Memory and thinking in later life, and their decline.
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76 to 100 of 1,152Effect of computerised cognitive training on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis.
Objectives: To determine the effect of computerised cognitive training (CCT) on improving cognitive function for older adults with mild cognitive impairment (MCI).
Design: Systematic review and meta-analysis.
Data sources: PubMed, Embase, Web of Science and the Cochrane Library were searched through January 2018.
Eligibility criteria: Randomised controlled trials comparing CCT with control conditions in those with MCI aged 55+ were included.
Data extraction and synthesis: Two independent reviewers extracted data and assessed the risk of bias. Effect sizes (Hedges' g and 95% CIs) were calculated and random-effects meta-analyses were performed where three or more studies investigated a comparable intervention and outcome. Heterogeneity was quantified using the I2 statistic.
Results: 18 studies met the inclusion criteria and were included in the analyses, involving 690 participants. Meta-an…
matched on Cognitive Dysfunction (mesh), mild cognitive impairment (text)
Cognitive intervention for persons with mild cognitive impairment: A meta-analysis.
Cognitive training for persons with mild cognitive impairment (MCI) has become a hot topic. However to date it remains controversial whether persons with MCI can really benefit from cognitive intervention. We aim to further investigate this by using meta-analysis of seventeen clinical studies of cognitive intervention for MCI. The results demonstrate that after training, patients with MCI improve significantly both in overall cognition and overall self-ratings. Specifically, persons with MCI obtain moderate benefits in language, self-rated anxiety and functional ability, and receive mild benefits in episodic memory, semantic memory, executive functioning/working memory, visuo-spatial ability, attention/processing speed, MMSE, self-rated memory problem, quality of life, activities of daily life and self-rated depression. The results also suggest that persons with MCI benefit from the cogn…
matched on Memory Disorders (mesh), mild cognitive impairment (text)
Potential Benefits of Physical Activity in MCI and Dementia.
Physical activity improves overall health and reduces the risk of many negative health outcomes and may be effective in improving cognition, independent functioning, and psychological health in older adults. Given the evidence linking physical activity with improvements in various aspects of health and functioning, interventions exploring pathways for decreasing risk of dementia in those with mild cognitive impairment (MCI) and improving outcomes for those with dementia are of critical importance. The present review highlights the work examining physical activity interventions in order to achieve a comprehensive understanding of the potential benefits of physical activity for individuals experiencing cognitive decline. The primary focus is on aerobic exercise as this is the main intervention in the literature. Our review supports the thesis that physical activity can promote healthy agin…
matched on Dementia (mesh), Cognitive Dysfunction (mesh), cognitive decline (text), mild cognitive impairment (text)
Inflammation and gut-brain axis link obesity to cognitive dysfunction: plausible pharmacological interventions.
Obesity prevalence is increasing steadily throughout the world's population in most countries and in parallel the prevalence of metabolic disorders including cardiovascular diseases and type 2 diabetes is also rising, but less is reported about excessive adiposity relationship with poorer cognitive performance, cognitive decline and dementia. Some human clinical studies have evidenced that obesity is related to the risk of the development of mild cognitive impairment, in the form of short-term memory and executive function deficits, as well as dementia and Alzheimer's disease. The precise mechanisms that underlie the connections between obesity and the risk of cognitive impairment are still largely unknown but potential avenues of further research include insulin resistance, the gut-brain axis, and systemic mediators and central inflammation processes. A common feature of metabolic disea…
matched on Alzheimer Disease (mesh), Cognitive Dysfunction (mesh), cognitive decline (text), mild cognitive impairment (text)
The diagnosis and management of mild cognitive impairment: a clinical review.
Importance: Cognitive decline is a common and feared aspect of aging. Mild cognitive impairment (MCI) is defined as the symptomatic predementia stage on the continuum of cognitive decline, characterized by objective impairment in cognition that is not severe enough to require help with usual activities of daily living.
