Introduction: Mild cognitive impairment with Lewy bodies (MCI-LB) is generally associated with more rapid cognitive decline than mild cognitive impairment due to Alzheimer's disease (MCI-AD). However, evidence regarding the potential cognitive trajectories of individuals with MCI-LB participating in structured non-pharmacological multimodal programs remains limited. The aim of the study was to preliminarily examine cognitive changes over time among individuals with MCI-LB and MCI-AD undergoing a multimodal intervention.
Methods: Conducted at the University of Tsukuba Hospital between April 2013 and February 2020, this prospective study enrolled 74 participants (MCI-LB: 14; MCI-AD: 60) in the Cognitive Improvement Day-Care (CIDC) program. The CIDC was a multimodal intervention offering structured sessions including physical exercise, cognitive training, music therapy, and art-based activities. Participants attended the program, mostly once a week, and underwent annual cognitive assessments for up to 3 years using the Japanese version of Mini-Mental State Examination (MMSE-J). Linear mixed-effects models were used to analyze longitudinal changes in MMSE-J scores.
Results: The overall annual cognitive decline was -0.36 points/year (95% CI: -0.63, 0.10). The annual decline was -0.44 points/year (95% CI: -0.95, 0.06) for the MCI-LB group and -0.34 points/year (95% CI: -0.64, -0.03) for the MCI-AD group. No significant group-by-time interaction was observed over the 3-year follow-up (p = 0.97).
Conclusions: These findings suggest that individuals with MCI-LB exhibited longitudinal cognitive trajectories under a structured multimodal intervention that were comparable to those observed in individuals with MCI-AD, at least as assessed by the MMSE-J. Future studies with larger samples and more detailed cognitive assessments are needed to clarify potential subtype-specific responses.
Keywords: Mild cognitive impairment due to Alzheimer’s disease; Mild cognitive impairment with Lewy bodies; Multimodal intervention.
Mild cognitive impairment with Lewy bodies (MCI-LB) is an early stage of Lewy body disease, a brain disorder that can cause problems with thinking, attention, movement, and alertness. People with MCI-LB often experience faster decline in memory and thinking abilities than those with mild cognitive impairment due to Alzheimer’s disease (MCI-AD). Although medicines for dementia exist, there are few nondrug programs specifically tested for people with MCI-LB. This study followed 74 older adults who joined a hospital-based day-care program called the Cognitive Improvement Day-Care (CIDC) at the University of Tsukuba Hospital. Among them, 14 had MCI-LB and 60 had MCI-AD. The CIDC is a structured, nondrug program that combines physical exercise, cognitive (brain) training, music therapy, and art activities in two-hour sessions, usually held once a week. Participants were observed for up to 3 years. Their thinking abilities were measured each year using the Mini-Mental State Examination (MMSE), a common test of global cognitive function. Overall, thinking abilities declined only slightly over time, and there was no meaningful difference between people with MCI-LB and those with MCI-AD. These findings suggest that people with MCI-LB may exhibit a similar pattern of cognitive change to people with MCI-AD when participating in structured, nondrug multimodal programs such as CIDC. Further research with larger groups of participants is needed to confirm these results and to better understand how such programs may support brain health in different types of mild cognitive impairment.
© 2026 The Author(s). Published by S. Karger AG, Basel.