The Effects of Cognitive-Based Interventions in Older Adults: A Systematic Review and Meta-Analysis
Abstract
Background: Cognitive-based intervention is divided into three types: Cognitive Stimulation (CS), Cognitive Training (CT), and Cognitive Rehabilitation (CR). This study was conducted to identify systematically the effects of cognitive-based interventions in randomized controlled trials (RCTs) applied to older adults in the following three groups: cognitively healthy, mild cognitive impairment (MCI), and dementia.
Methods: This search was carried out using the Ovid-MEDLINE, EMBASE, Cochrane library, CINAHL, ProQuest, and Korea databases. The effectiveness of the intervention was verified using the CMA 2.0 program.
Results: A total of 54 RCTs were included in systematic reviews and 38 studies were analyzed by meta-analysis. Meta-analysis showed that cognitive-based interventions were effective in improving the cognitive function (SMD=0.39, 95% CI=0.32-0.44) of older adults. The subgroup analysis of cognitive function revealed that CT was the most effective in the cognitively healthy (SMD=0.40, 95% CI=0.33-0.46) and the MCI (SMD=0.45, 95% CI=0.27-0.63) groups, and CS was the most effective in the dementia group (SMD=0.57, 95% CI=0.43-0.70).
Conclusion: In order to improve the cognitive function of older adults in each group, the most effective intervention type needs to be considered first. Evidence on the appropriate type of Cognitive-based intervention will be helpful in nursing practice.
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15. Liu XY, Li L, Xlao JQ, et al (2016). Cognitive training in older adults with mild cognitive im-pairment. Biomed Environ Sci, 29(5):356-64.
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19. Mewborn CM, Lindbergh CA, Miller LS (2017). Cognitive interventions for cognitively healthy, mildly impaired, and mixed samples of older adults: a systematic review and meta-analysis of randomized-controlled trials. Neuropsychol Rev, 27(4):1-37.
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23. Stein DJ, Phillips KA, Bolton D, et al (2010). What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychol Med, 40(11):1759-1765.
24. Higgins JPT, Savovic J, Page MJ, et al (2016). Revised Cochrane risk of bias tool for random-ized trials (RoB 2.0) [Internet]. Bristol: Authors; [cited 2018 November 29]. https://sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/archive-rob-2-0-2016
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27. Park SK, Hwang YS, Oh BT, et al (2017). The relationship between socioeconomic vulnerability and cognitive impairment among aged people in korea. Korean Journal of Clinical Geriatrics, 18(2):74-81.
28. Wolinsky FD, Mahncke HW, Kosinski M, et al (2009). The active cognitive training trial and pre-dicted medical expenditures. BMC Health Serv Res, 9:109.
29. Ryu SH (2018). The clinical significance of cogni-tive interventions for the patients with mild cog-nitive impairment. Journal of Korean Neuropsychiatric Association, 57(1):23-29.
30. Blazer DG (2003). Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci, 58(3):249-65.
31. Lohman MC, Rebok GW, Spira AP, et al (2013). Depressive symptoms and memory performance among older adults: results from the ACTIVE memory training intervention. J Aging Health. 25(0): 10.
2. Ertel KA, Glymour MM, Berkman LF (2008). Effects of social integration on preserving memory function in a nationally representative US elderly population. Am J Public Health, 98(7):1215-1220.
3. Baik OM (2015). The Trajectory and its predictors of the change of cognitive functioning among the elderly -A latent growth curve analysis. Locality and Globality: Korean Journal of Social Sciences, 39(3):79-103.
4. Pettersson AF, Olsson E, Wahlund LO (2005). Motor function in subjects with mild cognitive impairment and early alzheimer's disease. Dement Geriatr Cogn Disord, 19(5-6):299-304.
5. Clare L, Woods RT, Moniz Cook ED, et al (2003). Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular de-mentia (Review). Cochrane Database Syst Rev, (4):CD003260.
6. Valenzuela M, Sachdev P (2009). Can cognitive exercise prevent the onset of dementia? System-atic review of randomized clinical trials with lon-gitudinal follow-up. Am J Geriatr Psychiatry, 17(3):179-87.
7. Hsu WY, Ku Y, Zanto TP, et al (2015). Effects of noninvasive brain stimulation on cognitive func-tion in healthy aging and Alzheimer's disease: a systematic review and meta-analysis. Neurobiol Ag-ing, 36(8):2348-59.
8. Buckley JS, Salpeter SR (2015). A risk-benefit as-sessment of dementia medications: systematic review of the evidence. Drugs Aging, 32(6):453-467.
