JMIR Publications

ABSTRACT

Background:

As the global population ages, the prevalence of dementia is expected to rise significantly. To alleviate the burden on healthcare systems and the economy, it is essential to develop effective strategies to enhance cognitive function in older adults. Previous studies have shown that combined non-pharmacological interventions can improve cognition across various domains in older individuals. However, there is no established golden standard for the exact combination and duration of these interventions, which makes it challenging to assess their overall effectiveness.

Objective:

Given the diversity of non-pharmacological multimodal interventions aimed at preventing cognitive decline in older adults with mild cognitive impairment (MCI), this scoping review sought to identify and summarize the characteristics and outcomes of these interventions.

Methods:

This review adhered to the Arksey and O’Malley methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), four electronic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) were searched systematically from inception to 17th April 2024, using specific terms and keywords.

Results:

This review included 42 studies encompassing different combinations of physical training (PT), cognitive training (CT), nutrition intervention (NI), psychosocial intervention (PI), social activities (SA), and electrical stimulation. There is a growing trend towards combining PT and CT for MCI treatment, with additional modalities often added to address various aspects of the condition. Compared to single-modal interventions and usual care, multimodal approaches demonstrated significantly better improvements in cognition domains such as attention, global cognition, executive function, memory, processing speed, and verbal fluency. Technology has been instrumental in delivering these interventions and enhancing the effects of PT and CT. Multimodal interventions also show promise in terms of acceptability and user experience, which can improve treatment adherence.

Conclusions:

However, research is limited regarding the cost-effectiveness and optimal dosage of these interventions, making it difficult to assess the additional benefits of incorporating more modalities. Future research should examine the long-term effects of incorporating multiple modalities, using standardized MCI criteria and outcome measures. Clinical Trial: Open Science Framework; https://osf.io/y4hgk