Objective: To present evidence on the diagnosis, treatment, and prognosis of MCI and to provide physicians with an evidence-based framework for caring for older patients with MCI and their caregivers.
Evidence acquisition: We searched PubMed for English-language articles in peer-reviewed journals and the Cochrane Library database from inception through July 2014. Relevant references from retrieved articles were also evaluated.
Findings: The prevalence of MCI in adults aged 65 years and older is 10% to 20%; risk increases with age and men appear to be at higher risk than wo…
matched on Dementia (mesh), Cognitive Dysfunction (mesh), cognitive decline (text), mild cognitive impairment (text)
Heffernan M, Andrews G, Fiatarone Singh MA, Valenzuela M, Anstey KJ, Maeder AJ, McNeil J, Jorm L, Lautenschlager NT, Sachdev PS, Ginige JA, Hobbs MJ, Boulamatsis C, Chau T, Cobiac L, Cox KL, Daniel K, Flood VM, Guerrero Y, Gunn J, Jain N, Kochan NA, Lampit A, Mavros Y, Meiklejohn J, Noble Y, O'Leary F, Radd-Vagenas S, Walton CC, Maintain Your Brain Collaborative Team, Brodaty H (2019)clinical trialMEDLINE-indexed journal, not yet read by usJournal of Alzheimer's disease : JAD61 citations Maintain Your Brain: Protocol of a 3-Year Randomized Controlled Trial of a Personalized Multi-Modal Digital Health Intervention to Prevent Cognitive Decline Among Community Dwelling 55 to 77 Year Olds.
Background: Maintain Your Brain (MYB) is a randomized controlled trial of an online multi-modal lifestyle intervention targeting modifiable dementia risk factors with its primary aim being to reduce cognitive decline in an older age cohort.
Methods: MYB aims to recruit 8,500 non-demented community dwelling 55 to 77 year olds from the Sax Institute's 45 and Up Study in New South Wales, Australia. Participants will be screened for risk factors related to four modules that comprise the MYB intervention: physical activity, nutrition, mental health, and cognitive training. Targeting risk factors will enable interventions to be personalized so that participants receive the most appropriate modules. MYB will run for three years and up to four modules will be delivered sequentially each quarter during year one. Upon completing a module, participants will continue to receive less frequent booster…
matched on Cognitive Dysfunction (mesh), Dementia (keyword), cognitive decline (text)
evoke and evoke+: design of two large-scale, double-blind, placebo-controlled, phase 3 studies evaluating efficacy, safety, and tolerability of semaglutide in early-stage symptomatic Alzheimer's disease.
Background: Disease-modifying therapies targeting the diverse pathophysiology of Alzheimer's disease (AD), including neuroinflammation, represent potentially important and novel approaches. The glucagon-like peptide-1 receptor agonist semaglutide is approved for the treatment of type 2 diabetes and obesity and has an established safety profile. Semaglutide may have a disease-modifying, neuroprotective effect in AD through multimodal mechanisms including neuroinflammatory, vascular, and other AD-related processes. Large randomized controlled trials are needed to assess the efficacy and safety of semaglutide in early-stage symptomatic AD.
Methods: evoke and evoke+ are randomized, double-blind, placebo-controlled phase 3 trials investigating the efficacy, safety, and tolerability of once-daily oral semaglutide versus placebo in early-stage symptomatic AD. Eligible participants were men or w…
matched on Alzheimer Disease (mesh), mild cognitive impairment (text)
Cohen S, van Dyck CH, Gee M, Doherty T, Kanekiyo M, Dhadda S, Li D, Hersch S, Irizarry M, Kramer LD (2023)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe journal of prevention of Alzheimer's disease71 citations Lecanemab Clarity AD: Quality-of-Life Results from a Randomized, Double-Blind Phase 3 Trial in Early Alzheimer's Disease.
