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Br J Psychiatry. 2013 Sep;203(3):255-64. doi: 10.1192/bjp.bp.113.127811.

Treatment for mild cognitive impairment: systematic review.

Author information

1
Claudia Cooper, MRCPsych, PhD, Ryan Li, BSc, Mental Health Sciences Unit, University College London, UK; Constantine Lyketsos, MD, MHS, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine and Johns Hopkins Bayview, Johns Hopkins Medicine, Baltimore, Maryland, USA; Gill Livingston, FRCPsych, MD, Mental Health Sciences Unit, University College London, UK.

Erratum in

  • Br J Psychiatry. 2014 Jan;204(1):81.

Abstract

BACKGROUND:

More people are presenting with mild cognitive impairment (MCI), frequently a precursor to dementia, but we do not know how to reduce deterioration.

AIMS:

To systematically review randomised controlled trials (RCTs) evaluating the effects of any intervention for MCI on cognitive, neuropsychiatric, functional, global outcomes, life quality or incident dementia.

METHOD:

We reviewed 41 studies fitting predetermined criteria, assessed validity using a checklist, calculated standardised outcomes and prioritised primary outcome findings in placebo-controlled studies.

RESULTS:

The strongest evidence was that cholinesterase inhibitors did not reduce incident dementia. Cognition improved in single trials of: a heterogeneous psychological group intervention over 6 months; piribedil, a dopamine agonist over 3 months; and donepezil over 48 weeks. Nicotine improved attention over 6 months. There was equivocal evidence that Huannao Yicong improved cognition and social functioning.

CONCLUSIONS:

There was no replicated evidence that any intervention was effective. Cholinesterase inhibitors and rofecoxib are ineffective in preventing dementia. Further good-quality RCTs are needed and preliminary evidence suggests these should include trials of psychological group interventions and piribedil.

PMID:
24085737
PMCID:
PMC3943830
DOI:
10.1192/bjp.bp.113.127811
[Indexed for MEDLINE]
Free PMC Article
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