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Effectiveness of psychosocial and lifestyle interventions in promoting behaviour change and improving cognitive outcomes in older people with memory concerns: A systematic review.

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Title: Effectiveness of psychosocial and lifestyle interventions in promoting behaviour change and improving cognitive outcomes in older people with memory concerns: A systematic review.
Authors: Chapman H; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK; Academic Centre for Healthy Ageing, Barts Health NHS Trust, London, UK. Electronic address: h.m.chapman@qmul.ac.uk., Cooper C; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: claudia.cooper@qmul.ac.uk., Jeraldo RIE; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: r.i.espinozajeraldo@qmul.ac.uk., Lau Y; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: y.lokyiulau@qmul.ac.uk., Demnitz-King H; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: h.demnitz-king@qmul.ac.uk.
Source: Ageing research reviews [Ageing Res Rev] 2026 Oct; Vol. 121, pp. 103298. Date of Electronic Publication: 2026 Aug 12.
Publication Type: Journal Article; Systematic Review; Review
Language: English
Journal Info: Publisher: Elsevier Science Country of Publication: England NLM ID: 101128963 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-9649 (Electronic) Linking ISSN: 15681637 NLM ISO Abbreviation: Ageing Res Rev Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, UK : Elsevier Science, c2002-
MeSH Terms: Cognitive Dysfunction*/psychology , Cognitive Dysfunction*/therapy , Psychosocial Intervention*/methods , Memory Disorders*/psychology , Memory Disorders*/therapy , Life Style* , Cognition* , Health Behavior*, Humans ; Aged ; Cognitive Enhancement ; Risk Reduction Behavior ; Randomized Controlled Trials as Topic
Abstract: Background: Older adults with mild cognitive impairment or subjective cognitive decline have a greater dementia risk, particularly those from minority ethnic and socioeconomically disadvantaged backgrounds. Psychosocial and lifestyle interventions targeting modifiable risk factors offer hope for reducing risk, yet behavioural mechanisms remain unclear. This systematic review examines these mechanisms and associated outcomes.
Method: We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Web of Science, and Scopus for randomised control trials testing interventions that aimed to improve lifestyle and cognition in older adults with memory concerns. We explored behavioural mechanisms using the COM-B model and synthesised intervention effectiveness, overall and within underserved groups. We prioritised lower risk of bias studies.
Results: 26 studies described 23 randomised controlled trials (14 multidomain, 9 single domain interventions). Certainty of evidence that behaviour change was associated with cognition was low. Moderate-certainty evidence indicated that interventions providing a socially supportive environment and combining nutritional education and counselling for 6 + months improved diet. Physical activity improved primarily in interventions incorporating education, structured training, and enablement strategies (e.g., tailored programmes, providing tools). Interventions simultaneously targeting capability, opportunity and motivation showed greater overall effectiveness. Few studies recorded ethnicity (13%) or sociodemographic status (9%), and none explored their impact.
Conclusions: Non-pharmacological interventions can help this population improve their lifestyles if they feel capable, equipped and motivated, highlighting the value of careful design and implementation. There is scarce evidence on how these interventions work for underserved populations. Future research should explore this to inform tailored interventions and develop equitable dementia prevention strategies.
(Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: All authors were investigators on one intervention (Apple-Tree) included in this systematic review. To mitigate potential bias, eligibility assessment, data extraction, and risk-of-bias evaluation were performed according to predefined criteria and procedures specified in the review protocol.
Contributed Indexing: Keywords: Dementia; Equity; Mild cognitive impairment; Prevention; Randomised controlled trial; Subjective cognitive decline
Entry Date(s): Date Created: 20260812 Date Completed: 20260825 Latest Revision: 20260904
Update Code: 20260905
DOI: 10.1016/j.arr.2026.103298
PMID: 42586247
Database: MEDLINE
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  Data: Effectiveness of psychosocial and lifestyle interventions in promoting behaviour change and improving cognitive outcomes in older people with memory concerns: A systematic review.
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  Data: <searchLink fieldCode="AU" term="%22Chapman+H%22">Chapman H</searchLink>; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK; Academic Centre for Healthy Ageing, Barts Health NHS Trust, London, UK. Electronic address: h.m.chapman@qmul.ac.uk.<br /><searchLink fieldCode="AU" term="%22Cooper+C%22">Cooper C</searchLink>; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: claudia.cooper@qmul.ac.uk.<br /><searchLink fieldCode="AU" term="%22Jeraldo+RIE%22">Jeraldo RIE</searchLink>; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: r.i.espinozajeraldo@qmul.ac.uk.<br /><searchLink fieldCode="AU" term="%22Lau+Y%22">Lau Y</searchLink>; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: y.lokyiulau@qmul.ac.uk.<br /><searchLink fieldCode="AU" term="%22Demnitz-King+H%22">Demnitz-King H</searchLink>; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner St, London E1 2AB, UK. Electronic address: h.demnitz-king@qmul.ac.uk.
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  Data: Journal Article; Systematic Review; Review
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Elsevier+Science%22">Elsevier Science </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>101128963 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1872-9649 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2215681637%22">15681637 </searchLink><i>NLM ISO Abbreviation: </i>Ageing Res Rev <i>Subsets: </i>MEDLINE
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  Data: Background: Older adults with mild cognitive impairment or subjective cognitive decline have a greater dementia risk, particularly those from minority ethnic and socioeconomically disadvantaged backgrounds. Psychosocial and lifestyle interventions targeting modifiable risk factors offer hope for reducing risk, yet behavioural mechanisms remain unclear. This systematic review examines these mechanisms and associated outcomes.<br />Method: We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Web of Science, and Scopus for randomised control trials testing interventions that aimed to improve lifestyle and cognition in older adults with memory concerns. We explored behavioural mechanisms using the COM-B model and synthesised intervention effectiveness, overall and within underserved groups. We prioritised lower risk of bias studies.<br />Results: 26 studies described 23 randomised controlled trials (14 multidomain, 9 single domain interventions). Certainty of evidence that behaviour change was associated with cognition was low. Moderate-certainty evidence indicated that interventions providing a socially supportive environment and combining nutritional education and counselling for 6 + months improved diet. Physical activity improved primarily in interventions incorporating education, structured training, and enablement strategies (e.g., tailored programmes, providing tools). Interventions simultaneously targeting capability, opportunity and motivation showed greater overall effectiveness. Few studies recorded ethnicity (13%) or sociodemographic status (9%), and none explored their impact.<br />Conclusions: Non-pharmacological interventions can help this population improve their lifestyles if they feel capable, equipped and motivated, highlighting the value of careful design and implementation. There is scarce evidence on how these interventions work for underserved populations. Future research should explore this to inform tailored interventions and develop equitable dementia prevention strategies.<br /> (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
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  Data: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: All authors were investigators on one intervention (Apple-Tree) included in this systematic review. To mitigate potential bias, eligibility assessment, data extraction, and risk-of-bias evaluation were performed according to predefined criteria and procedures specified in the review protocol.
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  Data: <i>Keywords: </i>Dementia; Equity; Mild cognitive impairment; Prevention; Randomised controlled trial; Subjective cognitive decline
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