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Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression
J D Huntley1, R L Gould1, K Liu1
1Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
BMJ Open
|April 4, 2015
Summary
Cognitive stimulation (CS) improves general cognition in dementia patients, particularly on the MMSE. However, benefits on the ADAS-Cog may not be clinically significant and require further research.
Area of Science:
- Neurology
- Gerontology
- Cognitive Science
Background:
- Dementia significantly impairs general cognition.
- Effective non-pharmacological interventions are crucial for dementia care.
- Cognitive interventions aim to mitigate cognitive decline.
Purpose of the Study:
- To systematically review the efficacy of different cognitive interventions in improving general cognition in individuals with dementia.
- To analyze the impact of cognitive stimulation (CS), cognitive training (CT), cognitive rehabilitation (CR), and mixed CT and stimulation (MCTS).
Main Methods:
- Systematic review and random-effects meta-analyses of 33 randomized controlled trials.
- Interventions categorized into CS, CT, CR, and MCTS.
- Analyses compared outcomes for active and non-active control groups.
Main Results:
- Cognitive stimulation (CS) showed significant positive effects on the Mini-Mental State Examination (MMSE) compared to both non-active and active controls.
- CS also demonstrated a significant benefit on the Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog).
- Cognitive training (CT) and MCTS did not yield significant improvements in general cognition; insufficient CR studies for analysis.
Conclusions:
- Cognitive stimulation (CS) is effective in improving MMSE and ADAS-Cog scores in dementia patients.
- Clinical significance of CS benefits on ADAS-Cog is questionable.
- Challenges in blinding and placebo controls complicate comparisons with drug treatments.
Keywords:
GERIATRIC MEDICINE
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