Efficacy of a non-pharmaceutical multimodal intervention program in a group setting for patients with mild cognitive impairment: A single-arm interventional study with pre-post and external control analyses

This study aimed to evaluate the efficacy of a non-pharmaceutical multimodal intervention program consisting of physical exercise, cognitive stimulation, and health education in a group setting to slow the progression of mild cognitive impairment (MCI). A single-arm interventional study was conducted on 27 patients with MCI. To evaluate the efficacy of the intervention program, a pre-post analysis was performed using EuroQol-5 Dimension (EQ-5D), Mini-Mental State Examination (MMSE), Cognitive Function Instrument (CFI), 5 Cog test, depression, and physical performance before and after the 8-month intervention. Additionally, propensity score and the semi-Bayes analyses were performed to compare the intervention program with standard medical care, using the external control patients' data for MMSE scores. Twenty-four patients completed the intervention program. During the study period, although EQ-5D and MMSE scores remained unchanged (mean change 0.02 95 % confidence interval (CI): −0.004, 0.04, 0.5 -0.2, 1.3), CFI and the subcategories of 5Cog (attention and reasoning) improved (mean change −1.23 -2.24, −0.21, 4.3 0.9, 7.7, 3.0 0.4, 5.6). In the additional analysis comparing changes in MMSE scores, patients who underwent the intervention program had less decline than the external control patients (mean change −1.7 -2.1, −1.3) with an observed mean difference of 2.25 1.46, 3.03, and propensity score-adjusted difference of 2.26 1.46, 3.05. The semi-Bayesian approach also suggested that the intervention slowed the progression of MCI. A non-pharmaceutical multimodal intervention program could contribute to slowing cognitive decline in patients with MCI.