Combined therapy for Alzheimer’s disease and mild cognitive impairment: a systematic review of randomized clinical trials

ABSTRACT. The use of combined interventions for the treatment of Alzheimer’s disease (AD) has become increasingly popular in research, but inconsistencies remain regarding the optimal combinations. Objective: To conduct a systematic review of randomized controlled trials (RCTs) that applied combined or personalized interventions in individuals with mild cognitive impairment (MCI) or AD. Methods: Searches were conducted following predefined selection criteria in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Eighteen studies met the inclusion criteria. The analysis demonstrated that ten of the 18 studies had a low risk of bias. The results showed that, compared to different control or sham groups, there were improvements in scores on various neurocognitive tests, and in biochemical and imaging parameters in some studies. Conclusion: Treatments that combined dietary changes or physical exercise demonstrated greater benefits for individuals with AD or MCI when compared to other combinations.