiveness of GRADIOR: a neuropsychological rehabilitation program for people with mild cognitive impairment and mild dementia. Results of a randomized controlled trial after 4 and 12 months of treatment. J Alzheimers Dis, 2022, 86(2): 711-727.
22. Peng Z, Jiang H, Wang X, et al. The efficacy of cognitive training for elderly Chinese individuals with mild cognitive impairment. Biomed Res Int, 2019, 2019: 4347281.
23. Suzuki H, Kuraoka M, Yasunaga M, et al. Cognitive intervention through a training program for picture book reading in community-dwelling older adults: a randomized controlled trial. BMC Geriatr, 2014, 14: 122.
24. Tian R, Jiang Y, Zhang Y, et al. Cognitive training program improves cognitive ability and daily living ability in elderly patients with mild cognitive impairment. Aging Clin Exp Res, 2022, 34(5): 997-1005.
25. Weng W, Liang J, Xue J, et al. The transfer effects of cognitive training on working memory among Chinese older adults with mild cognitive impairment: a randomized controlled trial. Front Aging Neurosci, 2019, 11: 212.
26. Xue B, Xiao A, Luo X, et al. The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: a randomized controlled trial. Int J Methods Psychiatr Res, 2021, 30(4): e1887.
27. 李晨曦, 尚云峰, 王丽云, 等. 计算机认知训练对轻度认知障碍老年人认知功能的影响研究. 中华护理杂志, 2021, 56(5): 667-673.
28. Jeong JH, Na HR, Choi SH, et al. Group- and home-based cognitive intervention for patients with mild cognitive impairment: a randomized controlled trial. Psychother Psychosom, 2016, 85(4): 198-207.
29. Klainin-Yobas P, Kowitlawakul Y, Lopez V, et al. The effects of mindfulness and health education programs on the emotional state and cognitive function of elderly individuals with mild cognitive impairment: a randomized controlled trial. J Clin Neurosci, 2019, 68: 211-217.
30. 袁宏伟, 刘云霞, 张含, 等. “通督醒神”法针灸联合认知训练治疗卒中后轻度认知障碍: 随机对照试验. 中国针灸, 2022, 42(8): 839-843.
31. 陈悦琦, 吴焕淦, 尹平, 等. “通督调神”组穴针刺治疗轻度认知功能障碍: 随机对照研究.中国针灸, 2019, 39(11): 1141-1145.
32. Kim JH, Cho MR, Shin JC, et al. Factors contributing to cognitive improvement effects of acupuncture in patients with mild cognitive impairment: a pilot randomized controlled trial. Trials, 2021, 22(1): 341.
33. 陈晓军, 方剑乔, 商越, 等. 针刺配合西药治疗中风后轻度认知障碍: 随机对照研究. 中国针灸, 2016, 36(4): 337-341.
34. 王岩, 白艳杰, 张铭, 等. 通督醒神针刺法对卒中后轻度认知障碍患者认知功能及精神行为症状的改善效果研究. 中国全科医学, 2021, 24(33): 4223-4228.
35. Bae S, Lee S, Lee S, et al. The effect of a multicomponent intervention to promote community activity on cognitive function in older adults with mild cognitive impairment: a randomized controlled trial. Complement Ther Med, 2019, 42: 164-169.
36. Han JW, Lee H, Hong JW, et al. Multimodal cognitive enhancement therapy for patients with mild cognitive impairment and mild dementia: a multi- center, randomized, controlled, double-blind, crossover trial. J Alzheimers Dis, 2017, 55(2): 787-796.
37. Park H, Park JH, Na HR, et al. Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment: a randomized controlled clinical study. J Clin Med, 2019, 8(7): 940.
38. Liao YY, Tseng HY, Lin YJ, et al. Using virtual reality-based training to improve cognitive function, instrumental activities of daily living and neural efficiency in older adults with mild cognitive impairment. Eur J Phys Rehabil Med, 2020, 56(1): 47-57.
39. Park JH, Liao Y, Kim DR, et al. Feasibility and tolerability of a culture-based virtual reality (VR) training program in patients with mild cognitive impairment: a randomized controlled pilot study. Int J Environ Res Public Health, 2020, 17(9): 3030.
40. Thapa N, Park HJ, Yang JG, et al. The effect of a virtual reality-based intervention program on cognition in older adults with mild cognitive impairment: a randomized control trial. J Clin Med, 2020, 9(5): 1283.
41. 罗晓华, 胡琳丽, 徐静, 等. 沉浸式虚拟现实训练对帕金森病轻度认知功能障碍患者认知功能的影响. 中国康复, 2022, 37(4): 219-222.
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Chinese Journal of Evidence-Based Medicine

Efficacy of non-pharmacological intervention on cognitive function of elderly patients with mild cognitive impairment: a network meta-analysis

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