Research progress of non-pharmacological intervention therapy for mild cognitive impairment_West China Medical Journal

Authors：

SONG Jiao ¹ , WU Yan ² , PENG Tao ³ , DONG Birong ¹ ,  LI Ying ¹

1. Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Chengdu Jinxin Geriatrics Hospital, Chengdu, Sichuan 610011, P. R. China;
3. Chengdu Jinxin Huaxiang Pension Service Co., Ltd, Chengdu, Sichuan 610011, P. R. China;

Corresponding author：

LI Ying, Email: yingli@scu.edu.cn

Keywords：

Mild cognitive impairment; non-pharmacological therapy; exercise intervention; cognitive intervention; brain stimulation therapy

DOI：

10.7507/1002-0179.202201091

Video：

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Due to the aging population intensifies, the number of people suffering from mild cognitive impairment (MCI) or dementia is expected to increase, which may lead to a series of public health and social health problems. In the absence of drugs to prevent the transformation of MCI into dementia, it is urgent to find effective non-pharmacological therapies to delay the progress of cognitive impairment. This article will review the diagnosis of MCI and the research progress of non-pharmacological therapies, focusing on the non-pharmacological therapies related to MCI in recent years, including exercise intervention, cognitive intervention, physical and mental exercise, dietary intervention, electroacupuncture, repeated transcranial magnetic stimulation, and multi-component intervention, in order to provide an effective treatment for preventing or delaying the progression of MCI to dementia.

Citation： SONG Jiao, WU Yan, PENG Tao, DONG Birong, LI Ying. Research progress of non-pharmacological intervention therapy for mild cognitive impairment. West China Medical Journal, 2023, 38(3): 465-469. doi: 10.7507/1002-0179.202201091 Copy

