Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China.
Int J Geriatr Psychiatry. 2020 Jun;35(6):591-600. doi: 10.1002/gps.5289. Epub 2020 Mar 12.
To compare the effects of non-pharmacological therapies (NPTs) on improving the cognition of people with mild cognitive impairment (MCI) by performing a Bayesian network meta-analysis (NMA).
We searched eight databases for potentially eligible studies. Physical exercise (PE), cognitive stimulation (CS), cognitive training (CT), cognitive rehabilitation (CR), musical therapy (MT) and multi-domain interventions (MI). Pairwise meta-analyses were performed by estimating the weighted mean differences with 95% confidence interval (CI) for mini-mental state examination. The NMA was undertaken to compare different interventions.
CS, PE, MI, MT and CT may all be effective in improving the cognition of patients with MCI. CR was unable to show a significant efficacy. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR.
NPT has great potential to improve the cognition of the elderly with MCI. CS has the highest probability of being the optimal NPT. However, the result should be interpreted with cautions given the limited number and small samples of included randomized controlled trials (RCTs) in this field, large diversity existing in different study designs and potential risk of bias. Future RCTs with high quality and large sample sizes are required to confirm our results.
NPT, as a whole definition, has great potential to improve the cognition of the elderly with MCI. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR.
通过贝叶斯网状荟萃分析（NMA）比较非药物疗法（NPTs）对改善轻度认知障碍（MCI）患者认知的效果。
我们检索了八个数据库以寻找潜在的合格研究。包括身体锻炼（PE）、认知刺激（CS）、认知训练（CT）、认知康复（CR）、音乐治疗（MT）和多领域干预（MI）。通过估计加权均数差值并结合 95%置信区间（CI）对简易精神状态检查进行了两两荟萃分析。进行 NMA 以比较不同的干预措施。
CS、PE、MI、MT 和 CT 可能都能有效改善 MCI 患者的认知。CR 未能显示出显著的疗效。我们的 NMA 排名结果表明，六种 NPT 的有效性从最佳到最差的排名如下：CS、PE、MI、MT、CT 和 CR。
NPT 具有改善 MCI 老年患者认知的巨大潜力。CS 最有可能成为最佳的 NPT。然而，鉴于该领域纳入的随机对照试验（RCT）数量有限且样本量较小、不同研究设计之间存在较大差异以及存在潜在偏倚风险，该结果应谨慎解释。需要进行高质量、大样本量的未来 RCT 来证实我们的结果。
作为一个整体定义，NPT 具有改善 MCI 老年患者认知的巨大潜力。我们的 NMA 排名结果表明，六种 NPT 的有效性从最佳到最差的排名如下：CS、PE、MI、MT、CT 和 CR。
