Table 1.

Study characteristics of CIM Interventions

Reference	Study design	Intervention	Study sample	Findings
Mind–body and body-based therapies
Chobe et al. [16]	Systematic review	Yoga for cognition	13 RCTs, N = 1115, adults ages 55–92	Yoga-based intervention have some positive evidence on attention, executive functions and memory among cognitive variables compared to active controls but not specific for individuals with MCI or dementia Average Delphi scores (indication of risk bias) of RCTs = 3.92, suggesting moderate study quality
Bhattacharyya et al. [17••]	Meta-analysis	Yoga for cognition and cognition with MCI	11 RCTs, N = 912 adults with cognitive impairment	Significant beneficial effects on memory (Cohen's d = 0.38), executive function (Cohen’s d = 0.40), and attention and processing speed (Cohen’s d = 0.33) with no adverse effects
Yang et al. [46]	Systematic Review and Meta-analysis	Tai chi on cognition in MCI	11 RCTs, N = 1061, mean age > 60 with MCI	Tai Chi can have moderate to significant benefits for global cognitive function (SMD = 0.35) in older adults with MCI, as suggested by previous studies. Regarding the specific domain of cognition, Tai Chi may improve to a small to medium or significant degree memory and learning (SMD = 0.37), mental speed and attention (SMD = 0.51), ideas, abstraction, figural creations, and mental flexibility (SMD = 0.29), and visuospatial perception (SMD = 0.29)
Hsieh et al. [19]	Randomized Control Trial	Virtual Reality Tai Chi on Cognition in MCI and dementia	N = 60; ages ≥ 65 years and MMSE 11–26	VRTC exercise program posed a significant protective effect on abstract thinking and judgment, aerobic endurance, lower extremity endurance, balance, and gait speed but only the ability of abstract thinking and judgment was maintained for cognitive function in the VRTC group after 6 months Average movement accuracy score of 3 months significantly predicted improvement in the total CASI score (β = 0.426, t = 2.432, p = 0.023) but no significance at 6 months
Marciniak et al. [20]	Randomized Controlled Trial	MBSR on Cognition in MCI	N = 28 individuals with MCI	MSBR group showed a significant decrease in GDS score between baseline and visit 2 (p = 0.03) and baseline and visit 3 (p = 0.0461). No significant differences were observed in cognitive tests or scores between baseline and visit 2 or visit 3
Wells et al. [21]	Randomized Controlled Trial	MBSR for MCI	N = 14 adults, ages 55–90 with MCI	No significant differences detected between MBSR and control in ADAS-cog change from baseline
Lenze et al. [23]	Randomized Controlled Trial	MBSR for cognitive dysfunction in anxiety	N = 34 adults, ages 65 years or older with significant anxiety-related distress plus subjective cognitive dysfunction	MBSR showed a trend toward improvement in all cognitive measures but there was no advantage for 12-week MBSR: Cohen’s d for worry reduction was 1.47 for 8-week and 0.48 for 12-week
Wetherell et al. [24]	Randomized Controlled Trial	MBSR on Cognition	N = 103 adults, ages 65 or older with anxiety, depression, or SND	Mindfulness group experienced greater improvement on a memory composite score (p = .046) but groups did not differ on change in cognitive control
Oken et al. [25]	Pilot randomized control trial	MBSR/MBCT on caregiver stress	N = 31 caregivers aged 45–85 years of close relatives with dementia	Significant effect found on self-rated caregiver stress with MBCT intervention
Whitebird et al. [26]	Randomized Control Trial	MBSR on caregiver stress and caregiver depression	N = 78 caregivers for individuals with dementia	MBSR was more effective at improving overall mental health, reducing stress, and decreasing depression MBSR participants showed immediate improvement and reported better mental health (p = .007), reported lower stress (p = .007) and depression (p = .005) and maintained improvement at 6-month follow up, but the difference between MBSR and control groups at 6 months did not differ significantly
Brown et al. [27]	Pilot randomized control trial	MBSR on caregiver stress and caregiver depression	N = 38 caregivers for individuals with dementia	MBSR participants reported significantly lower levels of perceived stress and mood disturbance at post-intervention relative to standard social support participants but did not differ at 3-month follow-up
Watson et al. [54••]	Randomized Controlled Trial	Aromatherapy on Agitation in Dementia	N = 49; 39 with dementia and 10 without dementia	Lemon Balm was more effective in reducing agitation (p = .04) and physical non-aggressive behavior (PNAB) (p = .02) in participants without dementia. Lavender was more effective in reducing PNAB (p = 0.04) in dementia