1.	Karssemeijer EGA, Aaronson JA, Bossers WJ, et al. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: a meta-analysis. Ageing Res Rev, 2017, 40: 75-83.
2.	Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol, 1999, 56(3): 303-308.
3.	Qarni T, Salardini A. A multifactor approach to mild cognitive impairment. Semin Neurol, 2019, 39(2): 179-187.
4.	Larson EB. Guideline: in patients with mild cognitive impairment, the AAN recommends regular exercise and no drugs or supplements. Ann Intern Med, 2018, 168(8): JC38.
5.	Wei L, Chai Q, Chen J, et al. The impact of Tai Chi on cognitive rehabilitation of elder adults with mild cognitive impairment: a systematic review and meta-analysis. Disabil Rehabil, 2022, 44(11): 2197-2206.
6.	Anderson ND. State of the science on mild cognitive impairment (MCI). CNS Spectr, 2019, 24(1): 78-87.
7.	Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology, 2018, 90(3): 126-135.
8.	中国痴呆与认知障碍诊治指南写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018 中国痴呆与认知障碍诊治指南(五): 轻度认知障碍的诊断与治疗. 中华医学杂志, 2018, 98(17): 1294-1301.
9.	Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med, 2004, 256(3): 183-194.
10.	Breton A, Casey D, Arnaoutoglou NA. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: meta-analysis of diagnostic accuracy studies. Int J Geriatr Psychiatry, 2019, 34(2): 233-242.
11.	O’Caoimh R, Timmons S, Molloy DW. Screening for mild cognitive impairment: comparison of “MCI specific” screening instruments. J Alzheimers Dis, 2016, 51(2): 619-629.
12.	Nuzum H, Stickel A, Corona M, et al. Potential benefits of physical activity in MCI and dementia. Behav Neurol, 2020, 2020: 7807856.
13.	Law CK, Lam FM, Chung RC, et al. Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: a systematic review. J Physiother, 2020, 66(1): 9-18.
14.	Tsai CL, Pai MC, Ukropec J, et al. Distinctive effects of aerobic and resistance exercise modes on neurocognitive and biochemical changes in individuals with mild cognitive impairment. Curr Alzheimer Res, 2019, 16(4): 316-332.
15.	Zheng G, Xia R, Zhou W, et al. Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med, 2016, 50(23): 1443-1450.
16.	Choi W, Lee S. Ground kayak paddling exercise improves postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment: a randomized controlled trial. Med Sci Monit, 2018, 24: 3909-3915.
17.	Bisbe M, Fuente-Vidal A, López E, et al. Comparative cognitive effects of choreographed exercise and multimodal physical therapy in older adults with amnestic mild cognitive impairment: randomized clinical trial. J Alzheimers Dis, 2020, 73(2): 769-783.
18.	Biazus-Sehn LF, Schuch FB, Firth J, et al. Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: a systematic review and meta-analysis. Arch Gerontol Geriatr, 2020, 89: 104048.
19.	Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev, 2013, 2013(6): CD003260.
20.	Sherman DS, Mauser J, Nuno M, et al. The efficacy of cognitive intervention in mild cognitive impairment (MCI): a meta-analysis of outcomes on neuropsychological measures. Neuropsychol Rev, 2017, 27(4): 440-484.
21.	Sherman DS, Durbin KA, Ross DM. Meta-analysis of memory-focused training and multidomain interventions in mild cognitive impairment. J Alzheimers Dis, 2020, 76(1): 399-421.
22.	Peng Z, Jiang H, Wang X, et al. The efficacy of cognitive training for elderly Chinese individuals with mild cognitive impairment. Biomed Res Int, 2019, 2019: 4347281.
23.	Djabelkhir L, Wu YH, Vidal JS, et al. Computerized cognitive stimulation and engagement programs in older adults with mild cognitive impairment: comparing feasibility, acceptability, and cognitive and psychosocial effects. Clin Interv Aging, 2017, 12: 1967-1975.
24.	Hill NT, Mowszowski L, Naismith SL, et al. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry, 2017, 174(4): 329-340.
25.	Butler M, McCreedy E, Nelson VA, et al. Does cognitive training prevent cognitive decline?: a systematic review. Ann Intern Med, 2018, 168(1): 63-68.
26.	Xia R, Qiu P, Lin H, et al. The effect of traditional chinese mind-body exercise (Baduanjin) and brisk walking on the dorsal attention network in older adults with mild cognitive impairment. Front Psychol, 2019, 10: 2075.
27.	Park H, Park JH, Na HR, et al. Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment: a randomized controlled clinical study. J Clin Med, 2019, 8(7): 940.
28.	Zou L, Loprinzi PD, Yeung AS, et al. The beneficial effects of mind-body exercises for people with mild cognitive impairment: a systematic review with meta-analysis. Arch Phys Med Rehabil, 2019, 100(8): 1556-1573.
29.	Fortier M, Castellano CA, St-Pierre V, et al. A ketogenic drink improves cognition in mild cognitive impairment: results of a 6-month RCT. Alzheimers Dement, 2021, 17(3): 543-552.
30.	Yang T, Wang H, Xiong Y, et al. Vitamin D supplementation improves cognitive function through reducing oxidative stress regulated by telomere length in older adults with mild cognitive impairment: a 12-month randomized controlled trial. J Alzheimers Dis, 2020, 78(4): 1509-1518.
31.	Andrieu S, Guyonnet S, Coley N, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol, 2017, 16(5): 377-389.
32.	He W, Li M, Han X, et al. Acupuncture for mild cognitive impairment and dementia: an overview of systematic reviews. Front Aging Neurosci, 2021, 13: 647629.
33.	Kim H, Kim HK, Kim SY, et al. Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and meta-analysis. BMC Complement Altern Med, 2019, 19(1): 13.
34.	Lissek V, Suchan B. Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev, 2021, 122: 143-164.
35.	Ghafoor U, Lee JH, Hong KS, et al. Effects of acupuncture therapy on MCI patients using functional near-infrared spectroscopy. Front Aging Neurosci, 2019, 11: 237.
36.	Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet, 2015, 385(9984): 2255-2263.
37.	Bae S, Lee S, Lee S, et al. The effect of a multicomponent intervention to promote community activity on cognitive function in older adults with mild cognitive impairment: a randomized controlled trial. Complement Ther Med, 2019, 42: 164-169.
38.	Straubmeier M, Behrndt EM, Seidl H, et al. Non-pharmacological treatment in people with cognitive impairment. Dtsch Arztebl Int, 2017, 114(48): 815-821.

