Effectiveness of Multidomain Interventions for the Elderly with Mild Cognitive Impairment - A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

Oct 4, 2026

Mild cognitive impairment (MCI) represents a key transitional stage toward dementia, yet the cognitive benefits of multidomain interventions—and how they depend on dose and component mix—remain unclear. This systematic review and dose-response meta-analysis compares single-domain versus multidomain interventions in older adults with MCI and evaluates intensity, session density, and intervention composition. Searches covered six international databases through November 2025, pooling randomized trials using random-effects meta-analysis, meta-regression, and dose-response modeling.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages35

Reading Time1 h 28 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusions

Trial registration

1. Introduction

Effectiveness of multidomain interventions for the elderly with mild cognitive impairment: A systematic review and dose-response meta-analysis of randomized controlled trials Meixian Li Army Medical University Haiwei Fu Army Medical University Zonghua Wang Army Medical University Research Article Keywords: Mild Cognitive Impairment, Multidomain Intervention, Systematic Review, Meta-Analysis Posted Date: May 4th, 2026 DOI: [https://doi.org/10.21203/rs.3.rs-9170544/v1](https://doi.org/10.21203/rs.3.rs-9170544/v1) License: 􀁱 􀅏 This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Additional Declarations: No competing interests reported. Page 1/35 Abstract Background Mild cognitive impairment (MCI) is a high-risk and key transitional phase on the pathway to dementia. Multidomain interventions are increasingly used, but their cognitive beneﬁts and the inﬂuence of intervention dose and component mix in MCI remain uncertain. Objective This study aimed to ﬁrst compare the cognitive outcomes of single-domain and multidomain interventions in older adults with MCI, and second, to examine the inﬂuence of intervention parameters such as intensity, density, and component composition on cognitive improvements. Methods Six international databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, PsycINFO, and CINAHL, were searched from inception to November 2025. Two reviewers independently screened, extracted, and critically appraised the studies. Random-effects meta-analyses pooled standardized mean differences (Hedges' g) for post-intervention global cognition and cognitive domains. Meta-regression and subgroup analyses explored design and implementation factors. One-stage robust error meta-regression modeled the dose–response relationship between intervention intensity, sessions, intervention density, and component composition with cognitive outcomes. Results A total of 28 trials (3,377 participants) were included. Pooled analyses showed that multidomain interventions were associated with statistically signiﬁcant improvements in global cognition, memory, executive function, verbal ﬂuency, and attention (Hedges' g = 0 .31–0. 50) . A larger but less precise beneﬁt was observed for visuospatial ability (Hedges' g = 0 .80), whereas the pooled estimate for processing speed did not reach statistical signiﬁcance [Hedges' g = 0 .48, 95% CI (-0 . 12, 1 .08)] . Dose–response models suggested the optimal intervention density was found to be approximately 36.8 minutes/session, with greater cognitive beneﬁts. Notably, the optimal percentage of the total intervention time for physical activity was approximately 43 . 6%, beyond which further increases offered no additional cognitive gains. Conclusions Multidomain interventions were linked to modest to moderate improvements in both global and domain-speciﬁc cognition in older adults with MCI. Multidomain programs may be more successful and feasible if session density is optimized and the proportionate contribution of physical activity is balanced. To maximize cognitive beneﬁts, the ideal intervention intensity, density, and percentage of physical activity are essential. The creation of multidomain intervention protocols to stop cognitive decline and postpone the onset of dementia in older adults is supported by these ﬁndings. To improve their clinical applicability, future studies should investigate long-term effects and ﬁne-tune these intervention parameters. Trial registration The protocol was registered on PROSPERO (registration number: CRD420261283039, date created: 13 January 2026) . 1. Introduction Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia, characterized by subjective cognitive complaints and objective cognitive deﬁcits that do not signiﬁcantly interfere with daily life(Petersen, 2004) . Its prevalence increases with age, affecting app

FAQs

What is the primary purpose of this study?

To compare cognitive outcomes of single-domain versus multidomain interventions for older adults with MCI, and to assess how intervention parameters such as intensity, density, and component composition influence cognitive improvement.

Which databases and study designs were included?

Six international databases (PubMed, Embase, Cochrane CENTRAL, Web of Science, PsycINFO, and CINAHL) were searched through November 2025, and randomized controlled trials were included.

What cognitive benefits were found for multidomain interventions?

Multidomain interventions showed statistically significant improvements in global cognition and several domains including memory, executive function, verbal fluency, and attention, with additional findings for visuospatial ability.

What dose-related factors were suggested as optimal?

Dose-response modeling indicated an optimal intervention density of about 36.8 minutes per session, and an optimal physical-activity time proportion of about 43.6% of total intervention time for cognitive benefit.

Oct 4, 2026

Upload by Mafia Boss