Advances in Non-Pharmacological Interventions for Subjective Cognitive Decline: A Systematic Review and Meta-Analysis

Article type: Research Article

Authors: Sheng, Can^{a; b; *} | Yang, Kun^c | Wang, Xiaoni^a | Li, Hongyan^d | Li, Taoran^a | Lin, Li^a | Liu, Yi^a | Yang, Qin^a | Wang, Xiaoqi^a | Wang, Xue^{e; *} | Sun, Yu^{a; *} | Han, Ying^{a; f; g; *}

Affiliations: [a] Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China | [b] Department of Neurology, the First Hospital of Tsinghua University, Beijing, China | [c] Evidence-Based Medicine Center, Xuanwu Hospital of Capital Medical University, Beijing, China | [d] Department of Neurology, Civil Aviation General Hospital, Beijing, China | [e] Department of Library, Xuanwu Hospital of Capital Medical University, Beijing, China | [f] Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China | [g] National Clinical Research Center for Geriatric Disorders, Beijing, China

Correspondence: [*] Correspondence to: Ying Han, MD, PhD, Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. Tel.: +86 18515692701; Fax: +86 10 83167306; E-mail: [email protected]; Yu Sun, MD, Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. Tel.: +86 13810728286; E-mail: [email protected]; Xue Wang, MD, Department of Library, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. Tel.: +86 18801300329; E-mail: [email protected]; Can Sheng, MD, Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. Tel.: +86 18701257298; E-mail: [email protected].

Abstract: Background:Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer’s disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. Objective:This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. Methods:The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration’s tool. The Hedges’ g of change was analyzed. Results:Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges’ g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges’ g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges’ g = 0.49, p = 0.0003) and psychological well-being (Hedges’ g = 0.27, p = 0.03). Conclusion:Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.

Keywords: Alzheimer’s disease, cognitive training, intervention, lifestyle, non-pharmacological, psychological, subjective cognitive decline

DOI: 10.3233/JAD-191295

Journal: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 903-920, 2020