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Efficacy of cognitive remediation on activities of daily living in individuals with mild cognitive impairment or early-stage dementia: a systematic review and meta-analysis

Nikki Tulliani, M. Bissett, Paul Fahey, R. Bye, Karen P. Y. Liu

Systematic Reviews, 2022

1,414 participants · 30 citations

Abstract

Introduction Instrumental activities of daily living are essential for ageing well and independent living. Little is known about the effectiveness of cognitive remediation on instrumental activities of daily living performance for individuals with mild cognitive impairment or early-stage dementia. The objective of this study was to evaluate the immediate and long-term carryover effects of cognitive remediation on improving or maintaining instrumental activities of daily living performance in older adults with mild cognitive impairment and early-stage dementia. Methods Randomized controlled trials published from 2009 to 2022 were identified in OvidSP versions of MEDLINE and Embase, EBSCO versions of CINAHL and PsycINFO, and the Cochrane Central Register of Controlled Trials. A narrative synthesis of the findings was reported on the outcomes of the included studies. Relevant data was extracted and analysed using R software’s ‘metafor’ package with a random effect model with 95% CI. Results Thirteen studies, totalling 1414 participants, were identified in the narrative analysis. The results of meta-analysis, inclusive of 11 studies, showed that cognitive remediation elicited a significant improvement in the instrumental activities of daily living performance ( SMD : 0.17, 95% CI 0.03–0.31). There was insufficient evidence of any lasting effect. Discussion Cognitive remediation is effective in improving instrumental activities of daily living performance immediately…

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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,414 participants or records.

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