[Cognitive interventions in nursing homes : Systematic review of the preventive effectiveness on cognitive performance in persons in need of care].

BACKGROUND: The strengthening of cognitive resources is considered to be a preventive field of action within inpatient care. The aim is to evaluate the effectiveness of such interventions on cognitive performance in nursing home residents.

METHODS: A systematic literature search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL and PsycINFO, as well as searches in trial registries and a screening of reference lists. The combined results were based on meta-analyses in random-effects models.

RESULTS: By including 10 primary studies, participating in cognitive activities showed a statistically significant greater cognitive performance compared to controls (standardized mean difference SMD = 0.46, 95% confidence interval CI 0.06-0.87, p = 0.0252). Subgroup analyses suggest a superiority of individually oriented cognitive activities with longer training periods and that especially nursing home residents with a better initial level of cognitive performance might benefit from cognitive interventions. However, due to the high risk of bias in the included studies and the presence of substantial heterogeneity, the results must be interpreted with caution.

CONCLUSION: The findings imply that cognitive activities implemented in nursing homes might be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify our results.