The Effectiveness of Compensatory Cognitive Interventions in Mild Cognitive Impairment: A Meta-Analysis

<title>Abstract</title> <p> Background: Cognitive interventions that incorporate compensatory strategies may be particularly effective for individuals with Mild Cognitive Impairment (MCI). This meta-analysis evaluated the efficacy of compensatory cognitive interventions for individuals with MCI. Specifically, the following were evaluated: (1) the overall efficacy across cognitive outcomes, (2) effectiveness on different cognitive domains, and (3) influence of study-level moderators. Method: Database searches were conducted, and relevant studies were screened for inclusion criteria and underwent data extraction. A meta-analysis was performed across 23 included studies, followed by subgroup moderator and sensitivity analyses. Results The overall pooled effect size across all cognitive outcomes was <italic>g</italic>  = 0.37, though sensitivity analyses adjusting for small-study bias suggested an effect in the small range ( <italic>g</italic>  = 0.22). Domain-specific analyses indicated significant positive effects on mental status and general cognition ( <italic>g</italic>  = 0.31), memory ( <italic>g</italic>  = 0.43), working memory and attention ( <italic>g</italic>  = 0.44), executive functioning ( <italic>g</italic>  = 0.28), and language ( <italic>g</italic>  = 0.29). Subgroup analyses revealed no overall significant differences between intervention approach, strategy type, control type, or intervention format. However, multicomponent approaches yielded significant effects for executive functioning and working memory, external strategies showed larger effects for memory and working memory/attention, and group-based formats provided greater improvements across outcomes. Conclusion Compensatory-based interventions offer small-to-moderate benefits for individuals with MCI, particularly in the domains of memory and attention/working memory. While study-level moderators did not demonstrate significant differences, trends suggest that multicomponent approaches, using both external and internal strategies, and a group intervention format may confer some benefits. </p>