Table 3.

Summary of design characteristics and outcomes of randomized controlled trials evaluating the efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI)¹

Study	Inclusion and Exclusion Criteria	Descriptio n of Control Group Condition (n)	Description of Experiment al Group Intervention (n)	Experiment al Group: Length of Sessions (L), # of Sessions (S), # of Weeks (W)	ST Outcome Measures (SE?)	LT Outcome Measures (SE?)	F U
Focused Lifestyle Interventions
Baker et al. 2010	Amnestic MCI (Petersen, 2004); no significant cardiac disease, cerebrovascular disease, musculoskeletal impairment, or medical conditions with psychiatric, neurologic, or metabolic sequela; sedentary adults with < 30 minutes 3×/wk of physical activity at baseline; no diabetic medications	Stretching at intensity of below 50% of heart rate reserve (n = 10)	High intensity aerobic exercise at intensity of 75% to 85% of heart rate reserve (n = 19)	L = 45-60 S = 96 W = 24	SDMT (Y); verbal fluency (Y); stroop (Y); TMT B (Y); task switching (Y); story learning (N); list learning (N); delayed match to sample (N)	--	--
Bayer-Carter et al. 2011	Amnestic MCI (Roberts et al., 2008), delayed memory score 1.5 SD below expectation and consensus dx; no psychiatric disorders, alchoholism, neurologic disorders, renal/hepatic disease, diabetes, COPD, or cardiac issues; no cholesterol lowering medications	Higher fat/glycemi c index diet (n = 15)	Lower fat/glycemic index diet (n = 14)	W=4	Story recall (N); word list learning (N); BVMT (Y); TMT (N); stroop (N); verbal fluency (N)	--	--
Kwok et al. 2011	MCI based on Chinese MMSE score of 20-25; ≥70 years old; no blindness, aphasia, or behavioral disturbance	No- interventio n control (n=17)	Chinese calligraphy training led by trained assistant (n=14)	L = 30 S = 40 W = 8	MMSE (Y)	--	--
Lam et al. 2011	Chinese subjects > 65 years old; CDR=0.5 or Mayo criteria for amnestic MCI; physically fit as judged by allied health professional; excluded if already regularly practicing Tai Chi	Group stretching and toning (n=218)	Simplified group Tai Chi (n=171)	L = 30 S = 156 W = 52	CDR (Y); subjective memory complaints (N); ADAS-cog (N); digit span (N); visual span (Y); TMT (N); verbal fluency (N); Cantonese MMSE (N); Cornell Depression scale (N); Neuropsychiatr ic Inventory (N); Berg Balance Scale (Y)	--	--
Nagamats u et al. 2012	Women 70-80 years old; MOCA <26; subjective memory complaints	Stretching, balance, toning exercises (n=28)	Resistance training (n=28); aerobic training progressing to 70-80% heart rate reserve (walking; n=30)	L = 60 S = 48 W = 24	Stroop (Y); TMT (N); verbal digits test (N); associative memory (Y); everyday problems test (N); short physical performance battery (Y); six- minutewalk test (Y)	--	--
Scherder et al. 2005	Frail elderly with MCI (Petersen et al., 1999); short version of MMSE ≥7; no AD, alcoholism, head trauma, hydrocephalus, neoplasm, epilepsy, disturbance of consciousness, focal brain disorders	No interventio n control (n = 15) (8 received social visits and 7 were daily activities as usual)	Walking (n=15); hand/face exercises (n=13)	L = 30 for walking, 15 for hand/face S = 18 W = 6	Category fluency (Y); TMT (Y); digit span (N); visual memory span (N); dutch version of CVLT (N); Rivermead face recognition (N); Rivermead picture recognition (N)	Category fluency (N); TMT (N); digit span (N); visual memory span (N); dutch version of CVLT (N); Rivermead face recognition (N); Rivermead picture recognition (N)	6 wk
Van Uffelen et al. 2008	MCI (Petersen et al., 1999); community dwelling; 70-80 years old; able to walk independently; no B-vitamin supplementation; no epilepsy, multiple sclerosis, Parkinson’s, hemodiaysis, or psychiatric impairment; GDS < 6; no alcohol abuse; no medications for rheumatoid arthritis or psoriasis	Low intensity, nonaerobic activity (e.g., flexibility, balance, posture (n = 75)	Moderate intensity walking (n=77)	L = 60 S = 104 W = 52	RAVLT (Y); verbal fluency (N); digit symbol substitution test (N); stroop (Y)	--	--
Focused Restorative Cognitive Training Intervention – Single Domain, Attention/Information Processing
