Objective: Evaluate research on nonpharmacological treatments for symptoms of mild cognitive impairment (MCI). Method: We searched for relevant English-language articles published from 2000 to 2010 using PUBMED and PsycINFO. We included nonpharmacological interventions for treating cognitive and behavioral symptoms in persons with MCI other than cognitive/memory training, which has been reviewed elsewhere. Effect sizes and hazard ratios were calculated when possible. Results: Current research points to the potential influence of behavioral interventions on behavioral symptoms. Exercise/diet interventions may alleviate cognitive deficits, especially cognitive speed and executive functioning, but possibly not memory—a domain central to MCI. Results were limited by small sample sizes, lack of rigorous methodology, short follow-ups, and the limited number of published studies. Discussion: Behavioral, diet, and exercise regimens show some promise with respect to reducing behavioral and cognitive symptomology. Rigorous research studies are needed to create more certainty about their potential to complement drug and/or cognitive therapies.
AarslandD.SardaheeF. S.AnderssenS.BallardC. (2010). Is physical activity a potential preventive factor for vascular dementia? A systematic review. Aging and Mental Health, 14, 386-395. doi:10.1080/1360786090358613610.1080/13607860903586136
2.
AndelR.CroweM.PedersenN. L.FratiglioniL.JohanssonB.GatzM. (2008). Physical exercise at midlife and risk of dementia three decades later: A population-based study of Swedish twins. Journals of Gerontology: Series A, Biological and Medical Sciences, 63, 62-66.
3.
BakerL. D.FrankL. L.Foster-SchuberK.GreenP. S.WilkinsonC. W.McTiernanA.. . . CraftS. (2010). Effects of aerobic exercise on mild cognitive impairment. Archives of Neurology, 67, 71-79.
4.
ChertkowH. (2002). Mild cognitive impairment. Current Opinions in Neurology, 15, 401-407.
5.
ChuiC.SuK.ChengT.LiuH.ChangC.DeweyM.. . . HuangS. (2008). The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: A preliminary randomized double-blind placebo-controlled study. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 32, 1538-1544. doi:10.1016/j.pnpbp.2008.05.01510.1016/j.pnpbp.2008.05.015
6.
ClareL.van PaaschenJ.EvansS. J.ParkinsonC.WoodsR. T.LindenD. E. J. (2009). Goal-oriented cognitive rehabilitation for an individual with mild cognitive impairment: Behavioural and neuroimaging outcomes. Neurocase, 15, 318-331. doi:10.1080/13554710.1080/135547
7.
ColcombeS.KramerA. F. (2003). Fitness effects on cognitive function of older adults: A meta-analytic study. Psychological Science, 14, 125-130. doi:10.1111/1467-9280.t01-1-0143010.1111/1467-9280.t01-1-01430
8.
DharmarajanT. S.NorkusE. P. (2001). Approaches to vitamin B12 deficiency: Early treatment may prevent devastating complications. Postgraduate Medicine, 110, 99-105. doi:10.3810/pgm.2001.07.97710.3810/pgm.2001.07.977
9.
DoodyR. S.FerrisS. H.SallowayS.SunY.GoldmanR.WatkinsW. E.. . . MurthyA. K. (2009). Donepezil treatment of patients with MCI: A 48-week randomized-controlled trial. Neurology, 72, 1555-1561.
EricksonK. I.KramerA. F. (2009). Aerobic exercise effects on cognitive and neural plasticity in older adults. British Journal of Sports Medicine, 43, 22-24. doi:10.1136/bjsm.2008.05249810.1136/bjsm.2008.052498
12.
FeldmanH.FerrisS.WinbladB.SfikasN.MancioneL.HeY.. . . LaneR. (2007). Effect of rivastigmine on delay to diagnosis of Alzheimer’s disease from mild cognitive impairment: The InDDEx study. Lancet Neurology, 6, 501-512. doi:10.1016/S1474-4422(07)70109-610.1016/S1474-4422(07)70109-6
13.
