Brioschi Guevara, AndreaBieler, MelanieAltomare, DanieleBerthier, MarceloCsajka, ChantalDautricourt, SophieDémonet, Jean-FrançoisDodich, AlessandraFrisoni, Giovanni B.Miniussi, CarloMolinuevo, José LuisRibaldi, FedericaScheltens, PhilipChételat, Gael2022-07-062022-07-062021-10-11Brioschi Guevara A, Bieler M, Altomare D, Berthier M, Csajka C, Dautricourt S, et al. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6. Alzheimers Res Ther. 2021 Oct 11;13(1):172http://hdl.handle.net/10668/3748Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs ("smart drugs", acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Subjective cognitive declineCognitive enhancementCognitive interventionMindfulness meditationPhysical trainingNon-invasive brain stimulationDrugsBrain health serviceDisfunción cognitivaAtención plenaMeditaciónAcondicionamiento físicoMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Esterases::Carboxylic Ester Hydrolases::Cholinesterases::AcetylcholinesteraseMedical Subject Headings::Anatomy::Nervous System::Central Nervous System::BrainMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Clinical ProtocolsMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive AgentsMedical Subject Headings::Organisms::Eukaryota::Plants::Viridiplantae::Streptophyta::Embryophyta::Gymnosperms::Ginkgo bilobaMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Quality of LifeMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Esterases::Carboxylic Ester Hydrolases::Cholinesterases::AcetylcholinesteraseMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Bridged Compounds::Adamantane::Amantadine::MemantineMedical Subject Headings::Diseases::Nervous System Diseases::Neurologic Manifestations::Neurobehavioral Manifestations::Memory Disordersreview article34635149Acceso abierto10.1186/s13195-021-00844-11758-9193PMC8507160