Effectiveness of Technology-Assisted Nurse-Led Cognitive Interventions on Cognitive Function in Older Adultswith Mild Cognitive Impairment: A Systematic Review and Meta-Analysis
Abstract
Objective: This systematic review and meta-analysis examined the effectiveness of technology-assisted nurse-led cognitive (TNC) in improving cognitive function among older adults with mild cognitive impairment (MCI).
Material and Methods: A systematic search for randomized controlled trials (RCTs) was performed across five electronic databases (PsycINFO, PubMed, Scopus, CINAHL, and ProQuest) from inception to December 31, 2024. Primary outcomes included cognitive outcomes of older adults with MCI. The Cochrane Risk of Bias Assessment Tool 1 (ROB1) was used. Standardized mean differences (SMDs) with 95.0% confidence intervals (CIs) were synthesized using RevMan version 5.40 to calculate pooled effect sizes.
Results: Eight eligible studies comprising 2,574 participants were included. The findings demonstrated that TNC interventions led to modest improvements in cognitive function compared to standard care (SMD=0.23, 95.0% CI (0.06, 0.40), p-value=0.01). Subgroup analyses revealed that combined TNC interventions showed greater efficacy (SMD=0.31, 95.0% CI (0.09, 0.54), p-value=0.01). In contrast, single TNC interventions did not yield any significant effect (SMD=0.32, 95.0% CI (-0.05, 0.70), p-value=0.09). In terms of cognitive outcomes, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in both studied subgroups showed no significant difference.
Conclusion: These results highlight the potential of combined TNC interventions to promote cognitive function among older adults with MCI. However, further combined TNC studies are essential to examine the effectiveness of these interventions in improving cognitive outcomes among older adults with MCI.
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Yi Q, Liu Z, Zhong F, Selvanayagam VS, Cheong JPG. Cognitive and physical impact of combined exercise and cognitive intervention in older adults with mild cognitive impairment: a systematic review and meta-analysis. PLoS One 2024;19:e0308466. doi: 10.1371/journal.pone.0308466.
Wan X, Zhang Y, Liu T, Li D, Yu H, Wen D. Exercise therapy of mild cognitive impairment: EEG could enhance efficiency. Front Aging Neurosci 2024;16:1373273. doi: 10.3389/fnagi.2024.1373273.
Zou C, Amos-Richards D, Jagannathan R, Kulshreshtha A. Effect of home-based lifestyle interventions on cognition in older adults with mild cognitive impairment: a systematic review. BMC Geriatr 2024;24:200. doi: 10.1186/s12877-024-04798-5.
Gopalakrishnan P, Tiwari S, Nagaraja R, Krishnan G. Quality of life in persons with mild cognitive impairment: a systematic review and meta-analysis. Dement Neuropsychol 2024;18:e20230093. doi: 10.1590/1980-5764-DN-2023-0093.
Chen H, Liu W, Xu X, Xiao M, Yin Y. The Effects of a nonpharmacological intervention practice for older adults with mild cognitive impairment and their family caregivers in China. J Gerontol Soc Work 2024;67:1069-88. doi: 10.1080/01634372.2024.2355152.
Barthold D, Jiang S, Basu A, Phelan EA, Thielke S, Borson S, et al. Utilization of low- and high-value health care by individuals with and without cognitive impairment. Am J Manag Care 2024;30:316-23. doi: 10.37765/ajmc.2024.89580.
Reitano MR, Guidetti M, Maiorana NV, Sandi AD, Carusi F, Rosci C, et al. The effects of a new integrated and multidisciplinary cognitive rehabilitation program based on mindfulness and reminiscence therapy in patients with parkinson’s disease and mild cognitive impairment: a pilot study. Brain Sci 2023;13:201. doi: 10.3390/brainsci13020201.
Casemiro FG, Quirino DM, Diniz MAA, Rodrigues RAP, Pavarini SCI, Gratão ACM. Effects of health education in the elderly with mild cognitive impairment. Rev Bras Enferm 2018;71:801-10. doi: 10.1590/0034-7167-2017-0032.
