scholarly journals Cognitive training interventions and depression in mild cognitive impairment and dementia: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 49 (5) ◽  
pp. 738-747
Author(s):  
Joyce Y C Chan ◽  
Tak Kit Chan ◽  
Timothy C Y Kwok ◽  
Samuel Y S Wong ◽  
Allen T C Lee ◽  
...  

Abstract Background Depression is common in people with cognitive impairment but the effect of cognitive training in the reduction of depression is still uncertain. Aims The purpose of this paper is to evaluate the effect of cognitive training interventions in the reduction of depression rating scale score in people with cognitive impairment. Methods Literature searches were conducted via OVID databases. Randomized controlled trials (RCTs) evaluated the effect of cognitive training interventions for the reduction of depression rating scale score in people with mild cognitive impairment (MCI) or dementia were included. Mean difference (MD) with 95% confidence interval (CI) was used to combine the results of Geriatric Depression Scale (GDS). Standardized mean difference (SMD) was used to combine the results of different depression rating scales. Subgroup analyses were conducted according to the types of cognitive training and severity of cognitive impairment, i.e. MCI and dementia. Results A total of 2551 people with MCI or dementia were extracted from 36 RCTs. The baseline mean score of GDS-15 was 4.83. Participants received cognitive training interventions had a significant decrease in depression rating scale score than the control group (MD of GDS-15 = -1.30, 95% CI = -2.14–−0.47; and SMD of eight depression scales was −0.54 (95% CI = −0.77–−0.31). In subgroup analyses, the effect size of computerized cognitive training and cognitive stimulation therapy were medium-to-large and statistically significant in the reduction of depression rating scale score. Conclusions Cognitive training interventions show to be a potential treatment to ameliorate depression in people with cognitive impairment.

2019 ◽  
Vol 60 (8) ◽  
pp. e633-e642 ◽  
Author(s):  
Chenchen Yang ◽  
Ami Moore ◽  
Elias Mpofu ◽  
Diana Dorstyn ◽  
Qiwei Li ◽  
...  

Abstract Background and Objectives Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in individuals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research. Research Design and Methods We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to individuals with MCI over the age of 50 were eligible. Our search yielded 10 eligible, independent articles. Results Intervention participants with MCI self-reported, or demonstrated, improved functioning across a range of cognitive (global cognitive function, executive function, processing speed, memory, attention, mood, emotion, motivation, brain cortex, orientation), and physical (gait, balance, mobility) outcomes. Interventions which combined cognitive-physical training were comparable to those which isolated these same elements, in terms of their effects on executive function, processing speed, attention, mood, and cardiorespiratory fitness. Discussion and Implications There is preliminary evidence to support the positive effects of multicomponent interventions to improve cognitive-motor abilities in older adults at risk of developing dementia. The strength of this research evidence is, however, limited. Longitudinal studies are needed to determine whether these effects are maintained over time. The optimal intervention intensity and length also need to be established.


Author(s):  
I Putu Eka Widyadharma ◽  
Eric Hartono Tedyanto ◽  
Anak Agung Ayu Putri Laksmidewi ◽  
I Made Oka Adnyana ◽  
Dewa Putu Gede Purwa Samatra

The most common type of dementia is Alzheimer’s disease (AD). AD is characterized by loss of memory and cognitive impairment. In epidemiological studies, low folate could disturb vitamin B12 absorption, which leads to the inflammatory process, and it explains the association between both vitamins and AD. Authors did a systematic search through PubMed and Embase according to the PRISMA protocol. Authors included studies published in the last 5 years (from 2015 to June 2020). Authors assess the quality of studies using JADAD Scale for randomized-controlled trials. Authors found 426 journals in their search strategy. In the end, 2 studies met the eligibility criteria and were included in this review. These two randomized controlled trials revealed that folic acid improved cognitive function in AD (p<0.05) and mild cognitive impairment (p=0.028). In this systematic review, authors found that daily folic acid supplements could improve cognitive function in patients with AD and mild cognitive impairment. The exact mechanism is unknown, but it is believed that folic acid supplementation improves cognitive function by reducing the levels of peripheral inflammatory cytokines. Daily oral folic acid supplemental (400 µg and 1.2 mg) for 6-12 months improves cognitive function in AD and mild cognitive Impairment.


2020 ◽  
Author(s):  
Hanna Malmberg Gavelin ◽  
Christopher Dong ◽  
Ruth Minkov ◽  
Alex Bahar-Fuchs ◽  
Kathryn A Ellis ◽  
...  

AbstractCombining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k=41, Hedges’ g = 0.22, 95% CI 0.14 to 0.30) and physical function (k=32, g = 0.25, 95% CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.


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