1. Karssemeijer EGA, Aaronson JA, Bossers WJ, et al. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: a meta-analysis. Ageing Res Rev, 2017, 40: 75-83.
2. Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol, 1999, 56(3): 303-308.
3. Qarni T, Salardini A. A multifactor approach to mild cognitive impairment. Semin Neurol, 2019, 39(2): 179-187.
4. Larson EB. Guideline: in patients with mild cognitive impairment, the AAN recommends regular exercise and no drugs or supplements. Ann Intern Med, 2018, 168(8): JC38.
5. Wei L, Chai Q, Chen J, et al. The impact of Tai Chi on cognitive rehabilitation of elder adults with mild cognitive impairment: a systematic review and meta-analysis. Disabil Rehabil, 2022, 44(11): 2197-2206.
6. Anderson ND. State of the science on mild cognitive impairment (MCI). CNS Spectr, 2019, 24(1): 78-87.
7. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology, 2018, 90(3): 126-135.
8. 中国痴呆与认知障碍诊治指南写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018 中国痴呆与认知障碍诊治指南(五): 轻度认知障碍的诊断与治疗. 中华医学杂志, 2018, 98(17): 1294-1301.
9. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med, 2004, 256(3): 183-194.
10. Breton A, Casey D, Arnaoutoglou NA. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: meta-analysis of diagnostic accuracy studies. Int J Geriatr Psychiatry, 2019, 34(2): 233-242.
11. O’Caoimh R, Timmons S, Molloy DW. Screening for mild cognitive impairment: comparison of “MCI specific” screening instruments. J Alzheimers Dis, 2016, 51(2): 619-629.
12. Nuzum H, Stickel A, Corona M, et al. Potential benefits of physical activity in MCI and dementia. Behav Neurol, 2020, 2020: 7807856.
13. Law CK, Lam FM, Chung RC, et al. Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: a systematic review. J Physiother, 2020, 66(1): 9-18.
14. Tsai CL, Pai MC, Ukropec J, et al. Distinctive effects of aerobic and resistance exercise modes on neurocognitive and biochemical changes in individuals with mild cognitive impairment. Curr Alzheimer Res, 2019, 16(4): 316-332.
15. Zheng G, Xia R, Zhou W, et al. Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med, 2016, 50(23): 1443-1450.
16. Choi W, Lee S. Ground kayak paddling exercise improves postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment: a randomized controlled trial. Med Sci Monit, 2018, 24: 3909-3915.
17. Bisbe M, Fuente-Vidal A, López E, et al. Comparative cognitive effects of choreographed exercise and multimodal physical therapy in older adults with amnestic mild cognitive impairment: randomized clinical trial. J Alzheimers Dis, 2020, 73(2): 769-783.
18. Biazus-Sehn LF, Schuch FB, Firth J, et al. Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: a systematic review and meta-analysis. Arch Gerontol Geriatr, 2020, 89: 104048.
19. Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev, 2013, 2013(6): CD003260.
20. Sherman DS, Mauser J, Nuno M, et al. The efficacy of cognitive intervention in mild cognitive impairment (MCI): a meta-analysis of outcomes on neuropsychological measures. Neuropsychol Rev, 2017, 27(4): 440-484.
21. Sherman DS, Durbin KA, Ross DM. Meta-analysis of memory-focused training and multidomain interventions in mild cognitive impairment. J Alzheimers Dis, 2020, 76(1): 399-421.
22. Peng Z, Jiang H, Wang X, et al. The efficacy of cognitive training for elderly Chinese individuals with mild cognitive impairment. Biomed Res Int, 2019, 2019: 4347281.
23. Djabelkhir L, Wu YH, Vidal JS, et al. Computerized cognitive stimulation and engagement programs in older adults with mild cognitive impairment: comparing feasibility, acceptability, and cognitive and psychosocial effects. Clin Interv Aging, 2017, 12: 1967-1975.
24. Hill NT, Mowszowski L, Naismith SL, et al. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry, 2017, 174(4): 329-340.
25. Butler M, McCreedy E, Nelson VA, et al. Does cognitive training prevent cognitive decline?: a systematic review. Ann Intern Med, 2018, 168(1): 63-68.
26. Xia R, Qiu P, Lin H, et al. The effect of traditional chinese mind-body exercise (Baduanjin) and brisk walking on the dorsal attention network in older adults with mild cognitive impairment. Front Psychol, 2019, 10: 2075.
27. Park H, Park JH, Na HR, et al. Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment: a randomized controlled clinical study. J Clin Med, 2019, 8(7): 940.
28. Zou L, Loprinzi PD, Yeung AS, et al. The beneficial effects of mind-body exercises for people with mild cognitive impairment: a systematic review with meta-analysis. Arch Phys Med Rehabil, 2019, 100(8): 1556-1573.
29. Fortier M, Castellano CA, St-Pierre V, et al. A ketogenic drink improves cognition in mild cognitive impairment: results of a 6-month RCT. Alzheimers Dement, 2021, 17(3): 543-552.
30. Yang T, Wang H, Xiong Y, et al. Vitamin D supplementation improves cognitive function through reducing oxidative stress regulated by telomere length in older adults with mild cognitive impairment: a 12-month randomized controlled trial. J Alzheimers Dis, 2020, 78(4): 1509-1518.
31. Andrieu S, Guyonnet S, Coley N, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol, 2017, 16(5): 377-389.
32. He W, Li M, Han X, et al. Acupuncture for mild cognitive impairment and dementia: an overview of systematic reviews. Front Aging Neurosci, 2021, 13: 647629.
33. Kim H, Kim HK, Kim SY, et al. Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and meta-analysis. BMC Complement Altern Med, 2019, 19(1): 13.
34. Lissek V, Suchan B. Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev, 2021, 122: 143-164.
35. Ghafoor U, Lee JH, Hong KS, et al. Effects of acupuncture therapy on MCI patients using functional near-infrared spectroscopy. Front Aging Neurosci, 2019, 11: 237.
36. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet, 2015, 385(9984): 2255-2263.
37. Bae S, Lee S, Lee S, et al. The effect of a multicomponent intervention to promote community activity on cognitive function in older adults with mild cognitive impairment: a randomized controlled trial. Complement Ther Med, 2019, 42: 164-169.
38. Straubmeier M, Behrndt EM, Seidl H, et al. Non-pharmacological treatment in people with cognitive impairment. Dtsch Arztebl Int, 2017, 114(48): 815-821.

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