Non-pharmacological interventions for older adults with mild cognitive impairment: an umbrella review

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BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia in which preventive interventions may help delay cognitive decline. Multicomponent non-pharmacological interventions (NPTs) combining physical, cognitive, and psychosocial components have shown promising results; however, the available evidence remains heterogeneous. OBJECTIVE: Synthesize evidence from systematic reviews and meta-analyses (SRMAs) evaluating multicomponent, non-pharmacological interventions designed to improve cognitive function among community-dwelling older adults with MCI. METHODS: An umbrella review was conducted following PRISMA, PRIOR, and Joanna Briggs Institute recommendations. Searches were performed in Web of Science, Embase, PubMed, BIREME, Cochrane Library, and Google Scholar for systematic reviews published between 2012 and 2025. Methodological quality was assessed using AMSTAR 2 and certainty of evidence using GRADE. A narrative synthesis was performed due to methodological heterogeneity. RESULTS: Sixteen reviews were included, comprising five systematic reviews (SRs) and eleven systematic reviews with meta-analyses (SRMAs). Across these reviews, 322 randomized controlled trials were reported. Of these, 143 met eligibility criteria, yielding 84 unique primary trials after overlap removal (CCA = 4.68%), comprising 5,818 participants. Cognitive-physical combined interventions predominated. Median participant age was 74.8 years (IQR 71.7-77.6), session duration 60 min (IQR 45-92.5), frequency 2 sessions/week (IQR 2-3), and program length 16 weeks (IQR 10-24). Memory (57.1%), executive function (54.1%), global cognition (47.1%), and attention (42.9%) were the domains most frequently reported as showing statistically significant benefits. These proportions reflect the frequency of positive findings across trials rather than pooled effect estimates and should be interpreted cautiously given the heterogeneity and methodological variability of the included evidence. CONCLUSIONS: Multicomponent non-pharmacological interventions may provide cognitive benefits, particularly for memory and executive function, though certainty varied and findings from lower-quality reviews should be interpreted cautiously.

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