title: Non-pharmacological interventions for adults with mild cognitive impairment and early stage dementia: An updated scoping review.
abstract: The purpose of this scoping review was to examine the science related to non-pharmacological interventions designed to slow decline for older adults with Mild Cognitive Impairment or early-stage dementia. We reviewed 32 unique randomized controlled trials that employed cognitive training (remediation or compensation approaches), physical exercise, or psychotherapeutic interventions that were published before November 2014. Evidence suggests that cognitive training focused on remediation and physical exercise interventions may promote small improvements in selected cognitive abilities. Cognitive training focused on compensation interventions and selected psychotherapeutic interventions may influence how cognitive changes impact daily living. However, confidence in these findings is limited due to methodological limitations. To better assess the value of non-pharmacological interventions for this population, we recommend: (1) adoption of universal criteria for "early stage cognitive decline" among studies, (2) adherence to guidelines for the conceptualization, operationalization, and implementation of complex interventions, (3) consistent characterization of the impact of interventions on daily life, and (4) long-term follow-up of clinical outcomes to assess maintenance and meaningfulness of reported effects over time.
authors.affiliation: Department of Occupational Therapy, School of Health & Rehabilitation Sciences, University of Pittsburgh (Rodakowski, Skidmore), Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Juleen
authors.initials: J
authors.lastname: Rodakowski
authors.affiliation: Health Sciences Library System, University of Pittsburgh (Saghafi), Pittsburgh, PA, USA.
authors.forename: Ester
authors.initials: E
authors.lastname: Saghafi
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh (Butters), Pittsburgh, PA, USA.
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.affiliation: Department of Occupational Therapy, School of Health & Rehabilitation Sciences, University of Pittsburgh (Rodakowski, Skidmore), Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: skidmore@pitt.edu.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Skidmore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology / Q000628:therapy*; D060825:Cognitive Dysfunction / Q000473:pathology / Q000628:therapy*; D003704:Dementia / Q000473:pathology / Q000628:therapy*; D015444:Exercise; D006801:Humans; D013811:Psychotherapeutic Processes; D016032:Randomized Controlled Trials as Topic
keywords: Alzheimer's disease; Behavioral interventions; Cognitive rehabilitation; Dementia; Mild cognitive impairment; Non-pharmacological interventions