Current Pharmacological and Emerging Non-pharmacological Treatments in Slowing the Progression of Mild Cognitive Impairment: A Literature Review

Abstract

Introduction: MCI is considered as a prodromal stage between normal cognitive aging and dementia given its potential to develop into various forms of dementia, most notably Alzheimer’s disease (AD). This translates to a need for effective pharmacological and non-pharmacological treatments to prevent the progression of MCI and subsequently slowing AD onset. This review aims to discuss the effectiveness of pharmacological and non-pharmacological interventions in slowing MCI progression.

Methods: A literature search was conducted using the PubMed database for randomized controlled trials (RCTs) examining the effectiveness of interventions with individuals with MCI. Keywords included “mild cognitive impairment”, “drug”, “treatment”, and “randomized controlled trials”. Articles were evaluated on criteria relevant to the review’s purpose.   

Results: Studies on different pharmacological and non-pharmacological interventions demonstrated promising results in slowing the progression of MCI into dementia. Acetylcholinesterase inhibitors (AChEIs) display favourable results on multiple cognitive assessments when compared to placebo. Non-pharmacological interventions, such as diet supplementation or exercise, also have the potential in improving performance in a multitude of cognitive domains.

Discussion: In multiple RCTs, AChEIs displayed effectiveness in alleviating cognitive impairment associated with MCI, but only temporarily with some adverse effects. Given the difficulty in determining a clear use of AChEIs on slowing the progression of MCI, additional research is needed. Non-pharmacological interventions have also displayed effectiveness without risk of adverse drug effects. Literature regarding multimodal approaches combining both pharmacological and non-pharmacological interventions is a novel area of research, and these studies have suggested positive additive effects.

Conclusion: Pharmacological and non-pharmacological interventions for slowing the progression of MCI display promising results. More studies are needed to determine which treatment plans, whether pharmacological, non-pharmacological, or a combination of the two, will prove to be the most effective for individuals with MCI.