title: Non-Pharmacologic Interventions for Older Adults with Subjective Cognitive Decline: Systematic Review, Meta-Analysis, and Preliminary Recommendations.
abstract: In subjective cognitive decline (SCD), older adults present with concerns about self-perceived cognitive decline but are found to have clinically normal function. However, a significant proportion of those adults are subsequently found to develop mild cognitive impairment, Alzheimer's dementia or other neurocognitive disorder. In other cases, SCD may be associated with mood, personality, and physical health concerns. Regardless of etiology, adults with SCD may benefit from interventions that could enhance current function or slow incipient cognitive decline. The objective of this systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, is to examine the benefits of non-pharmacologic intervention (NPI) in persons with SCD. Inclusion criteria were studies of adults aged 55 + with SCD defined using published criteria, receiving NPI or any control condition, with cognitive, behavioural, or psychological outcomes in controlled trails. Published empirical studies were obtained through a standardized search of CINAHL Complete, Cochrane Central Register of Controlled Trials, MEDLINE with Full Text, PsycINFO, and PsycARTICLES, supplemented by a manual retrieval of relevant articles. Study quality and bias was determined using PEDro. Nine studies were included in the review and meta-analysis. A wide range of study quality was observed. Overall, a small effect size was found on cognitive outcomes, greater for cognitive versus other intervention types. The available evidence suggests that NPI may benefit current cognitive function in persons with SCD. Recommendations are provided to improve future trials of NPI in SCD.
authors.affiliation: Department of Psychology, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada. csmart@uvic.ca.|Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada. csmart@uvic.ca.
authors.forename: Colette M
authors.initials: CM
authors.lastname: Smart
authors.affiliation: Department of Psychology, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Karr
authors.affiliation: Department of Psychology, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
authors.forename: Corson N
authors.initials: CN
authors.lastname: Areshenkoff
authors.affiliation: Brooklyn College and The Graduate Center of The City University of New York, New York, NY, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Rabin
authors.affiliation: Universite Laval, Quebec City, QC, Canada.|Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Quebec City, QC, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Hudon
authors.affiliation: University of New South Wales, Sydney, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Gates
authors.affiliation: Department of Psychology, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
authors.forename: Jordan I
authors.initials: JI
authors.lastname: Ali
authors.affiliation: INSERM, U1077, 14074, Caen, France.|Université de Caen Basse-Normandie UMR-S1077, 14074, Caen, France.|Ecole Pratique des Hautes Etudes, UMR-S1077, 14074, Caen, France.|CHU de Caen, U1077, 14000, Caen, France.
authors.forename: Eider M
authors.initials: EM
authors.lastname: Arenaza-Urquijo
authors.affiliation: Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.|Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.|Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Buckley
authors.affiliation: INSERM, U1077, 14074, Caen, France.|Université de Caen Basse-Normandie UMR-S1077, 14074, Caen, France.|Ecole Pratique des Hautes Etudes, UMR-S1077, 14074, Caen, France.|CHU de Caen, U1077, 14000, Caen, France.
authors.forename: Gael
authors.initials: G
authors.lastname: Chetelat
authors.affiliation: AXA Research Fund and UPMC Chair, Sorbonne Universities, Pierre et Marie Curie University, Paris, France.|Institute of Memory and Alzheimer's Disease (IM2A) and Brain and Spine Institute (ICM) UMR S 1127, Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Harald
authors.initials: H
authors.lastname: Hampel
authors.affiliation: Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Jessen
authors.affiliation: Division of Psychiatry, University College London, London, England, UK.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Marchant
authors.affiliation: Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Sietske A M
authors.initials: SAM
authors.lastname: Sikkes
authors.affiliation: Swansea University, Swansea, Wales, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tales
authors.affiliation: Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.affiliation: Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Wesselman
mesh_terms: D000368:Aged; D001521:Behavior Therapy; D060825:Cognitive Dysfunction / Q000523:psychology* / Q000628:therapy*; D000529:Complementary Therapies; D006801:Humans
keywords: Alzheimer’s disease; Cognitive interventions; Complementary therapies; Mild cognitive impairment; Treatment outcome