Non-Pharmacologic Interventions for Older Adults with Subjective Cognitive Decline: Systematic Review, Meta-Analysis, and Preliminary Recommendations

Abstract

In subjective cognitive decline (SCD), older adults present with concerns about self-perceived cognitive decline but are found to have clinically normal function. However, a significant proportion of those adults are subsequently found to develop mild cognitive impairment, Alzheimer's dementia or other neurocognitive disorder. In other cases, SCD may be associated with mood, personality, and physical health concerns. Regardless of etiology, adults with SCD may benefit from interventions that could enhance current function or slow incipient cognitive decline. The objective of this systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, is to examine the benefits of non-pharmacologic intervention (NPI) in persons with SCD. Inclusion criteria were studies of adults aged 55 + with SCD defined using published criteria, receiving NPI or any control condition, with cognitive, behavioural, or psychological outcomes in controlled trails. Published empirical studies were obtained through a standardized search of CINAHL Complete, Cochrane Central Register of Controlled Trials, MEDLINE with Full Text, PsycINFO, and PsycARTICLES, supplemented by a manual retrieval of relevant articles. Study quality and bias was determined using PEDro. Nine studies were included in the review and meta-analysis. A wide range of study quality was observed. Overall, a small effect size was found on cognitive outcomes, greater for cognitive versus other intervention types. The available evidence suggests that NPI may benefit current cognitive function in persons with SCD. Recommendations are provided to improve future trials of NPI in SCD.

Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews

“…Populations. Seventeen reviews reported meta-analytic results for healthy older adults (Table 1), three of which focused specifically on individuals with subjective cognitive complaints (Bhome, Berry, Huntley, & Howard, 2018;Metternich, Kosch, Kriston, Harter, & Hull, 2010;Smart et al, 2017). Four reviews focused on individuals with MCI (Chandler, Parks, Marsiske, Rotblatt, & Smith, 2016;Sherman, Mauser, Nuno, & Sherzai, 2017;Wang et al, 2014).…”

Factors Explaining Language Performance After Training in Elders With and Without Subjective Cognitive Decline

“…Nowadays there is an increasing interest in non-pharmacological intervention effects on older adult cognition. Some studies have shown that cognitive training (CT) is beneficial for older adults’ memory ( Gross et al, 2012 ; Rosi et al, 2017 ) but also for other domains in this population, as for attention ( Rahe et al, 2015 ), working memory, reasoning and language comprehension ( Carretti et al, 2013 ; Karbach and Verhaeghen, 2014 ), processing speed and reasoning ( Willis and Caskie, 2013 ), or executive functions ( Jackson et al, 2012 ; Mowszowski et al, 2016 ); CT is also beneficial for older adults with subjective cognitive decline (SCD) or people with mild cognitive impairment ( Martin et al, 2011 ; Rebok et al, 2014 ; Smart et al, 2017 ).…”

Practical algorithms for managing patients with cognitive impairments

“…По данным C.M. Smart et al, 2017, когнитивный тренинг способствует улучшению высших мозговых функций у пациентов с синдромом субъективных КН, при этом величина эффекта когнитивного тренинга в данной популяции пациентов больше, чем других немедикаментозных стратегий [32].…”