Evidence for health promotion interventions to improve cognitive and physical functioning outcomes in older adults with MCI: A state-of-the-art review

• State-of-the-art review synthesising the current evidence for health promotion interventions in older adults with MCI. • Dementia prevention through health promotion is increasing. • Intervening in a high-risk group is important to ensure healthy ageing. • Multicomponent exercise conducted alongside cognitive training has most evidence for improving cognitive outcomes. • More evidence needed for nutrition, psychological, and social interventions. Health promotion activities for people with mild cognitive impairment (MCI) may improve their overall health and prevent progression to dementia. We need to understand the best approaches to behaviour change in this population. To summarise the types of health promotion interventions and current evidence of clinical effectiveness for physical and cognitive functioning outcomes in people with MCI. State-of-the art review Medline was searched in April 2025, for systematic reviews synthesising randomised controlled trials testing effectiveness of health promotion interventions in older adults with MCI, published since 2015. Abstracts, titles, and full texts were single screened and for eligible reviews characteristics, intervention type, primary outcome, and evidence for people with MCI, were extracted. Key messages were narratively synthesised across reviews, grouping by type of intervention and outcome measure. From 1776 titles and abstracts, 57 systematic reviews were eligible. Regular moderate intensity multicomponent physical exercise and memory-focussed cognitive training interventions had the strongest evidence base for improving cognitive functioning. However, combining physical exercise and cognitive training was more beneficial for cognitive domains and physical functioning, in comparison to doing them individually. The evidence for nutrition interventions was mixed. One review of psychological interventions showed improvements for wellbeing. There is evidence that health promotion interventions can support people with MCI and dementia to improve or maintain their cognitive function, through multicomponent physical activity combined with cognitive training. More evidence is needed for nutritional recommendations, psychological interventions, and social inclusion interventions.