9. Teixeira CVL, Gobbi LTB, Corazza DI, et al (2012). Non- pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI). Arch Gerontol and Geriatr, 54(1):175-80.
10. Woods B, Aguirre E, Spector A, Orrell M (2012). Cognitive stimulation to improve cognitive func-tioning in people with dementia. Cochrane Database Syst Rev, 15;(2):CD005562.
11. Durlak JA, DuPre EP (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol, 41(3-4):327-50.
12. Tranter LJ, Koutstaal W (2008). Age and flexible thinking: An experimental demonstration of the beneficial effects of increased cognitively stimu-lating activity on fluid intelligence in healthy older adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 15(2):184-207.
13. Kim HY. Effects of cognitive control training on brain function in older adults [PhD thesis]. Yonsei University, Seoul;2012.
14. Tsolaki M, Kounti F, Agogiatou C, et al (2011). Effectiveness of nonpharmacological approaches in patients with mild cognitive impairment. Neu-rodegener Dis, 8:138-45.
15. Liu XY, Li L, Xlao JQ, et al (2016). Cognitive training in older adults with mild cognitive im-pairment. Biomed Environ Sci, 29(5):356-64.
16. Schmitter-Edgecombe M, Dyck, DG (2014). Cognitive rehabilitation multi-family group inter-vention for individuals with mild cognitive im-pairment and their care-partners. J Int Neuropsychol Soc, 20(9):897-908.
17. Mantzoukas S (2008). A review of evidence-based practice, nursing research and reflection: levelling the hierarchy. J Clin Nurs, 17(2):214-23.
18. Kim SH, Kim BK (2018). Effects of cognitive-based interventions of older adults with mild cognitive impairment: A systematic preview and meta-analysis. Korean Journal of Adult Nursing, 30(4):347-361.
19. Mewborn CM, Lindbergh CA, Miller LS (2017). Cognitive interventions for cognitively healthy, mildly impaired, and mixed samples of older adults: a systematic review and meta-analysis of randomized-controlled trials. Neuropsychol Rev, 27(4):1-37.
20. Kim SH. A systematic review and meta-analysis on the effectiveness of cognition-based interven-tions for older adults with dementia [PhD thesis]. Chung-ang University, Seoul;2018.
21. Jo MJ (2009). The prevalence and risk Factors of dementia in the Korean elderly. Health and welfare policy forum, 156:43-48.
22. Petersen RC, Morris JC. (2005). Mild cognitive impairment as a clinical entity and treatment tar-get. Arch Neurol, 62(7):1160-3.
23. Stein DJ, Phillips KA, Bolton D, et al (2010). What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychol Med, 40(11):1759-1765.
24. Higgins JPT, Savovic J, Page MJ, et al (2016). Revised Cochrane risk of bias tool for random-ized trials (RoB 2.0) [Internet]. Bristol: Authors; [cited 2018 November 29]. https://sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/archive-rob-2-0-2016
25. Higgins JPT, Green S (2011). Cochrane hand-book for systematic reviews of interventions ver-sion 5.1.0 [Internet]. London (UK): The Cochrane Collaboration; [cited 2018 November 29]. Available from: http://handbook.cochrane.org
26. Cooper, Harris M (1998). Research synthesis and meta-analysis: a step-by-step approach. Califor-nia (US): SAGE Publications. p. 167-217.
27. Park SK, Hwang YS, Oh BT, et al (2017). The relationship between socioeconomic vulnerability and cognitive impairment among aged people in korea. Korean Journal of Clinical Geriatrics, 18(2):74-81.
28. Wolinsky FD, Mahncke HW, Kosinski M, et al (2009). The active cognitive training trial and pre-dicted medical expenditures. BMC Health Serv Res, 9:109.
29. Ryu SH (2018). The clinical significance of cogni-tive interventions for the patients with mild cog-nitive impairment. Journal of Korean Neuropsychiatric Association, 57(1):23-29.
30. Blazer DG (2003). Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci, 58(3):249-65.
31. Lohman MC, Rebok GW, Spira AP, et al (2013). Depressive symptoms and memory performance among older adults: results from the ACTIVE memory training intervention. J Aging Health. 25(0): 10.
| Files | ||
| Issue | Vol 51 No 1 (2022) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i1.8286 | |
| Keywords | ||
| Older adults Cognitive Education Rehabilitation Systematic review | ||
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How to Cite
1.
Yun S, Ryu S. The Effects of Cognitive-Based Interventions in Older Adults: A Systematic Review and Meta-Analysis. Iran J Public Health. 2022;51(1):1-11.
