AUTHOR=Ying Gelan , Perez-Lao Ambar , Marsiske Michael , Levy Shellie-Anne , Smith Glenn E. 

TITLE=Multimodal cognitive and behavioral interventions for patients with MCI: a systematic review and meta-analysis on cognition and mood

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 16 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2024.1390699

DOI=10.3389/fnagi.2024.1390699

ISSN=1663-4365

ABSTRACT=Background: Research has increasingly suggested a benefit to combining multiple cognitive or behavioral strategies in a single treatment program for cognitively impaired older adults. Therefore, this systematic review and meta-analysis aimed to summarize results on the effects of multimodal cognitive and behavioral interventions versus control conditions on changes in cognition and mood in patients with mild cognitive impairment (pwMCI). 
Methods: The review followed a general PRISMA guideline for systematic literature review with a format consisting of participants, interventions, comparators, and outcomes (PICO). Multilevel meta-analyses of aggregated efficacy were performed to assess the pooled effect sizes for cognitive and mood outcomes. Risk-of-bias, heterogeneity across studies, and publication bias were assessed for each outcome. 
Results: After primary and reference searches, eighteen studies with low or some concerns of risk of bias were included. Low heterogeneity was found for mood and cognition. Funnel plots did not indicate publication bias. All the studies assessed changes in cognition (n=1,555) while seven studies with mood outcomes (n=343) were included. Multilevel meta-analyses demonstrated moderate effect (Hedge’s g=.44, 95% CI=[.21-.67]) in cognitive outcomes and large effect in mood (g=.65, 95% CI=[.37 -.93]). Subdomain analyses found low-moderate effects in global cognition, verbal and non-verbal memory, executive function, visuospatial abilities, and semantic fluency (.20