Chow G, Gan JKE, Chan JKY, Wu XV, Klainin-Yobas P. Effectiveness of psychosocial interventions among older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021;25:1986-97. doi: 10.1080/13607863.2020.1839861.
Kwan RYC, Liu J, Sin OSK, Fong KNK, Qin J, Wong JCY, et al. Effects of virtual reality motor-cognitive training for older people with cognitive frailty: multicentered randomized controlled trial. J Med Internet Res 2024;26:e57809. doi: 10.2196/57809.
Park EA, Jung AR, Lee KA. The humanoid robot sil-bot in a cognitive training program for community-dwelling elderly people with mild cognitive impairment during the covid-19 pandemic: a randomized controlled trial. Int J Environ Res Public Health 2021;18:8198. doi: 10.3390/ijerph18158198.
Sung CM, Lee TY, Chu H, Liu D, Lin HC, Pien LC, et al. Efficacy of multi-domain cognitive function training on cognitive function, working memory, attention, and coordination in older adults with mild cognitive impairment and mild dementia: a one-year prospective randomised controlled trial. J Glob Health 2023;13:04069. doi: 10.7189/jogh.13.04069.
Chien SC, Yen CM, Chang YH, Chen YE, Liu CC, Hsiao YP, et al. Use of artificial intelligence, internet of things, and edge intelligence in long-term care for older people: comprehensive analysis through bibliometric, google trends, and content analysis. J Med Internet Res 2025;27:e56692. doi: 10.2196/56692.
Chae HJ, Lee SH. Effectiveness of online-based cognitive intervention in community-dwelling older adults with cognitive dysfunction: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2023;38:e5853. doi: 10.1002/gps.585.
Saragih ID, Wei CW, Batubara SO, Saragih IS, Lee BO. Effects of technology-assisted interventions for people with dementia: A systematic review and meta-analysis. J Nurs Scholarsh 2023;55:291-303. doi: 10.1111/jnu.12808.
Luo Y, Lin R, Yan Y, Su J, Lin S, Ma M, et al. Effects of remote expressive arts program in older adults with mild cognitive impairment: a randomized controlled trial. J Alzheimers Dis 2023;91:815-31. doi: 10.3233/JAD-215685.
Malek-Ahmadi M, Nikkhahmanesh N. Meta-analysis of montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment. Front Psychol 2024;15:1369766. doi: 10.3389/fpsyg.2024.1369766.
Lee MJ, Park JS, Lee SH. Effects of mobile health applications in older adults with dementia or mild cognitive impairment: a systematic review and meta-analysis. Korean J Adult Nurs 2024;36:112-25.
Chan ATC, Ip RTF, Tran JYS, Chan JYC, Tsoi KKF. Computerized cognitive training for memory functions in mild cognitive impairment or dementia: a systematic review and meta-analysis. NPJ Digit Med 2024;7:1. doi: 10.1038/s41746-023-00987-5.
Yu D, Li X, Lai FH. The effect of virtual reality on executive function in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2023:663-73. doi: 10.1080/13607863.2022.2076202.
Dahlke S, Butler JI, Hunter KF, Law J, Martin LS, Pietrosanu M. Improving practicing nurses' knowledge of the cognitive impairment, continence, and mobility needs of older people. Int J Nurs Educ Scholarsh 2023;20:20220130. doi: 10.1515/ijnes-2022-0130.
Son YJ, Choi J, Lee HJ. Effectiveness of nurse-led heart failure self-care education on health outcomes of heart failure patients: a systematic review and meta-analysis. Int J Environ Res Public Health 2020;17:6559. doi: 10.3390/ijerph17186559.
Quan C, Clark N, Costigan CL, Murphy J, Li M, David A, Ganesan S, Guzder J, Cross B. JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts. BMJ Open 2023;13:e069753. doi: 10.1136/bmjopen-2022-069753.
Cooper K, Gregory JD, Walker I, Lambe S, Salkovskis PM. Cognitive behaviour therapy for health anxiety: a systematic review and meta-analysis. Behav Cogn Psychother 2017;45:110-23. doi: 10.1017/S1352465816000527.
