Abstract
BACKGROUND: With global aging, dementia prevalence is rising, imposing significant burdens. Reminiscence therapy (RT) shows promise for improving cognition in older adults with cognitive impairment or dementia, but evidence remains inconsistent, potentially moderated by factors like age, intervention frequency, and setting. AIMS: This systematic review and network meta-analysis aimed to evaluate RT's efficacy on cognitive function in older patients with cognitive impairment or dementia and identify moderating factors through subgroup analyses. METHODS: A comprehensive search was conducted across 11 English and Chinese databases from inception until May 1, 2025, to identify eligible randomized controlled trials (RCTs) evaluating RT versus standard care in older adults with cognitive impairment or dementia, utilizing the cognitive outcome. Two independent reviewers screened the studies, extracted data, and assessed risk of bias and evidence quality. Using RevMan 5.4 for meta-analysis and subgroup analysis. RESULTS: Twenty-four RCTs involving 1,963 patients were included. RT significantly improved cognitive function, with benefits sustained at follow-up. RT also improved memory, reduced depression, and enhanced quality of life, but not executive function. Subgroup analyses revealed significantly greater cognitive improvement in patients aged 60-70 years, with intervention frequencies of 12-16 sessions, and in nursing home settings. CONCLUSION: RT is an effective intervention for improving cognition, memory, depression, and quality of life in older adults with cognitive impairment or dementia. Patient age, intervention frequency, and setting are potential moderators of its cognitive efficacy, providing actionable insights for optimizing clinical RT protocols.