MNJ (Malang Neurology Journal)
Vol. 11 No. 1 (2025): January

UNRAVELING THE BEST NON-PHARMACOLOGICAL INTERVENTIONS FOR COGNITIVE FUNCTION AND DEPRESSION IN ELDERLY WITH COGNITIVE IMPAIRMENT: A NETWORK META-ANALYSIS

Masykur, Umar Jundullah (Unknown)
Janet, Karensa Abby (Unknown)
Putri, Dwi Sandhi Aulia Pramesti (Unknown)
Jatmiko, Sarazata Indi Rozaany (Unknown)
Kurniawan, Shahdevi Nandar (Unknown)



Article Info

Publish Date
01 Feb 2025

Abstract

Background: Emerging evidence suggests that non-pharmacological interventions can improve cognitive function and alleviate depressive symptoms in elderly individuals with cognitive impairment. However, the comparative effectiveness of these interventions remains unclear. Objective: This network meta-analysis (NMA) compares the efficacy of eight non-pharmacological interventions—Virtual Reality (VR) or Exergame, Computerized Cognitive Training (CCT), Mind-Body Exercise (MBE), Physical Exercise, Music or Art Therapy, Health Education, Treatment as Usual (TAU), and a Control group (no intervention, placebo)—on cognitive function and depression in elderly individuals with cognitive impairment. Methods: Randomized controlled trials (RCTs) published up to August 10, 2024, were systematically searched in Web of Science, PubMed, Embase, and Cochrane Library databases. A Frequentist random-effects network meta-analysis was conducted using R. Results: Total 46 RCTs with 3043 participants were included. The pooled results showed that CCT (SMD = 2.33, 95% CI [1.34, 3.32]), Physical Exercise (SMD = 2.24, 95% CI [1.24, 3.23]), and VR or Exergame (SMD = 2.09, 95% CI [1.10, 3.08]) significantly improved global cognition. VR or Exergame was also effective in enhancing attention (SMD = -3.49, 95% CI [-6.85, -0.14]), executive function (SMD = -75.54 (95% CI [-118.24, -33.04]), and reducing depressive symptoms (SMD = -2.62, 95% CI [-4.08, -1.15]). Conclusion: This NMA highlights the superior efficacy of CCT, Physical Exercise, and VR or Exergame in improving global cognition in elderly individuals with cognitive impairment. Additionally, VR or Exergame is particularly effective for enhancing attention, executive function, and reducing depressive symptoms, suggesting it should be integrated into cognitive rehabilitation programs.

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Journal Info

Abbrev

MNJ

Publisher

Subject

Neuroscience

Description

Malang Neurology Journal is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short ...