The effect of integrated care interventions on cognitive decline among older adults: A systematic review and...

To pool existing studies to determine the efficacy of integrated care interventions on mitigating cognitive decline among older adults.

Systematic review with a meta-analysis of randomized controlled trials (RCTs).

Ten databases were searched from their inception to June 18th, 2024, with an update on November 10th, 2024. Standardized mean difference (SMD) was calculated using random effects models. The version 2 of the cochrane tool for assessing the risk of bias in randomized trials (RoB 2) and the Grades of Recommendation, Assessment, Development and Evaluation profiler Guideline Development Tool (GRADEpro GDT) were used to assess the methodological quality and confidence in the cumulative evidence. Funnel plots, egger's test, and begg's test were used to analyze publication bias. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity.

The results of 26 studies showed integrated care interventions had a significant effect on mitigating cognitive decline (SMD=0.54; 95 % CI, 0.34 to 0.73; P<0.001; 26 RCTs, 5615 participants; moderate-quality evidence). Subgroup analysis showed the intervention group was characterized by mean age (60-70 years old), intervention duration between 6 and 12 months, gender (female<50 %), and vertical integration (VI) appeared to be more effective. Sensitivity analysis found the results to be robust.

Integrated care interventions demonstrate potential as an effective approach for addressing cognitive decline in older adults. However, further high-quality studies are necessary to enhance the certainty of evidence.