ObjectivesTo systematically review the efficacy of seven types of cognitive interventions for older adults with mild to moderate Alzheimer's Disease (AD).MethodsWe searched The Cochrane Library, PubMed, EMbase, CNKI, WanFang Data, VIP and CBM databases to collect randomized controlled trials on cognitive interventions for mild to moderate Alzheimer's Disease (AD) from inception to January 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. STATA 14.0 software was then used to perform a meta-analysis.ResultsA total of 49 randomized controlled trials (RCTs) were included. The results of network meta-analysis revealed that each cognitive intervention had significantly improved the cognitive ability of AD patients. Specifically, nursing intervention (NI) (MD=3.01, 95%CI 1.70 to 4.50, P<0.005) was the most effective enhancer of cognitive ability, followed by music therapy (MT) (MD=2.60, 95%CI 0.96 to 4.30, P<0.001), physical exercise (PE) (MD=2.4, 95%CI 1.0 to 3.9, P<0.001), cognitive rehabilitation (CR) (MD=2.3, 95% CI 0.92 to 3.7, P=0.013), cognitive simulation (CS) (MD=1.7, 95%CI 1.2 to 2.3, P=0.037), computerized cognitive training (CCT) (MD=1.6, 95%CI 0.42 to 2.8, P<0.001), and pharmacological therapies (PT) (MD=1.5, 95%CI 0.24 to 2.8, P=0.041).ConclusionsThe seven types of cognitive interventions are helpful in improving the cognitive ability of Alzheimer's patients, and nursing intervention is the most effective cognitive intervention. Moreover, non-pharmacological therapies may be better than pharmacological therapies.
Objective To systematically review the efficacy of six cognitive interventions on cognitive function of patients with mild cognitive impairment after stroke. Methods The PubMed, EMbase, Cochrane Library, SinoMed, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials on the effects of non-drug interventions on the cognitive function of patients with mild cognitive impairment after stroke from inception to March 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using Openbugs 3.2.3 and Stata 16.0 software. Results A total of 72 studies involving 4 962 patients were included. The results of network meta-analysis showed that the following five cognitive interventions improved the cognitive function of stroke patients with mild cognitive impairment: cognitive control intervention (SMD=−1.28, 95%CI −1.686 to −0.90, P<0.05) had the most significant effect on the improvement of cognitive function, followed by computer cognitive training (SMD=−1.02, 95%CI −1.51 to −0.53, P<0.05), virtual reality cognitive training (SMD=−1.20, 95%CI −1.78 to −0.62, P<0.05), non-invasive neural regulation (SMD=−1.09, 95%CI −1.58 to −0.60, P<0.05), and cognitive stimulation (SMD=−0.94, 95%CI −1.82 to −0.07, P<0.05). Conclusion Five cognitive interventions are effective in improving cognitive function for stroke patients with mild cognitive impairment, among which cognitive control intervention is the most effective. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.