Table 1.

Summary of the Available Evidence on Psychosocial Intervention for Improving Cognitive Function among Older Adult.

Author year country	Participants	Setting	Psychosocial intervention	Duration and frequency	Measurement for cognitive outcomes	Findings
Mahendran et al. (2018) Singapore	A total of 68 elderly people, aged 60 to 85 years, (M = 71.1) both genders, fulfill Petersen’s criteria for MCI	Community dwelling	AT: two components: (1) Guided viewing and cognitive evaluation of art works at the respective sites, involved narration of thoughts and inner experiences (2) visual art production (physical creation of themed artwork was followed by image appreciation activities to gain insight and discuss feelings, and took place at the research center) MRA: Listening and recalling memories and experiences related to the music.	weekly for 3 months, then fortnightly for 6 months Average: 1 hour	Memory: Rey auditory verbal learning test (RAVLT) List Learning, Delayed Recall, Recognition Trial Visuospatial abilities: Wechsler Adult Intelligence Scale-third edition (WAIS-III) Block design Attention and working memory: Digit span forward executive function: Color trails test 2	Mean of all neurocognitive domains in AT is significantly higher than CG at the third month Significant improvement only seen in List Learning and Digit Span Forward in AT compared to CG from baseline to 3 months assessment (estimated mean change) The effect of AT on memory domain was also sustained at 9 months.
Pitkala et al. (2011) Finland	A total of 235 participants (≥75 years) (M = 80, SD = 3.6) MMSE ≥ 19 CDR ≤ 1	Seven daycare centers	Art group: various artists (musicians, actors, artists, etc.) attended the meetings, and participants visited cultural events and sights, also actively producing their own art. They discussed their experiences in their group. therapeutic writing groups: the participants wrote about their past, their loneliness, and their feelings about the group meetings. They shared their writings and experiences in discussions with their group members and reminisced about their pasts. All interventions were solely use to stimulate social engagement of the partcipants Participants had breakfast together, engaged in activity, discussion of the activity, continued with lunch in the group, again engaged with activity, followed by discussion about it over coffee.	Weekly session for 3 months (12 sessions) 6 hours/session	Alzheimer’s Disease Assessment Scale (ADAS-Cog)	ADAS Cog scale improved more in the intervention group than in the control group within 3 months period. When compared between groups, subgroup therapeutic writing showed significant improvement in ADAS-Cog scale compared to their control groups, where the difference between art and exercise interventions and their controls were not significant. Dimension “mental function” in 15D showed significant improvement at 12 months in the IV compared to control group
Masika et al. (2021) Tanzania	A toal of 39 participants, 60 years or older (M = 72.7, SD = 7.1) and diagnosed with MCI by a psychiatrist using DSM (V).	community dwelling	Visual Art Therapy using Zentangle Method the first two sessions focused on understanding the basic ingredients of Zentangle art, that is, a dot, line, circle, and curved lines, and how to put together these elements to make shapes, space, form, texture, color intensity, and value. During the third session, participants made some attempts by following the principles learned in sessions 1 and 2 to draw some patterns and simple objects. To enhance participants’ socializations and build their other cognitive and social skills, they used session 4 to present their work in plenary, to evaluate one another’s work, and to provide feedback to each other. Sessions 5 and 6 were the repeat of sessions 3 and 4 to enhance the basic skills. The second part of VAT involved expression of life experiences into art. This included making the drawings using the principles of Zentangle art learned in sessions 1 to 6 to narrate their memorable objects, their life experiences, and portraits of their loved people and then sharing the art and the story behind such moments in session 7 to 12	Twice weekly for 6 weeks (12 sessions)	Montreal Cognitive Assessment-5-minute protocol (MoCA-5-minutes) Focus Group Discussion (FGD)	Both VAT and HE showed significant improvement in cognitive scores in post intervention assessment. But Insignificant improvement of MoCA-5-min scores between VAT and HE groups (group × time effect) FGD: Perceived brain challenges and improved memory “. . .it is a good brain exercise for old people. . .” (P4) “in the past, I would be home, then I would go to kitchen to pick somethings. . ...i would stand still having forgotten what I have gone to the kitchen for. . ...nowadays I don’t forget as before.” (P12)
