The effectiveness of non-pharmacological community dementia prevention interventions on older adults with mild cognitive impairment in China: a systematic review and meta-analysis

Objectives: Given that Mild Cognitive Impairment (MCI) represents a transitional stage between normal aging and dementia, this study examined whether non-pharmacological interventions could effectively improve cognitive function and slow cognitive decline in Chinese community-dwelling older adults with MCI. Method: This study was conducted to identify randomized controlled trials involving non-pharmacological interventions for preventing dementia in Chinese community settings. A comprehensive literature search was performed across 10 electronic databases through December 2024. Two reviewers independently assessed research quality using the Cochrane Risk of Bias Tool 1. Statistical analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs) to synthesize outcomes data. Results: The included studies (n = 19) evaluated cognitive changes in response to non-pharmacological interventions, which showed significant cognitive improvements (MD: 2.08, 95% CI [1.30, 2.85], p <.001). Both multi-domain (n = 10) and single-domain interventions (n = 9) demonstrated cognitive benefits across 2705 MCI participants. Multi-domain interventions (MD: 3.39, 95% CI [2.03, 4.76], p <.001) showed greater benefits than single-domain approaches (MD: 1.41, 95% CI [0.87, 1.96], p <.001). Our findings also revealed significant beneficial effects on multi-domain interventions, including multiple exercises (MD = 5.40, 95% CI [3.90, 6.90]), combined multiple types of approaches (MD = 3.34, 95% CI [1.11, 5.58]), and multiple cognitive trainings (MD = 2.26, 95% CI [1.67, 2.84]). Conclusion: Non-pharmacological interventions significantly enhanced cognitive function among Chinese community-dwelling older adults with MCI. Furthermore, multi-domain approaches demonstrated superior efficacy compared to single-domain strategies. Specifically, exercise-based interventions, combined modality programs, and cognitive training protocols all exhibited substantial effectiveness for improving cognitive outcomes in this population.