The efficacy of cognitive interventions on the performance of instrumental activities of daily living in individuals with mild cognitive impairment or mild dementia: Protocol for a systematic review and meta-analysis

Background: Cognitive changes associated with mild cognitive impairment or mild dementia can lead to difficulties in completing instrumental activities of daily living. The ability to live independently at home and in the community is often compromised due to the inability to complete these activities. Cognitive interventions have been reported as beneficial in maintaining or improving cognitive functions among this group of adults. However, the effectiveness of different types of cognitive interventions on the performance of instrumental activities of daily living in older adults with mild cognitive impairment and mild dementia is not well established. The aim of this paper is to develop a protocol for a systematic review and meta-analysis to investigate the effectiveness of cognitive interventions in maintaining or improving the performance of instrumental activities of daily living in individuals with mild cognitive impairment or mild dementia. Methods: Randomised control studies which investigate the effectiveness of cognitive interventions on the performance in instrumental activities of daily living for older adults with mild cognitive impairment and mild dementia will be sought. A systematic search will be conducted in five databases: CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials. The search strategy was developed with assistance from a health science librarian. Two independent reviewers will perform the study selection and data extraction. Quality assessment will be implemented using the Physiotherapy Evidence Database (PEDro) scale. A narrative synthesis of the findings will be used to report outcomes of all included studies. If appropriate, a meta-analysis will combine the results of individual studies. Discussion: This systematic review and meta-analysis will determine the effectiveness of cognitive interventions in maintaining or improving the performance of IADL in individuals with MCI or mild dementia. It is anticipated that the results will inform rehabilitation professionals of the most effective cognitive interventions to be implemented into clinical practice. It will potentially provide substantial benefit to both the persons with MCI or dementia and the health care system by keeping more people out of full-time care and allowing those in full-time care to require less intensive support. Systematic review registration: PROSPERO CRD42016042364.