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September 12, 2026Journal of Alzheimer s Disease

Clinical efficacy of non-pharmacological interventions on cognitive improvement in patients with mild to moderate Alzheimer's disease: A systematic review and Bayesian network meta-analysis

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Authors

TCTong CuiXHXiaodong HanQYQi Yao

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Overview

Network meta-analysis reveals dual-task training and non-invasive brain stimulation improve cognition in mild-to-moderate Alzheimer's disease, highlighting targeted non-drug therapy benefits.

Key Points

  • To evaluate and rank the comparative cognitive efficacy of various non-pharmacological interventions in individuals diagnosed with mild-to-moderate Alzheimer's disease.
  • Systematic review and Bayesian network meta-analysis of 50 randomized controlled trials (N=2856) across 11 intervention categories searched up to May 2026.
  • Primary cognitive outcomes included the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Cog).
  • Analyses were performed in R using gemtc with surface under the cumulative ranking curve (SUCRA) metrics, alongside Cochrane risk of bias and GRADEpro certainty evaluations.
  • Dual-task training ranked first for global cognitive screening measures, achieving the highest cumulative probability for MMSE (SUCRA = 88.84%) and MoCA (SUCRA = 90.67%).
  • Transcranial direct current stimulation (tDCS) demonstrated favorable cognitive rankings on MMSE (SUCRA = 85.69%) and MoCA (SUCRA = 75.63%).
  • Repetitive transcranial magnetic stimulation (rTMS) ranked highest for ADAS-Cog (SUCRA = 85.22%) and was the only non-pharmacological intervention showing significant cognitive improvement compared with usual care.

Cite This Study

Cui et al. (2026) studied this question.

synapsesocial.com/papers/6aa6e8be3f91f0dc52791fe3https://doi.org/10.1177/13872877261485496
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