Nurse-led non-pharmacological interventions for cognitive improvement in dementia patients: a systematic review and meta-analysis of randomized controlled trials

Jie Zhang, Rong Luo, Jialei Chen

Introduction Nurse-led non-pharmacological interventions (NLNPIs) have gradually been recognized as a safe strategy to improve cognitive function in patients with dementia. Nevertheless, current research findings remain controversial and the adequacy of sample sizes in previous investigations has not been clarified. This study aimed to evaluate the efficacy of NLNPIs in improving cognitive function in patients with dementia. Methods A systematic literature search for eligible English publications was conducted across three electronic databases (PubMed, EMBASE, and Scopus) on November 25, 2025. Narrative synthesis was adopted to summarize the characteristics of NLNPIs, while a meta-analysis was performed to quantitatively pool effect sizes regarding intervention efficacy. Results A total of 18 randomized controlled trials (RCTs) involving 1,858 patients were included in the systematic review, among which 13 trials were eligible for quantitative meta-analysis. Pooled analyses revealed that NLNPIs significantly improved post-intervention cognitive function assessed immediately upon intervention termination, compared with routine nursing care. Moreover, a cumulative intervention duration (CID) exceeding 480 min was identified as a potential threshold for achieving meaningful cognitive benefits. In terms of long-term efficacy, no statistically significant cognitive improvements were observed at the 6-month follow-up after intervention completion. Conclusions NLNPIs effectively improve cognitive function in patients with dementia, with therapeutic benefits sustained at least until the end of the intervention. Furthermore, the intervention effect may follow a dose-dependent pattern. Large-sample, high-quality RCTs with standardized intervention protocols and rigorous blinding designs are warranted to further validate long-term outcomes and optimal dose thresholds, thereby generating more robust evidence for clinical dementia care. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251228955 , identifier: CRD420251228955.