Barnes et al. 2009	MCI (Winblad et al., 2004); stable on medications	Computer activities on provided laptop at home (games, audio books, reading) (n = 25)	Posit Science auditory processing exercises on provided laptop at home (n = 22)	L = 100 S = 30 W = 6	RBANS Attention (N); spatial span (Y); RBANS Immediate Memory (N); RBANS Delayed Memory (N); CVLT total learning (N); CVLT Delayed Recall (N); DKEFS Trails (N); DKEFS Design Fluency (N); Global cognition – RBANS (N); Geriatric Depression Scale (U)	--	--
Focused Compensatory Cognitive Training Intervention – Single Domain, Memory
Greenaway et al. 2012	Amnestic MCI (Petersen, 2004); informant with twice weekly contact; DRS-2 > 120; stable on medications	Calendar provision (n = 20)	Calendar provision plus Memory Support System training in appointment s, to do list, and journaling (n = 20)	L = 60 S = 12 W = 6	DRS-2 (N); MMSE (N); eCOG (Y); QoL–AD (N); Depression – CESD (N); caregiver burden (N); caregiver mood (Y); memory	DRS-2 (N); MMSE (N); eCOG (Y); QoL – AD (N); Depression – CESD (N); caregiver burden (N); self efficacy (Y	6 m o caregiver mood (Y); memory self efficacy (N)
Comprehensive Interventions – Single Domain, Memory
Rapp et al. 2002	MCI (Petersen et al., 1999)	No treatment (n = 10)	Education about memory loss, relaxation training, compensator y memory strategy training, and cognitive restructuring for memory related beliefs (n = 9)	L = 120 S = 6 W = 6	Word list memory task (N); grocery list memory task (N); names and faces memory task (N); paragraph recall task (N); perceived memory ability -MCIn and MFQ (Y); perceived control over memory - MCIn (Y); use of memory strategies - MFQ (N); perceived impact of memory problems - MFQ (N)	Word list memory task (N); grocery list memory task (N); names and faces memory task (N); paragraph recall task (N); perceived memory ability - MCIn and MFQ (Y); perceived control over memory - MCIn (N); use of memory strategies - MFQ (N); perceived impact of memory problems - MFQ (N)	--
Troyer et al. 2008	MCI (Petersen, 2004)	Waitlist control (n = 24)	Compensato ry memory strategies in attention; intensive lifestyle education including relaxation and stress management skills, nutrition skills, community resources, importance of recreational activities, physical exercise, and cognitive activities (n = 24)	L = 120 S = 10 W = 26	Memory strategy use – MMQ (Y), memory task (Y); memory strategy knowledge (Y); self-reported memory ability – MMQ (N); memory contentment - MMQ (N); perceived impact of memory on daily functioning (N); perceived importance of lifestyle factors’ impact on memory (N); face name learning (N); number learning N); wordlist learning (N)	Memory strategy use – MMQ (Y), memory task (Y); memory strategy knowledge (Y); selfreported memory ability - MMQ (N); memory contentme nt - MMQ (N); perceived impact of memory on daily functioning (N); perceived importance of lifestyle factors’ impact on memory (N); face name learning (N); number learning (N); wordlist learning (N)	3 m o
Comprehensive Interventions – Multi-Modal
Buschert et al. 2011	Amnestic MCI (Petersen et al., 2001); MMSE ≥ 23; ≥ 50 years; adequate vision and hearing for participation; no major medical or psychiatric disorder or disability precluding participation; stable on medications ≥ 3 months; no cognitive intervention in past year	Monthly group meetings with paper pencil cognitive activities (n = 12)	Restorative cognitive training exercises and compensator y cognitive strategies in attention, memory, and executive function; reminiscence , psychomotor , recreational, creative, and social activities; discussion groups;aging education (n = 12)	L = 120 S = 20 W = 26	MMSE (Y); ADAS-cog (Y); RBANS – immediate story recall (N), delayed story recall (N); TMT A (N); TMT B (N); depression - MADRS (Y); QoL-AD (N)	--	--
