Outcomes tested in non-pharmacological interventions in mild cognitive impairment and mild dementia: a scoping review

BMJ Open. 2020 Apr 20;10(4):e035980. doi: 10.1136/bmjopen-2019-035980.

Abstract

Objectives: Non-pharmacological treatments are an important aspect of dementia care. A wide range of interventions have been trialled for mild dementia and mild cognitive impairment (MCI). However, the variety of outcome measures used in these trials makes it difficult to make meaningful comparisons. The objective of this study is to map trends in which outcome measures are used in trials of non-pharmacological treatments in MCI and mild dementia.

Design: Scoping review.

Data sources: EMBASE, PsychINFO, Medline and the Cochrane Register of Controlled Trials were searched from inception until February 2018. An additional search was conducted in April 2019 ELIGIBILITY: We included randomised controlled trials (RCTs) testing non-pharmacological interventions for people diagnosed with MCI or mild dementia. Studies were restricted to full RCTs; observational, feasibility and pilot studies were not included.

Charting methods: All outcome measures used by included studies were extracted and grouped thematically. Trends in the types of outcome measures used were explored by type of intervention, country and year of publication.

Results: 91 studies were included in this review. We extracted 358 individual outcome measures, of which 78 (22%) were used more than once. Cognitive measures were the most frequently used, with the Mini-Mental State Examination being the most popular.

Conclusions: Our findings highlight an inconsistency in the use of outcome measures. Cognition has been prioritised over other domains, despite previous research highlighting the importance of quality of life and caregiver measures. To ensure a robust evidence base, more research is needed to highlight which outcome measures should be used over others.

Prospero registration number: CRD42018102649.

Keywords: dementia; old age psychiatry; statistics & research methods.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Caregivers
  • Cognition
  • Cognitive Dysfunction* / therapy
  • Dementia* / therapy
  • Humans
  • Quality of Life
  • Randomized Controlled Trials as Topic