Does Multidomain Intervention Reduce The Risk Of Developing Dementia In MCI Patients?

Abstract

Background: Mild cognitive impairment (MCI) affects about 12% to 36% of older adults and the mean annual conversion rate of MCI to dementia is approximately 10%. MCI provides an optimal window in preventing the progression to dementia and a consensus has emerged about non-drug treatments being a viable alternative to drug treatments. Objectives: The primary objective of this review is to quantify the overall effect of multidomain interventions on the global cognitive function in older adults with MCI; the secondary objective is to show the superiority of a multidomain intervention over single physical or cognitive intervention. Methods: Databases including PubMed, Medline and the Cochrane Library were used to search for studies that reported effects of non-drug treatments in older adults with MCI. Exercise interventions, cognitive interventions, combined interventions and multidomain interventions of all selected studies were summarized and effect sizes of different interventions were calculated. Results: The results showed that physical activity improved cognitive function and reduced global cognitive decline whereas cognitive interventions improved executive functioning, attention, memory and other cognitive domains. Combined interventions (physical activity + cognitive intervention) demonstrated superiority over single physical exercise on memory, global cognition and executive function and over single cognitive intervention on memory and global cognition. Multidomain interventions (intended as nutritional guidance, exercise, cognitive training, social stimulation and management of metabolic/vascular risk factors) reduced the risk of developing mild cognitive impairment or the composite of mild cognitive impairment and probable dementia and improved cognitive function. Conclusion: Multidomain interventions have demonstrated a limited superiority over the single exercise/cognitive intervention on cognitive functions. These results are encouraging but more evidence is needed to determine the optimal exposure to the multidomain intervention and whether improvements are maintained over time.