{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:32:05Z","timestamp":1793158325235,"version":"4.5.0"},"reference-count":64,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Older adults with mild cognitive impairment (MCI) have the highest risk of progressing to dementia. Evidence suggests that nonpharmacological, single-domain interventions can prevent or delay progressive declines, but it is unclear whether greater cognitive benefits arise from multidomain interventions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether multidomain interventions, composed of 2 or more interventions, are associated with greater improvements in cognition among older adults with MCI than a single intervention on its own.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n MEDLINE, Embase, PsycInfo, AgeLine, CINAHL, and Cochrane Central Register of Controlled Trials were systematically searched from database inception to December 20, 2021.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Included studies contained (1) an MCI diagnosis; (2) nonpharmacological, multidomain interventions that were compared with a single active control; (3) older adults aged 65 years and older; and (4) randomized clinical trials.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Data were screened and extracted by 3 independent reviewers. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, random-effects meta-analyses were used to calculate effect sizes from the standardized mean difference (SMD) and 95% CIs.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Postintervention cognitive test scores in 7 cognitive domains were compared between single-domain and multidomain groups. Exposure to the intervention was analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 28 studies published between 2011 and 2021, including 2711 older adults with MCI, reported greater effect sizes in the multidomain group for global cognition (SMD, 0.41; 95% CI, 0.23-0.59;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), executive function (SMD, 0.20; 95% CI, 0.04-0.36;\n P<\/jats:italic>\n \u2009=\u2009.01), memory (SMD, 0.29; 95% CI, 0.14-0.45;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and verbal fluency (SMD, 0.30; 95% CI, 0.12-0.49;\n P<\/jats:italic>\n \u2009=\u2009.001). The Mini-Mental State Examination (SMD, 0.40; 95% CI, 0.17-0.64;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), category verbal fluency test (SMD, 0.34; 95% CI, 0.13-0.56;\n P<\/jats:italic>\n \u2009=\u2009.002), Trail Making Test\u2013B (SMD, 0.46; 95% CI, 0.13-0.80;\n P<\/jats:italic>\n \u2009=\u2009.007), and Wechsler Memory Scale\u2013Logical Memory I (SMD, 0.47; 95% CI, 0.15-0.80;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and II (SMD, 0.26; 95% CI, 0.07-0.45;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) favored the multidomain group. Exposure to the intervention varied between studies: the mean (SD) duration was 71.3 (36.0) minutes for 19.8 (14.6) weeks with sessions taking place 2.5 (1.1) times per week, and all interventions lasted less than 1 year.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, short-term multidomain interventions (&amp;lt;1 year) were associated with improvements in global cognition, executive function, memory, and verbal fluency compared with single interventions in older adults with MCI.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.6744","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T11:03:14Z","timestamp":1651575794000},"page":"e226744","source":"Crossref","is-referenced-by-count":128,"title":["Associations of Multidomain Interventions With Improvements in Cognition in Mild Cognitive 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