Can Sheng1,2, Kun Yang3, Xiaoni Wang1, Hongyan Li4, Taoran Li1, Li Lin1, Yi Liu1, Qin Yang1, Xiaoqi Wang1, Xue Wang5, Yu Sun1, Ying Han1,6,7. 1. Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China. 2. Department of Neurology, the First Hospital of Tsinghua University, Beijing, China. 3. Evidence-Based Medicine Center, Xuanwu Hospital of Capital Medical University, Beijing, China. 4. Department of Neurology, Civil Aviation General Hospital, Beijing, China. 5. Department of Library, Xuanwu Hospital of Capital Medical University, Beijing, China. 6. Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. 7. National Clinical Research Center for Geriatric Disorders, Beijing, China.
Abstract
BACKGROUND: Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer's disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. OBJECTIVE: This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. METHODS: The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration's tool. The Hedges' g of change was analyzed. RESULTS: Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges' g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges' g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges' g = 0.49, p = 0.0003) and psychological well-being (Hedges' g = 0.27, p = 0.03). CONCLUSION: Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.
BACKGROUND: Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer's disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. OBJECTIVE: This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. METHODS: The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration's tool. The Hedges' g of change was analyzed. RESULTS: Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges' g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges' g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges' g = 0.49, p = 0.0003) and psychological well-being (Hedges' g = 0.27, p = 0.03). CONCLUSION: Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.