Gomez-PinillaF. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9, 568-578. doi:10.1038/nrn242110.1038/nrn2421
14.
GreenawayM. C.HannaS. M.LeporeS. W.SmithG. E. (2008). A behavioral rehabilitation intervention for amnestic mild cognitive impairment. American Journal of Alzheimer’s Disease and Other Dementias, 23, 451-461. doi:10.1177/153331750832035210.1177/1533317508320352
15.
GuanZ. Z.SoderbergM.SindelarP.EdlundC. (1994). Content and fatty acid composition of cardiolipin in the brain of patients with Alzheimer’s disease. Neurochemistry International, 25, 295-300. doi:10.1016/0197-0186(94)90073-610.1016/0197-0186(94)90073-6
16.
JeanL.BergeronM.ThieviergeS.SimardM. (2010). Cognitive interventions for individuals with mild cognitive impairment: Systematic review of the literature. American Journal of Geriatric Psychiatry, 18, 281-296. doi:10.1097/JGP.0b013e3181c37ce910.1097/JGP.0b013e3181c37ce9
17.
Joosten-Weyn BanninghL. W. A.KesselsR. P. C.Olde RikkertM. G. M.Geleihns-LantingC. E.KraaimaatF. W. (2008). A cognitive-behavioral group therapy for patients diagnosed with mild cognitive impairment and their significant others: Feasibility and preliminary results. Clinical Rehabilitation, 22, 731-740.
18.
KinsellaG. J.MullalyE.RandE.OngB.BurtonC.PriceS.. . . StoreyE. (2009). Early intervention for mild cognitive impairment: A randomized controlled trial. Journal of Neurology, Neurosurgery, and Psychiatry with Practical Neurology, 80, 730-736. doi:10.1136/jnnp.2008.14834610.1136/jnnp.2008.148346
19.
KoontzJ.BaskysA. (2005). Effects of galantamine on working memory and global cognitive functioning in patients with mild cognitive impairment: A double-blind placebo-controlled study. American Journal of Alzheimer’s Disease and Other Dementias, 20, 295-302. doi:10.1177/15333175050200050210.1177/153331750502000502
20.
LogsdonR. G.McCurryS. M.PikeK. C.TeriL. (2009). Making physical activity accessible to older adults with memory loss: A feasibility study. The Gerontologist, 49, S94-S99. doi:10.1093/geront/gnp08210.1093/geront/gnp082
21.
LondosE.BoschianK.LindenA.PerssonC.MintonL.LexellJ. (2008). Effects of a goal-oriented rehabilitation program in mild cognitive impairment: A pilot study. American Journal of Alzheimer’s Disease and Other Dementias, 23, 177-183. doi:10.1177/153331750731262210.1177/1533317507312622
22.
LuP. H.EdlandS. D.TengE.TingusK.PetersenR. C.CummingsJ. L. (2009). Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72, 2115-2121. doi:10.1212/WNL.0b013e3181aa52d310.1212/WNL.0b013e3181aa52d3
23.
LyketsosC. G.LopezO.JonesB.FitzpatrickA. L.BreitnerJ.DeKoskyS. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: Results from the Cardiovascular Health Study. Journal of the American Medical Association, 288, 1475-1483. doi:10.1001/jama.288.12.147510.1001/jama.288.12.1475
24.
MazzaM.PomponiM.JaniriL.BriaP.MazzaS. (2007). Omega-3 fatty acids and antioxidants in neurological and psychiatric diseases: An overview. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 31, 12-26. doi:10.1016/j.pnpbp.2006.07.01010.1016/j.pnpbp.2006.07.010
PerryR. J.HodgesJ. R. (1999). Attention and executive deficits in Alzheimer’s disease: A critical review. Brain, 122, 383-404.
27.
