Front Public Health. 2026 Aug 11;14:1820948. doi: 10.3389/fpubh.2026.1820948. eCollection 2026.
ABSTRACT
OBJECTIVE: This Bayesian network meta-analysis evaluates the comparative efficacy of cognitive interventions on cognitive function in elderly individuals with cognitive impairment.
METHODS: Randomized controlled trials examining the effects of cognitive interventions on cognitive function in older adults aged 60 years and above with cognitive impairment were searched in the Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Service System (SinoMed), VIP Database, and Wanfang Data. The search covered the period from database inception to August 2025. Two researchers independently performed study selection, data extraction, and risk-of-bias assessment using the Cochrane risk-of-bias tool. RevMan 5.4 was used for risk-of-bias visualization, Stata 16.0 was used to construct the evidence network plots, and Bayesian network meta-analysis was conducted using the gemtc package in R version 4.5.2.
RESULTS: This meta-analysis incorporated 35 randomized controlled trials (RCTs), encompassing a total of 2,316 patients. Eight distinct cognitive intervention modalities were evaluated. Regarding the Mini-Mental State Examination (MMSE) scores, surface under the cumulative ranking curve (SUCRA) analysis revealed the following probability ranking for efficacy: computerized cognitive training (CCT; SUCRA = 81.08%), non-invasive brain stimulation (NIBS; SUCRA = 73.87%), cognitive stimulation therapy (CST; SUCRA = 67.24%), serious games (SUCRA = 65.64%), memory training (SUCRA = 61.79%), integrated cognitive training (SUCRA = 51.87%), virtual reality (VR; SUCRA = 27.02%), usual care (SUCRA = 14.38%), and olfactory training (OT; SUCRA = 7.10%). League table comparisons further demonstrated statistically significant improvements in MMSE scores compared to control groups for several interventions: CCT (mean difference [MD] = 2.14, 95% CI: 0.90 to 3.39), integrated cognitive training (MD = 1.28, 95% CI: 0.24 to 2.31), CST (MD = 1.70, 95% CI: 0.80 to 2.65), and serious games (MD = 1.67, 95% CI: 0.23 to 3.13). For the Montreal Cognitive Assessment (MoCA) scores, the SUCRA ranking was: memory training (SUCRA = 70.92%), CST (SUCRA = 70.63%), CCT (SUCRA = 69.71%), integrated cognitive training (SUCRA = 60.27%), virtual reality (VR; SUCRA = 48.24%), serious games (SUCRA = 46.16%), NIBS (SUCRA = 29.93%), and usual care (SUCRA = 4.15%). Significant enhancements in MoCA scores versus control were observed for: CCT (MD = 3.13, 95% CI: 1.79 to 4.50), integrated cognitive training (MD = 2.81, 95% CI: 1.41 to 4.28), and CST (MD = 3.26, 95% CI: 1.16 to 5.50).
CONCLUSION: Current evidence suggests that CCT, CST, memory training, and NIBS may be more effective interventions for improving cognitive function in elderly individuals with cognitive impairment.
PMID:42643257 | PMC:PMC13503207 | DOI:10.3389/fpubh.2026.1820948
