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Article type: Research Article
Authors: Sherman, Dale S.a; b; * | Durbin, Kelly A.a; c | Ross, David M.a; d
Affiliations: [a] Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA | [b] Rossier School of Education, University of Southern California, Los Angeles, CA, USA | [c] Department of Psychology, University of Southern California, Los Angeles, CA, USA | [d] Department of Psychology, Loma Linda University, Loma Linda, CA, USA
Correspondence: [*] Correspondence to: Dale S. Sherman, Department of Physical Medical & Rehabilitation, Cedars-Sinai Medical Center, 444 S. San Vicente Blvd., Suite 103, Los Angeles, CA 90048, USA. Tel.: +1 323 839 7231; E-mail: [email protected].; E-mail: [email protected].
Abstract: Background:Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention. Objective:A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions. Methods:A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions. Results:We found significant, large effects for memory-focused training (Hedges’ g observed = 0.947; 95% CI [–1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges’ g observed = 0.420; 95% CI [–0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain. Conclusion:Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
Keywords: Cognitive dysfunction, cognitive remediation, meta-analysis, neuropsychology, rehabilitation
DOI: 10.3233/JAD-200261
Journal: Journal of Alzheimer's Disease, vol. 76, no. 1, pp. 399-421, 2020
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