Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia-A network meta-analysis of randomized controlled trials

Guangxin Luo; Junqiu Zhang; Zeyi Song; Ying Wang; Xiaojing Wang; Haifeng Qu; Fang Wang; Chengjiang Liu; Fujia Gao

doi:10.3389/fnagi.2023.1131744

Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia-A network meta-analysis of randomized controlled trials

Front Aging Neurosci. 2023 Mar 2:15:1131744. doi: 10.3389/fnagi.2023.1131744. eCollection 2023.

Authors

Guangxin Luo¹, Junqiu Zhang¹, Zeyi Song², Ying Wang¹, Xiaojing Wang¹, Haifeng Qu², Fang Wang³, Chengjiang Liu⁴, Fujia Gao^{1

5}

Affiliations

¹ School of Public Health, North China University of Science and Technology, Tangshan, China.
² School of Clinical Medicine, North China University of Science and Technology, Tangshan, China.
³ Department of Psychology, The Fourth People's Hospital of Wuhu, Wuhu, China.
⁴ Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anqing, China.
⁵ Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, China.

Abstract

Objective: Non-pharmacological therapies (NPTs) have received increasing attention from researchers as a category of treatment to improve cognitive impairment in patients with dementia because of their fewer side effects. In this study, photobiomodulation (PBM), enriched environment (EE), exercise therapy (ET), computerized cognitive training (CCT), and cognitive stimulation therapy (CST) were selected to compare the effects of NPTs that improve dementia by quantifying information from randomized controlled trials (RCTs).

Methods: We did a systematic review and network meta-analysis. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure Database, Wan Fang Database, Chinese Biomedical Literature Database, Web of Science, and VIP Database from the time of database creation to 1 August 2022. Two investigators independently screened the literature, extracted information, and assessed the RCTs' quality with the Cochrane Collaboration Network Risk of Bias 2.0. Network meta-analysis was performed using R language (X64 version 4.1.3) and STATA 17.0.

Results: We identified 1,268 citations and of these included 38 trials comprising 3,412 participants. For improving dementia, the results of the network meta-analysis showed that compared with the control group (CON), PBM (SMD = 0.90, 95% CI: 0.43-1.37), EE (SMD = 0.71, 95% CI: 0.02-1.41), ET (SMD = 0.42, 95% CI: 0.16-0.68), and CST (SMD = 0.36, 95% CI: 0.11-0.62) were significantly different (P < 0.05); There was no significant difference in CCT (SMD = 0.41, 95% CI: -0.07-0.88) (P > 0.05). The ranked results showed that PBM has more potential to be the best intervention (P = 0.90). In addition, there was a significant difference between PBM and CST in improving cognitive function (SMD = 0.54, 95% CI: 0.00; 1.08, P < 0.05).

Conclusion: In this study, NPTs have excellent potential to improve cognition in people with dementia, and PBM may have more significant benefits in improving cognition than the other four NPTs.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022363746.

Keywords: cognitive; dementia; network meta-analysis; non-pharmacological therapy; randomized controlled trials.

Publication types

Systematic Review

Grants and funding

This study was supported by the Innovation and Entrepreneurship Training Programmed for University Students Funding (X2022308).