Clinical efficacy of non-pharmacological interventions on cognitive improvement in patients with mild to moderate Alzheimer's disease: A systematic review and Bayesian network meta-analysis.

Several non-drug approaches showed promising scale-specific results. rTMS ranked highest for ADAS-Cog, but rankings do not prove that one option is best for every person.

Cui T, Han X, Yao Q, Xu C, Shan A, Wang X, Li S, Luan H, Wen B, Chen R, Guo J, Lian Q, Li C, Sun Y, Lv S, Wei C.
Journal of Alzheimer's disease : JAD · Publication date: 2026-09-12
Added to site: 2026-09-15
DOI: 10.1177/13872877261485496

First electronic publication date from the authoritative index; the September issue date is less precise.

Modalities

rTMS, tDCS

Clinical focus

Alzheimer's disease, Cognition

Population

People with mild-to-moderate Alzheimer's disease

Sample

50 randomized trials with 2,856 participants

Intervention / method

Eleven non-pharmacological intervention categories evaluated on MMSE, MoCA or ADAS-Cog outcomes

Comparator

Network of direct and indirect comparisons, including usual care

Clinician summary

Dual-task training ranked highest for MMSE and MoCA, with tDCS also favorable. rTMS ranked highest for ADAS-Cog and was the only intervention reported as significantly better than usual care on that outcome.

How to interpret the findings

Network rankings depend on the quality and comparability of included trials. The reviewed abstract did not provide individual protocols, durability, adverse-event synthesis or detailed certainty ratings, and the authors caution interpretation of the rTMS finding.

Equipment and disclosures

Individual devices and stimulation protocols were not available in the reviewed abstract. No BrainMaster equipment attribution.

Funding and conflicts were unavailable in the reviewed abstract.

Related evidence

Compare findings from the same clinical area, including mixed results.

• Multimodal evidence associated with 20Hz rTMS in AD: neuroaxonal injury reduction, neural oscillatory rebalancing, and multilayer network integration · Positive with limitations
• Synergistic modulation of the dorsolateral prefrontal cortex and precuneus enhances cognitive recovery in mild cognitive impairment: A multimodal neuroimaging study · Positive with limitations
• Transcranial infrared laser stimulation produces beneficial cognitive and emotional effects in humans. · Positive with limitations
• The potential of infra-low frequency neurofeedback training in peak performance: The first double-blinded placebo-controlled longitudinal study in healthy adults. · Neutral / negative
• Personalized Brain Stimulation based on Brain Oscillations: A Systematic Review of MEG- and EEG-informed Transcranial Alternating Current Stimulation (tACS). · Positive with limitations
• Bilateral Angular Gyrus 810-nm Transcranial Near-Infrared Stimulation Reshapes Brain Network: Ameliorate Alzheimer's Disease Cognitive Deficits. · Positive with limitations
• Effects and safety of repetitive transcranial magnetic stimulation on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis · Positive with limitations
• Multimodal Neurorehabilitation Including Auditory EEG Neurofeedback: A Proof of Concept Tested After Resection of a Giant Olfactory Groove Meningioma · Positive with limitations
• Temporal-Targeted Accelerated 40 Hz tACS Enhances Cognitive Function and Network Integration in Alzheimer's Disease: A Randomized Clinical Trial. · Positive with limitations
• Feasibility of immersive 40 Hz gamma sensory stimulation in early-stage Alzheimer's disease. · Positive with limitations