Ballard et al. [55]	Randomized Controlled Trial	Aromatherapy on Agitation in Severe Dementia	N = 72 with agitation in the context of severe dementia	60% of participants treated with lemon balm versus 14% of placebo treated group experienced a reduction in 30% of Cohen-Mansfield Agitation Inventory (CMAI), with an overall improvement in agitation of 35% in participants receiving lemon balm oil and 11% in those treated with placebo (Mann–Whitney U test; Z = 4.1, p < .0001)
Aerobic exercise
de Oliveira Silva et al. [28]	Randomized Controlled Trial	Exercise on Cognition in MCI and dementia	N = 28 adults ages 65 and older with MCI or AD	Significant difference only in the simple task mobility test (ΔCG: − 0.18 ± 0.53; ΔEG: − 1.05 ± 0.57; p = 0.03) and in the verbal fluency (ΔCG: − 1.30 ± 2.49; ΔEG: 3.16 ± 1.72, p = 0.05) of the elderly with MCI, showing a beneficial effect of the multimodal exercise in this group (not AD group)
Song et al. [29]	Meta-analysis	Exercise on Cognition	11 RCTs; N = 929, adults ages 18 and older with MCI	Physical exercise had beneficial effects for global cognition in MCI (SMD) = 0.30, 95% confidence interval (CI): 0.10–0.49, p = 0.002]. Further subgroup analysis demonstrated that aerobic exercise program are consistently associated with medium effect size (SMD: 0.54–0.58)
Huang et al. [30••]	Meta-analysis	Exercise on Cognition	71 trials; N = 5606 participants	All types of exercise were effective in increasing or maintaining global cognition, and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition: (standard mean difference (SMD) = 1.05, 95% confidence interval (95%CI): 0.56–1.54), executive function (SMD = 0.85, 95%CI: 0.21–1.49), and memory function (SMD = 0.32, 95%CI: 0.01–0.63) in patients with cognitive dysfunction Only resistance exercise showed significant effects on memory function for patients with MCI (SMD = 0.35, 95%CI: 0.01–0.69)
Lamb et al. [31]	Randomized Controlled Trial	Moderate to high intensity exercise training for individuals with mild-moderate dementia	N = 494 participants diagnosed with dementia	A moderate to high intensity aerobic and strength exercise training program does not slow cognitive impairment in people with mild to moderate dementia
Yan et al. [32••]	Meta-analysis	Sedentary Lifestyle on Dementia Risk	18 cohort studies; N = 250,063 adults and N = 2269 adults with dementia	Sedentary behavior was significantly associated with increased risk of dementia (RR = 1.30; 95% CI: 1.12–1.51)
Vitamins and natural supplements
Burckhardt et al. [39]	Cochrane Review	Omega-3 polyunsaturated fatty acids	3 RCTs; 632 participants with mild to moderate AD	No evidence of a benefit from omega-3 PUFAs on cognitive function when measured at 6 months with Alzheimer’s Disease Assessment Scale–Cognitive subscale (SMD − 0.02, 95% CI − 0.19 to 0.15; 566 participants, 3 studies) or MMSE (MD 0.18, 95% CI − 1.05 to 1.41; 202 participants; 2 studies)
Levkovitz et al. [44]	Randomized Controlled Trial	SAMe on MDD	N = 46 with MDD administered adjunctive oral SAMe	There was a greater improvement in the ability to recall information (p = 0.04) and a trend toward statistical significance for greater improvement in word-finding (p = 0.09) for patients who received adjunctive SAMe than placebo
Yang et al. [46]	Meta-analysis	Ginkgo biloba in cognitive impairment (MCI and AD)	2608 participants in 21 RCTs, adults	Gingko biloba in combination with conventional medicine was superior in improving MMSE scores at 24 weeks for patients with AD (MD 2.39, 95% CI 1.28 to 3.50, p < 0.0001) and mild cognitive impairment (MD 1.90, 95% CI 1.41 to 2.39, p < 0.00001), and ADL scores at 24 weeks for AD (MD -3.72, 95% CI − 5.68 to − 1.76, p = 0.0002)
Malouf et al. [37]	Cochrane Review	Vitamin B 6 on cognition	109 health older adults in 2 RCTs	No statistically significant differences between treatment with vitamin B6 supplementation versus placebo was found on cognition or mood

MCI mild cognitive impairment, SMD standardized mean difference, VRTC virtual reality Tai Chi, MMSE Mini-Mental Status Exam, CASI Cognitive Abilities Screening Instrument, MBSR Mindfulness-based stress reduction, GDS geriatric depression scale, ADAS-cog Alzheimer’s Disease Assessment Scale, cognitive subscale; SND subjective neurocognitive difficulties, MBCT mindfulness-based cognitive therapy, AD Alzheimer’s disease, PUFA polyunsaturated fatty acids, CI confidence interval, SAMe S-Adenosyl-l-methionine, MD mean difference, ADL activity of daily living