Kinsella et al. 2009	Amnestic MCI (Petersen, 2004; Winblad et al., 2004); no cormorbidities associated with functional decline or cognition; no major psychiatric disorders; no significant cerebrovascular disease; no significant hearing, vision, or communication impairments; English speaking	Waitlist control (n = 22)	Training in compensator y memory strategies and external memory aids; training in strategies to improve organization al and attention skills in approaching learning and remembering ; discussion of coping strategies; education about lifestyle strategies including physical exercise and cognitive activities (n = 22)	L = 90 S = 5 W = 5	Prospective memory tasks (Y); MMQ – perceived memory ability (N), contentment associated with memory (N), memory strategy usage (Y); SKR - memory strategy knowledge (Y)	Prospectiv e memory tasks (Y); MMQ – perceived memory ability (N), contentment associated with memory (N), memory strategy usage (N); SKR - memory strategy knowledge (Y)	4 m o
Tsolaki et al. 2011	MCI (Petersen et al., 2001); free of neuropsychiatric symptoms per the Neuropsychologic al Inventory; no history of stroke or ischemic lesions; No cholinesterase inhibitors; no dementia; no lack of insight into deficits; no visual/hearing impairments or reading/writing disability that would preclude cognitive training	No therapy (n = 72)	Practice of paper-pencil and oral tasks of attention and executive function with ecological validity; practice of tasks aimed at enhancing memory; cognitivebehavioral techniques such as autogenic relaxation and progressive muscle relaxation (n = 104)	L = 60 S = 60 W = 26	Visual or verbal memory - RBMT (N), RAVLT (N), ROCFT Delayed Recall (N), MoCA memory subtest (Y); Attention – TEA (N), WAIS-R Digit Symbol (N); Executive Function – FUCAS (Y), TMT B (N), FAS (N); Language – BNT (N), BDAE (N); Visual Construction – ROCFT Copy (Y), MoCA Clock Drawing (Y); Daily Functioning – FRSSD (Y); MMSE (Y); MoCA (Y)	--	--

¹Note: Note that some studies included treated and untreated groups with dementia in addition to the MCI groups; only information on the MCI groups are included in this table. Abbreviations: AD = Alzheimer’s disease. ADAS – cog = Alzheimer’s Disease Assessment Scale – cognitive subscale. ADL = Activities of daily living. BADL = Basic Activities of Daily Living. BDAE = Boston Diagnostic Aphasi Examination. BNT = Boston Naming Test. CCMB = Cote-des-Neiges Computerized Memory Battery. CDR = Clinical Dementia Rating. COPD = Chronic obstructive pulmonary disease. CR = Clinical Dementia Rating. DRS = Dementia Rating Scale. dx = Diagnosis. FRSSD = Functional Rating Scale of Symptoms of Dementia. FU = Long-term follow-up period, in months. FUCAS = Functional Cognitive Assessment Scale. GDS = Geriatric Depression Scale. IADL = Instrumental Activities of Daily Living. ICQ = Illness Cognition Questionnaire. L = Length of sessions, in minutes. LT = Long-term (>1 month since the intervention ended). MADRS = Montgomery Asberg Depression Rating Scale. MCI = Mild cognitive impairment. MCIn = Memory Controllability Inventory. MFQ = Memory Functioning Questionnaire. MMQ = Multifactorial Metamemory Questionnaire. MMSE = Mini Mental Status Exam. mo = months. MoCA = Montreal Cognitive Assessment. n = Group sample size. N = No. NPI = Neuropsychiatric Symptom Inventory. PMS = Profile of Mood States. PPT = Physical Performance Test. QoL-AD = Quality of Life-Alzheimer’s Disease. RAVLT = Rey Auditory Verbal Learning Test. RBMT = Rivermead Behavioral Memory Test. ROCFT = Rey Osterrieth Complex Figure Test. SE? = Were there statistically significant results indicating that the intervention was associated with improvement on this measure, above and beyond any that were observed in the control group, OR that the intervention was associated with significantly less decline on this measure than what was seen in the control group? S = Number of sessions. SD = standard deviation. SKR = Strategy Knowledge Repertoire. ST = Short-term (≤ 1 month since the intervention ended). STAI = State Trait Anxiety Inventory. TEA = Test of Everyday Attention. TMT = Trail Making Test. W = Number of weeks over which the intervention was conducted. WAIS-R = Wechsler Adult Intelligence Scale, Revised. Wk = weeks. Y = Yes.