The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures

Sherman, Dale; Mauser, Justin; Nuño, Miriam A; Sherzai, Dean

doi:10.1007/s11065-017-9363-3

Cited by 218 publications

(199 citation statements)

References 142 publications

(167 reference statements)

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“…One low‐quality, exploratory study evaluated cognitive rehabilitation for improving cognitive impairment in PD patients receiving computer‐based cognitive training; some significant effects were reported. Because of the exploratory character of the study and the small sample size, the efficacy conclusion is “ insufficient evidence .” Because of the limited data available for MCI in PD, the practice implication is “ investigational .” Because of the lack of safety data, there is “ insufficient evidence ” to conclude on the safety of cognitive rehabilitation for cognitive impairment in PD.…”

Section: Results and Conclusionmentioning

confidence: 99%

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Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

et al. 2019

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Objective To update evidence‐based medicine recommendations for treating nonmotor symptoms in Parkinson's disease (PD). Background The International Parkinson and Movement Disorder Society Evidence‐Based Medicine Committee's recommendations for treatments of PD were first published in 2002, updated in 2011, and now updated again through December 31, 2016. Methods Level I studies testing pharmacological, surgical, or nonpharmacological interventions for the treatment of nonmotor symptoms in PD were reviewed. Criteria for inclusion and quality scoring were as previously reported. The disorders covered were a range of neuropsychiatric symptoms, autonomic dysfunction, disorders of sleep and wakefulness, pain, fatigue, impaired olfaction, and ophthalmologic dysfunction. Clinical efficacy, implications for clinical practice, and safety conclusions are reported. Results A total of 37 new studies qualified for review. There were no randomized controlled trials that met inclusion criteria for the treatment of anxiety disorders, rapid eye movement sleep behavior disorder, excessive sweating, impaired olfaction, or ophthalmologic dysfunction. We identified clinically useful or possibly useful interventions for the treatment of depression, apathy, impulse control and related disorders, dementia, psychosis, insomnia, daytime sleepiness, drooling, orthostatic hypotension, gastrointestinal dysfunction, urinary dysfunction, erectile dysfunction, fatigue, and pain. There were no clinically useful interventions identified to treat non‐dementia‐level cognitive impairment. Conclusions The evidence base for treating a range of nonmotor symptoms in PD has grown substantially in recent years. However, treatment options overall remain limited given the high prevalence and adverse impact of these disorders, so the development and testing of new treatments for nonmotor symptoms in PD remains a top priority. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Results and Conclusionmentioning

confidence: 99%

“…Because of the limited data available for MCI in PD, 34 the practice implication is "investigational." Because of the lack of safety data, 34,89 there is "insufficient evidence" to conclude on the safety of cognitive rehabilitation for cognitive impairment in PD.…”

Section: R E a T M E N T O F T H E N O N M O T O R S Y M P T O M S Imentioning

confidence: 99%

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

et al. 2019

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“…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). Ten reviews focused on people with dementia (Alves et al, 2013;Folkerts, Roheger, Franklin, Middelstadt, & Kalbe, 2017;Huntley, Gould, Liu, Smith, & Howard, 2015;Kim et al, 2017;Lee et al, 2019;P.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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

et al. 2020

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Cognition-oriented treatmentscommonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulationare promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of cognition-oriented treatments on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR). We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (mean Hedges' g = 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (mean Hedges' g = 0.40, range 0.32-0.60, five reviews), and dementia (mean Hedges' g = 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (mean Hedges' g = 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of cognition-oriented treatments improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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“…Six were classified as mixed COTs (Chandler et al, 2016;Lee et al, 2019;P. Leung et al, 2017;Rogers et al, 2018;Sherman et al, 2017;Yang et al, 2018), one of which focused specifically on COTs with caregiver involvement (P. Leung et al, 2017).…”

Section: Interventionsmentioning

confidence: 99%

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Gavelin¹,

Lampit²,

Hallock³

et al. 2019

Preprint

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Cognition-oriented treatments (COTs) -commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation -are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of COTs on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by AMSTAR 2. We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (Hedge's g 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (Hedge's g 0.40, range 0.32-0.60, five reviews), and dementia (Hedge's g 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (Hedge's g 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of COTs improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures

Cited by 218 publications

References 142 publications

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

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

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

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