Dementia Care Practice.

Background: Technology has been increasingly integrated into controlling the decline of cognitive function for persons with mild cognitive impairment (MCI). It is unclear whether technology-based cognitive and exercise interventions could generate synergistic benefits and what components would optimize this effect.

Methods: In this study, we searched MEDLINE, Web of Science, Scopus, Embase and APA PsycInfo from inception to Nov 4, 2023. We included randomized controlled trails that evaluated the effects of technology-based cognitive and exercise interventions on cognitive function for persons with MCI. Our primary outcome was global cognition. Outcomes were summarized in narrative synthesis and combined using meta-analysis. Pairwise meta-analysis and network meta-analysis were sequentially performed to identify the effects of each category of interventions and their comparative intervention effectiveness, respectively. Meta-regression was performed to examine any influence of study design and participants' characteristics on the intervention effectiveness. This systematic review protocol was registered in PROSPERO (CRD 42023486359).

Findings: A total of 28 studies with 1633 participants were included. The results of pairwise meta-analyses indicated that technology-based cognitive and exercise interventions were superior to active/passive controls in global cognition, cognitive shifting, proceeding speed, working memory, delayed recall, and category fluency (p<0.05). The results of network meta-analyses indicated that the optimal components were cognitive stimulation combined with mind-body exercise in improving global cognition (SUCRA: 77.0%, SMD 0.85, 95%CI -0.17 to 1.87) and cognitive shifting (SUCRA: 92.4%, SMD 1.57, 95%CI 0.88 to 2.25), while cognitive training combined with mind-body exercise were the most beneficial in developing proceeding speed (SUCRA: 88.5%, SMD 0.68, 95%CI 0.14 to 1.22). Meta-regression further suggested that the effects of the tested interventions were independent of the various factors relating to study design and participants' characteristics.

Interpretation: Technology-based cognitive and exercise interventions can be effective in improving global cognition and core subdomains of cognition in persons with MCI. This review highlights the more superior effects of technology-based cognitive stimulation combined with mind-body exercise in improving global cognition.