Reminiscence therapy delivery formats for older adults with dementia or mild cognitive impairment: A systematic review and network meta-analysis

Background: Reminiscence therapies are beneficial for people who have dementia or mild cognitive impairment and are widely used among older adults in service institutions and community health care. However, it is not clear which reminiscence therapy delivery format is the most effective. Objectives: To evaluate all reminiscence therapy delivery formats with regard to comparative cognitive function, depressive symptoms, quality of life and adherence, among people with dementia or mild cognitive impairment. Methods: Nine databases were searched systematically to screen pertinent randomized controlled trials (RCTs) published as of March 7, 2025. The effects of and adherence to reminiscence therapy delivery formats were ranked by using a network meta-analysis based on frequentist approaches. The inconsistency between direct comparison and indirect comparison was examined by the node-splitting method. The surface under the cumulative ranking curve (SUCRA) was calculated to rank probability of all reminiscence therapy delivery formats. Results: Fifty-three RCTs involving 4582 participants were included from 4363 records. Compared to the control groups, reminiscence therapy improved cognitive function, reduced depressive symptoms and improved quality of life and this differed according to delivery format. Digital reminiscence therapy had better effects relative to treatment as usual (SMD = 5.02, 95 % CI: 2.57, 7.48) was the highest ranking (SUCRA = 93.6 %) for cognitive function. Digital reminiscence therapy had better effects compared to treatment as usual (SMD =-5.98, 95 % CI:-10.67,-1.30) with highest ranking (SUCRA = 94.9 %) for depressive symptoms. Individual reminiscence therapy had better effects compared to treatment as usual (SMD = 5.15, 95 % CI: 3.61, 6.70) and ranked first (SUCRA = 98.3 %) for quality of life. Group reminiscence therapy was the best format compared to individual reminiscence therapy (SMD = 2.36, 95 % CI: 1.37, 4.06) and treatment as usual (SMD = 1.71, 95 % CI: 1.07, 2.73) with highest ranking (SUCRA = 95.6 %). Conclusions: This review suggests that digital reminiscence therapy seems to be the most effective format for people with dementia or mild cognitive impairment and adherence is likely to be higher following group reminiscence therapy. Considering the limitations of this review, more comprehensive multi-group randomized controlled trials are warranted to compare the effects of and adherence to reminiscence therapy delivery formats for people with dementia or mild cognitive impairment. Registration: This review was registered with PROSPERO (CRD42024530754).