Author Identifier (ORCID)
Abstract
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.
Keywords
Cancer, Cancer-related cognitive impairment, Cognition, Cognitive rehabilitation, Exercise, Intervention, Non-pharmacological
Document Type
Journal Article
Date of Publication
2-1-2025
Volume
33
Issue
2
PubMed ID
39904905
Publication Title
Supportive Care in Cancer
Publisher
Springer
School
Exercise Medicine Research Institute / School of Medical and Health Sciences
Funding Information
This project was completed within a MASCC Cognition Fellowship. AMH is supported by a grant from the National Institutes of Health (R21NR020497). NHH, JLV, and RJC receive salary support from the National Health and Medical Research Council (NHMRC) as Investigator Fellows (APP2018070, APP1176221, APP1194051). SLR was funded by a Senior NHMRC Fellowship (GNT1154651).
Funding received from the National Health and Medical Research Council (NHMRC)
APP2018070, APP1176221, APP1194051, GNT1154651
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Haywood, D., Henneghan, A. M., Chan, A., Chan, R. J., Dhillon, H. M., Lustberg, M. B., ... & Hart, N. H. (2025). The effect of non-pharmacological interventions on cognitive function in cancer: An overview of systematic reviews. Supportive Care in Cancer, 33. https://doi.org/10.1007/s00520-025-09212-3
Comments
Haywood, D., Henneghan, A. M., Chan, A., Chan, R. J., Dhillon, H. M., Lustberg, M. B., ... & Hart, N. H. (2025). The effect of non-pharmacological interventions on cognitive function in cancer: An overview of systematic reviews. Supportive Care in Cancer, 33. https://doi.org/10.1007/s00520-025-09212-3