Belleville et al. (2018) Canada	A 145 older adults aged above 55 years old (Mean = 72.2 ± 7.2) meeting criteria Petersen criteria for amnestic MCI	memory clinics	Psychosocial intervention based on the cognitive-behavioral approach, and aims to improve general psychological well-being. Session 1 focuses on psychoeducation, exploring the links between activities, aging, and psychological well-being. Participants are also invited to identify satisfactory aspects of their lives and to find ways to increase positive situations. Session 2 focuses on cognitive restructuring of thoughts, beliefs, and attitudes to help participants understand their relationships and modify thoughts that cause unhelpful emotions and includes diaphragmatic breathing. Sessions 3 and 4 consist of behavioral activation to increase the level of daily activities. Session 5 introduces participants to problem-solving skills, for instance, ways to manage stressful life events. In Session 6, participants learn to manage their anger and frustration Sessions 7 and 8 review key concepts and consolidate knowledge	Weekly session for 2 months (eight sessions) 2 hours A booster dose 1 week after 3 months	immediate and delayed composite performance memory score	No significant improvement on cognition in psychosocial intervention as compared to CT
Nakatsuka et al. (2015) Japan	A 127 older adult aged ≥75 years (mean CI = 82.2 ± 3.8, PA = 81.3 ± 3.8, GRA-RO = 81.2 ± 4.0) and evaluated as having a CDR of 0.5	community-dwelling	About 12 group sessions and 12 home assignments, weekly session. Home assignments were designed according to the intervention methods and contained tasks that require about 1 hour to be completed. Group Reminiscence Approach-Reality Orientation: talks about the current days and events of daily life (reality orientation) and discussions about memories of earlier days (reminiscence approach). The timetable of each session contained a reality orientation part (10 minutes) and a set of reminiscence approach parts (50 minutes in total). Topics included activities, jobs, events, and experiences from earlier days including childhood and adolescence. Pictures or items that related to these topics were also presented as an aid to discussion	Weekly for 3 months (12 sessions) 1 hour	MMSE word fluency (WF) Trail Making Test part A (TMT-A)	Significant improvement for MMSE, Word Fluency (WF) and Trail Making Test Part A (TMT-A) between IG (GRA, Physical Activity group, Cognitive Intervention group) and CG after 3 months. Post Hoc: significant improvement of MMSE only in CI and PA group only
Zhao et al. (2018) China	A total of 93 participants aged 60 years or older (M = 69.2, SD = 6.3) MCI (by Chinese guideline for cognitive impairment and dementia)	hospital	Creative Expressive Therapy group 25 sessions over 16 weeks, facilitated by a group of professional therapists. All sessions began with a 5 to 10 minutes warm-up of an interaction game, followed by a 10 minutes drawing and then a 30 minutes core CrExp. Session ended with a 5 to 10 minutes discussion and a 5 minutes conclusion. Storytelling is used to strengthen memory. Conducted in group setting, CrExp program involves five steps of functional tasks related to the presentation of a picture, including the topic of the picture, the background scenery, the development of a story, the actions of the leading character, and the ending of the story. Symbols, graphs, lines, numbers, and colors can be used to express feelings or emotions in order to narrate a vivid and complete story during the task.	16 weeks 25 sessions (Average: 1 hour)	Chinese-Changsha version of Montreal Cognitive Assessment (MoCA) Chinese Version of the Auditory Verbal Learning Test Chinese Version of the Category Verbal Fluency Test Digital Span Test Chinese version of the Trail Making Test A and B	At postintervention, patients receiving CrExp therapy scored significantly higher than patients receiving standard cognitive training, in general cognitive functioning, memory, executive function, functional status, and everyday living ability. At 6 months follow up, significant group differences remained in MoCA, memory, executive function, and attention functioning
Ciasca et al. (2018) Brazil	A 56 older adult aged 60 years or older (mean CG 69.8 ± 6.4, IG 66.1 ± 5.7), ability to read and write, lifetime DSM-5 diagnosis of MDD, female, participants had to be stable on pharmacotherapy for depression, that is, with no change in medication regimen (agent or dosage) throughout the study period MMSE score above 25 for people with 1 to 4 years of formal schooling or above 27 for people with 5 years or more of schooling	hospital	Art Therapy Relaxation and guided imagery by inducing the participants to imagine a nature setting of their choice. Then, the topic for artistic creation during the session was proposed After the guided imagery activity, the art therapist instructed the participants to work out the topic that had been proposed, using the art supplies available. Techniques such as painting, drawing, clay modeling, weaving, and collage. Example of activity; fashion a mandala out of grains and seeds glued onto a piece of cardboard, and were told that each grain or seed was to represent a quality they recognized in their personality. “Difficulty in dealing with difficult situations” was worked through by providing participants with rocks, which they were instructed to “place in a more beautiful context” within their artworks, thus helping them change their outlook on the situation. Once the artworks were completed, each participant was invited to verbally express her reflections and any feelings that surfaced during the activity.	Weekly session for 20 weeks Average: 1.5 hour	MMSE Verbal Fluency Test (animal category) Trail Making Test Rey Complex Figure (Rey CF) task	Significant higher score of MMSE and Rey DR from baseline to post intervention in IG. No significant difference between IG and CG in terms of the change in cognitive battery scores (group × time)