Cognitive Flexibility in Individuals with Mild Cognitive Impairment: A Systematic Literature Review

Abstract

When older adults are diagnosed with mild cognitive impairment (MCI), a condition marked by cognitive decline beyond what is expected for their age, cognitive flexibility becomes increasingly important. Cognitive Flexibility plays a vital role in older adults’ ability to complete activities of daily living and maintain their independence by allowing a person to adapt to changing situations and overcome challenges. Despite its significance, there is limited research regarding the fundamental characteristics of cognitive flexibility in individuals with MCI. This systematic review following the PRISMA (2020) guideline, investigated the operational definition for cognitive flexibility; methodologies commonly used to measure cognitive flexibility; intervention methods being utilized to improve cognitive flexibility; and outcomes of these interventions. Out of 33 sources included in the final full review, only seven reported a definition of cognitive flexibility, and discrepancies exist in how it is conceptualized. Sources used a variety of tests (n=15) to assess cognitive flexibility, most commonly with a version of the Trail Making Test (n=17). Ten intervention sources examined improvements in cognitive flexibility, with positive outcomes reported in six of them, including various pharmaceutical and behavioral approaches. The lack of consensus in definition and measurement may undermine the validity and reliability of studies. A clear conceptual framework and aligned measurement are needed to evaluate cognitive flexibility more accurately. There is potential to improve cognitive flexibility in individuals with MCI, but the evidence is limited and requires more vigorous sources.