PetersenR. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183-194. doi:10.1111/j.1365-2796.2004.01388.x10.1111/j.1365-2796.2004.01388.x
28.
PetersenR. C.DoodyR.KurzA.MohsR. C.MorrisJ. C.RabinsP. V.. . . WinbladB. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 12, 1985-1992.
29.
PetersenR. C.SmithG. E.WaringS. C.IvnikR. J.TangalosE. G.KokmenE. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56, 303-308.
30.
PetersenR. C.ThomasR. G.GrundmanM.BennettD.DoodyR.FerrisS.. . . ThalL. J. (2005). Vitamin E and donepezil for the treatment of mild cognitive impairment. New England Journal of Medicine, 352, 2379-2388.
31.
RaschettiR.AlbaneseE.VanacoreN.MagginiM. (2007). Cholinesterase inhibitors in mild cognitive impairment: A systematic review of randomized trials. PLoS Medicine, 4, e338. doi:10.1371/journal.pmed.004033810.1371/journal.pmed.0040338
32.
RovioS.KareholtI.HelkalaE.ViitanenM.WinbladB.TuomilehtoJ.. . . KivipeltoM. (2005). Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease. Lancet Neurology, 4, 705-711. doi:10.1016/S1474-4422(05)70198-810.1016/S1474-4422(05)70198-8
33.
RozziniL.CostardiD.ChiloviB. V.FranzoniS.TrabucchiM.PadovaniA. (2006). Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors. International Journal of Geriatric Psychiatry, 22, 356-360. doi:10.1002/gps.168110.1002/gps.1681
ScherderE. J. A.PaasschenJ. V.DeijenJ. B.Van Der KnokkeS.OrlebekeJ. F. K.BurgersI.. (2005). Physical activity and executive functions in the elderly with mild cognitive impairment. Aging and Mental Health, 3, 272-280. doi:10.1080/1360786050008993010.1080/13607860500089930
36.
SchneiderL. S.OlinJ. T.DoodyR. S.ClarkC. M.MorrisJ. C.ResibergB.. . . FerrisS. H. (1997). Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Disease & Associated Disorders, 11, S22-S32.
37.
SelhubJ.JacquesP. F.WilsonP. W. F.RushD.RosenbergI. H. (1993). Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. Journal of the American Medical Association, 270, 2693-2698. doi:10.1001/jama.1993.0351022004903410.1001/jama.1993.03510220049034
38.
UnverzagtF. W.KastenL.JohnsonK. E.RebokG. W.MarsiskeM.KoepkeK. M. . . . TennstedtS. L. (2007). Effect of memory impairment on training outcomes in ACTIVE. Journal of the International Neuropsychology Society, 13, 953-960. doi:10.1017/S135561770707151210.1017/S1355617707071512
39.
van UffelenJ. G. Z.ChinapawM. J. M.van MechelenW. (2008). Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomized controlled trial. British Journal of Sports Medicine, 42, 344-351. doi:10.1136/bjsm.2007.04473510.1136/bjsm.2007.044735
40.
WhitehouseP. J. (2007). Mild cognitive impairment: A confused concept?Nature Reviews Neurology, 3, 62-63. doi:10.1038/ncpneuro040310.1038/ncpneuro0403
41.
WhitehouseP. J.GeorgeD. (2008). Clinical diagnosis and management of Alzheimer’s disease (3rd ed.). Archives of Neurology, 65, 1392-1393.
42.
WinbladB.GauthierS.ScintoL.FeldmanH.WilcockG. K.TruyenL.NyeJ. S. (2008). Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology, 70, 2024-2035. doi:10.1212/01.wnl.0000303815.69777.2610.1212/01.wnl.0000303815.69777.26
43.
YanJ. H.DickM. B. (2006). Practice effects on motor control in healthy seniors and patients with mild cognitive impairment and Alzhimer’s disease. Aging, Neuropsychology, and Cognition, 13, 385-410. doi:10.1080/13825589096960910.1080/138255890969609
