The effects of visual art therapy in older adults with mild cognitive impairment: a systematic review and meta-analysis

Objective To systematically evaluate the effectiveness of visual art therapy (VAT) in older adults with mild cognitive impairment (MCI). Methods A systematic search of multiple bibliographic databases and gray literature sources was conducted from inception to January 25, 2026, and RCTs comparing VAT with control conditions were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Continuous outcomes were pooled using a random-effects model and summarized as SMDs or MDs. Heterogeneity was assessed using Cochran’s Q test and the I 2 statistic. Meta-analyses were performed in RevMan 5.3, and certainty of evidence was rated using the GRADE approach. Results Nine RCTs ( N = 595) were included. For the primary outcome, VAT improved global cognition [SMD = 0.55, 95% CI 0.38 to 0.72; I 2 = 0%; (number of studies) k = 8; N = 564, moderate certainty]. For secondary outcomes, VAT improved long-term memory (SMD = 0.34, 95% CI 0.13 to 0.56; I 2 = 0%; k = 5; N = 331; low certainty) and short-term memory (SMD = 0.42, 95% CI 0.19 to 0.65; I 2 = 11%; k = 4; N = 336; low certainty). No clear benefit was observed for language function (SMD = 0.14, 95% CI −0.10 to 0.37; I 2 = 0%; k = 4; N = 277; low certainty). VAT reduced depressive symptoms (SMD = −0.53, 95% CI −0.86 to −0.21; I 2 = 42%; k = 5; N = 312; low certainty) and improved activities of daily living (SMD = −0.41, 95% CI −0.64 to −0.19; I 2 = 0%; k = 4; N = 305; low certainty). Conclusion Current RCT evidence suggests that VAT improves global cognition in older adults with MCI and may improve memory, depressive symptoms, and activities of daily living, whereas no clear benefit was found for language function. These findings require confirmation in larger, methodologically rigorous trials with more standardized outcome measurement. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251167927 , CRD420251167927.