Cognition-oriented treatments (COTs) are a group of non-pharmacological treatments aimed at maintaining or improving cognitive functioning. Specific recommendations on the use of these interventions in people living with dementia (PLwD) are included in the Italian Guideline on the Diagnosis and Treatment of Dementia and Mild Cognitive Impairment, developed by the Italian National Institute of Health. This systematic review and meta-analysis, based on the GRADE methodology, is part of the guideline. Considered outcomes included the cognitive functions, quality of life, and functional abilities of PLwD, taking into account disease severity, modality and system of delivery, and form of the intervention. The effectiveness of these interventions on caregivers’ outcomes was also assessed. Both group and individual cognitive stimulation were reported as effective in supporting cognitive functions in PLwD at any degree of severity. Individual cognitive training and group cognitive training were reported as effective in improving global cognitive functions in people with mild dementia. Cognitive rehabilitation appeared to be effective only in improving the functional abilities of people with mild dementia. Cognitive rehabilitation appeared to be the most effective in improving caregivers’ outcomes, with results suggesting a reduction in care burden. The observed differences in the effectiveness of these interventions in people with different disease severity can be explained by the intrinsic characteristics of each intervention. Despite the large number of available studies, a high clinical, statistical, and methodological heterogeneity was observed. More methodologically rigorous studies are needed to clarify the effectiveness of each protocol and modality of intervention.

认知导向治疗 （COT） 是一组旨在维持或改善认知功能的非药物治疗。意大利国立卫生研究院制定的意大利痴呆症和轻度认知障碍诊断和治疗指南中包括了关于痴呆症患者使用这些干预措施的具体建议。本系统评价和荟萃分析基于 GRADE 方法，是指南的一部分。考虑的结局包括 PLwD 的认知功能、生活质量和功能能力，同时考虑到疾病严重程度、给药方式和系统以及干预形式。还评估了这些干预措施对照顾者结局的有效性。据报道，群体和个人认知刺激在任何严重程度下都能有效支持 PLwD 的认知功能。据报道，个体认知训练和团体认知训练可有效改善轻度痴呆患者的整体认知功能。认知康复似乎仅在改善轻度痴呆患者的功能能力方面有效。认知康复似乎是改善护理人员结局的最有效方法，结果表明护理负担减轻。观察到的这些干预措施在不同疾病严重程度的人群中的有效性差异可以用每种干预措施的内在特征来解释。尽管有大量可用的研究，但观察到临床、统计学和方法学的异质性很高。需要更严格的方法学研究来阐明每种方案和干预方式的有效性。