Non-Pharmacological Interventions Targeting Working Memory in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Introduction
This study aims to evaluate the effects of non-pharmacological cognitive interventions on working memory (WM) in individuals with Mild Cognitive Impairment (MCI). Given WM's critical role in cognitive functioning and its predictive value for daily activities, this meta-analysis focuses on assessing the effectiveness of various interventions to enhance WM in MCI patients.

Material and methods
A systematic search was conducted in PubMed, Scopus, Google Scholar, ScienceDirect, and SID until March 2024. Eligible studies were randomized controlled trials assessing non-pharmacological cognitive interventions on working memory in Mild Cognitive Impairment. Effect sizes were calculated using the Standardized Mean Difference (Hedges' g), and heterogeneity was assessed using the I² statistic with Comprehensive Meta Analysis Software (CMA2).

Results
From 1,509 identified studies, 27 met the inclusion criteria, and 7 were eligible for meta-analysis. Cognitive interventions, particularly digital-based programs, showed significant improvements in working memory. The effect size was moderate (0.456, p < 0.05) with low to moderate heterogeneity (I² = 35%). Risk of bias was generally low, supporting the reliability of findings. Cognitive interventions show significant potential in enhancing WM among individuals with MCI. Our meta-analysis reveals a moderate effect size, supporting the efficacy of nonpharmacological approaches. Cognitive interventions may serve as a valuable tool for delaying cognitive decline. Future research should investigate optimal intervention strategies and long-term effects to maximize cognitive benefits.