TY - JOUR
T1 - The effect of non-pharmacological interventions on cognitive function in cancer
T2 - an overview of systematic reviews
AU - Haywood, Darren
AU - Henneghan, Ashley M.
AU - Chan, Alexandre
AU - Chan, Raymond J.
AU - Dhillon, Haryana M.
AU - Lustberg, Maryam B.
AU - Vardy, Janette L.
AU - O’Connor, Moira
AU - Elvidge, Norah
AU - Dauer, Evan
AU - Franco-Rocha, Oscar Y.
AU - Vasan, Shradha
AU - Murray, James
AU - Crichton, Megan
AU - Wilding, Helen
AU - Rossell, Susan L.
AU - Hart, Nicolas H.
PY - 2025/2
Y1 - 2025/2
N2 - Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind–body, and multi-modal/complex interventions. This umbrella review provides a critical overview to inform guidelines and current practice, identify the most promising interventions, and uncover gaps in the research literature. Methods: This umbrella review of systematic reviews was pre-registered on Open Science Framework and PROSPERO. Six databases were searched. Systematic reviews (SR) assessing any non-pharmacological interventions to improve cognition in cancer (any type) were included. The overview followed gold-standard guidelines and recommendations. The results were narratively synthesised, and descriptive statistics and effect size ranges were calculated. Results: Sixty-four (n = 64) SRs were included. Results were synthesised into four non-pharmacological domains. Cognitive training/rehabilitation had the strongest evidence for efficacy. Physical activity/exercise showed promising efficacy; however, the variability of findings was considerable. Mind–body and psychological/behavioural therapy interventions were limited, but there was evidence for short-term effectiveness. Multi-modal/complex interventions showed potential for improving cognition in cancer but were poorly defined. Conclusions: Overall, non-pharmacological interventions demonstrated efficacy for improving cognition in cancer. There were limited intervention characteristics within domains which were consistently related to efficacy. Three key recommendations are provided for future research: (1) adopt harmonisation and reporting guidelines; (2) develop definitional guidelines of cognitive domains for CRCI research; and (3) assess intervention and participant characteristics associated with positive versus null/negative findings.
AB - Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind–body, and multi-modal/complex interventions. This umbrella review provides a critical overview to inform guidelines and current practice, identify the most promising interventions, and uncover gaps in the research literature. Methods: This umbrella review of systematic reviews was pre-registered on Open Science Framework and PROSPERO. Six databases were searched. Systematic reviews (SR) assessing any non-pharmacological interventions to improve cognition in cancer (any type) were included. The overview followed gold-standard guidelines and recommendations. The results were narratively synthesised, and descriptive statistics and effect size ranges were calculated. Results: Sixty-four (n = 64) SRs were included. Results were synthesised into four non-pharmacological domains. Cognitive training/rehabilitation had the strongest evidence for efficacy. Physical activity/exercise showed promising efficacy; however, the variability of findings was considerable. Mind–body and psychological/behavioural therapy interventions were limited, but there was evidence for short-term effectiveness. Multi-modal/complex interventions showed potential for improving cognition in cancer but were poorly defined. Conclusions: Overall, non-pharmacological interventions demonstrated efficacy for improving cognition in cancer. There were limited intervention characteristics within domains which were consistently related to efficacy. Three key recommendations are provided for future research: (1) adopt harmonisation and reporting guidelines; (2) develop definitional guidelines of cognitive domains for CRCI research; and (3) assess intervention and participant characteristics associated with positive versus null/negative findings.
KW - Cancer
KW - Cancer-related cognitive impairment
KW - Cognition
KW - Cognitive rehabilitation
KW - Exercise
KW - Intervention
KW - Non-pharmacological
UR - http://www.scopus.com/inward/record.url?scp=85218068456&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/2018070
UR - http://purl.org/au-research/grants/NHMRC/1194051
U2 - 10.1007/s00520-025-09212-3
DO - 10.1007/s00520-025-09212-3
M3 - Review article
C2 - 39904905
AN - SCOPUS:85218068456
SN - 0941-4355
VL - 33
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 2
M1 - 151
ER -
