INTRODUCTION: Dementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity (Sobral, Pestana, & Paúl, 2015). Fifty million people are living with dementia globally. This number will be projected to grow to 82 million by 2030 and 152 million by 2050 (Alzheimer's Disease International, 2020. Since dementia is complex syndrome, multimodal non-pharmacologic interventions (MNPIs) are highly recommended (Dannhauser et al., 2014; Graessel et al., 2011; Han et al., 2017; Yang et al., 2019). Currently, there is little available evidence to determine which multimodal interventions are effective for cognitive function improvement.
METHOD: A comprehensive search was done in PubMed, EMBASE, CINHAL, Web of Science and Medline international databases. The inclusion criteria of this review were; concerned adults with primary diagnosis of dementia, measured cognitive function outcome, used two or more type of interventions, published in English language and employed controlled trial study design. The quality appraisal of the studies was done by Cochrane risk of bias assessment tools for randomized controlled trail and non-randomized controlled trial studies (Sterne et al., 2016; Sterne et al., 2016).
RESULTS: Fourteen RCTs and five non-RCT studies were included in the systematic review. Nearly ninety percent of studies resulted in an improvement or maintenance of cognitive function among people with dementia. Integrated, multicomponent and dyadic based interventions implemented for longer duration resulted in improve cognitive function of people with dementia. The combination of three modes of non-pharmacologic intervention that includes exercise, music, and cognitive training with intervention design of more than three sessions per week for at least 12 - 48 weeks is recommended.
CONCLUSION: This study showed that multimodal non-pharmacologic interventions might improve cognitive functions among people with dementia. Future high quality randomized controlled trail studies with repeated-measured design on the combined effect of physical exercise, music and cognitive training on cognitive function for people with dementia is recommended.