Chaiard J, Bhatarasakoon P. Effectiveness of behavioral and psychosocial interventions for continuous positive airway pressure adherence among patients with obstructive sleep apnea: A systematic review and meta-analysis. Appl Nurs Res 2023;69:151654. doi: 10.1016/j.apnr.2022.151654.
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions. 2nd ed. Chichester (UK): John Wiley & Sons; 2019. Available from: https://doi.org/10.1002/9781119536604
Stern C, Munn Z, Barker TH, Porritt K, Stone JC, Pap R, Khalil H, Aromataris E. Implementing GRADE in systematic reviews that adhere to JBI methodological conduct. JBI Evid Synth 2024;22:351-58. doi: 10.11124/JBIES-23-00543.
Kumar R, Singh S, Maharshi V. Therapeutic effects of Cannabinoids on ulcerative colitis: a systematic review and meta-analysis of randomized controlled trials. J Health Sci Med Res 2024;42:20241041.
Bevilacqua R, Felici E, Cucchieri G, Amabili G, Margaritini A, Franceschetti C, et al. Results of the Italian RESILIEN-T Pilot study: a mobile health tool to support older people with mild cognitive impairment. J Clin Med 2023;12:6129. doi: 10.3390/jcm12196129.
Jeong JH, Na HR, Choi SH, Kim J, Na DL, Seo SW, et al. group-and home-based cognitive intervention for patients with mild cognitive impairment: a randomized controlled trial. psychother psychosom 2016;85:198-207. doi: 10.1159/000442261.
Lu W, Mao Q. The effects of family follow-up nursing on elderly cognitive impairment patients' Barthel index scores and mental statuses. Am J Transl Res 2021 Jun 15;13:6702-09.
Wen X, Song S, Tian H, Cui H, Zhang L, Sun Y, et al. Intervention of computer-assisted cognitive training combined with occupational therapy in people with mild cognitive impairment: a randomized controlled trial. Front Aging Neurosci 2024;16:1384318. doi: 10.3389/fnagi.2024.1384318.
Choukou MA, Olatoye F, Urbanowski R, Caon M, Monnin C. Digital health technology to support health care professionals and family caregivers caring for patients with cognitive impairment: scoping review. JMIR Ment Health 2023;10:e40330. doi: 10.2196/40330.
Asiri HM, Asiri AM, Alruwaili HF, Almazan J. A scoping review of different monitoring-technology devices in caring for older adults with cognitive impairment. Front Public Health 2023;11:1144636. doi: 10.3389/fpubh.2023.1144636.
Yang QH, Lyu X, Lin QR, Wang ZW, Tang L, Zhao Y, et al. Effects of a multicomponent intervention to slow mild cognitive impairment progression: A randomized controlled trial. Int J Nurs Stud 2022;125:104110. doi: 10.1016/j.ijnurstu.2021.104110.
Lissek VJ, Orth S, Suchan B. go4cognition: Evaluation of a newly developed multicomponent intervention in mild cognitive impairment. J Alzheimers Dis 2024;99:377-392. doi: 10.3233/JAD-230802.
Tran-Chi VL, Maes M, Nantachai G, Hemrungrojn S, Solmi M, Tunvirachaisakul C. Distress symptoms of old age and mild cognitive impairment are two distinct dimensions in older adults without major depression. Psychol Res Behav Manag 2024;17:101-16. doi: 10.2147/PRBM.S447774.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-98. doi: 10.1016/0022-3956(75)90026-6.
Nagaratnam JM, Sharmin S, Diker A, Lim WK, Maier AB. Trajectories of mini-mental state examination scores over the lifespan in general populations: a systematic review and meta-regression analysis. Clin Gerontol 2022;45:467-76. doi: 10.1080/07317115.2020.1756021.
Kim H, Yang S, Park J, Kim BC, Yu KH, Kang Y. Effect of education on discriminability of montreal cognitive assessment compared to mini-mental state examination. Dement Neurocogn Disord 2023;22:69-77. doi: 10.12779/dnd.2023.22.2.69.
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