Background: Lecanemab is a humanized IgG1 monoclonal antibody binding with high affinity to amyloid-beta protein protofibrils. In phase 3 development, lecanemab has been shown to reduce markers of amyloid in early Alzheimer's disease and reduce decline on clinical endpoints of cognition and function at 18 months.
Objectives: To describe the health-related quality-of-life (HRQoL) results from Clarity AD which were exploratory outcomes in this trial.
Design: Clarity AD was an 18-month, multi-center, double-blind, phase 3 trial.
Setting: Early Alzheimer's disease.
Participants: Individuals 50-90 years of age with a diagnosis of mild cognitive impairment or mild dementia due to Alzheimer's disease and positron emission tomography or cerebrospinal fluid evidence of cerebral amyloid accumulation.
Intervention: Placebo or lecanemab 10-mg/kg IV biweekly.
Measurements: HRQoL was measured at basel…
matched on Alzheimer Disease (mesh), mild cognitive impairment (text)
Non-Pharmacological interventions for the anxiety in patients with dementia. A cross-over randomised controlled trial.
Background: Behavioural and Psychiatric Symptoms in dementia (BPSD) tend to be a crucial and big problem in dementia. Anxiety several times remains under-diagnosed because it is often considered to be a psychological response to cognitive decline. As only the 10 % of patients were correctly treated, the pharmacological treatment should be well- considered. The aim of this study was to evaluate three non-pharmacological interventions for the treatment of anxiety in dementia.
Methods: A cross-over randomised controlled trial with 60 participants (different types and stages of dementia) conducted in Greece. The sample was randomly assigned to 6 different groups of 10 participants each. The non-pharmacological interventions that have been evaluated are: a) Music Therapy b) Exercise and c) Aromatherapy & Massage. The measurements that were used are: MMSE, ACE-R, GDS, FRSSD and NPI questionnai…
matched on Dementia (mesh), cognitive decline (text)
Music and Dementia: Individual Differences in Response to Personalized Playlists.
Personalized music playlists are increasingly being used in health-care contexts to address the psychological and behavioral symptoms in people with dementia. However, there is little understanding of how people with different mental health histories and symptoms respond differently to music. A factorial experiment was conducted to investigate the influence of depression, anxiety, apathy, and cognitive decline on affective response to music. Ninety-nine people with dementia listened to three music playlists based on personal preferences. Activation of facial action units was measured, and behavioural responses continuously observed. Results demonstrated that people with high levels of depression and with symptoms of Alzheimer's type dementia demonstrated increased levels of sadness when listening to music. People with low depression but high levels of apathy demonstrated the highest beha…
matched on Dementia (mesh), cognitive decline (text)
Curcumin and cognition: a randomised, placebo-controlled, double-blind study of community-dwelling older adults.
Curcumin therapy in animals has produced positive cognitive and behavioural outcomes; results of human trials, however, have been inconsistent. In this study, we report the results of a 12-month, randomised, placebo-controlled, double-blind study that investigated the ability of a curcumin formulation to prevent cognitive decline in a population of community-dwelling older adults. Individuals (n 96) ingested either placebo or 1500 mg/d BiocurcumaxTM for 12 months. A battery of clinical and cognitive measures was administered at baseline and at the 6-month and 12-month follow-up assessments. A significant time×treatment group interaction was observed for the Montreal Cognitive Assessment (repeated-measures analysis; time×treatment; F=3·85, P<0·05). Subsequent analysis revealed that this association was driven by a decline in function of the placebo group at 6 months that was not observed …
matched on Dementia (mesh), cognitive decline (text)
Signe A, Elmståhl S (2008)randomised controlled trialMEDLINE-indexed journal, not yet read by usScandinavian journal of caring sciences49 citations Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months.
A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervent…
matched on Dementia (mesh), cognitive decline (text)
Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study.
Objective: To assess the cost effectiveness of community based occupational therapy compared with usual care in older patients with dementia and their care givers from a societal viewpoint.
Design: Cost effectiveness study alongside a single blind randomised controlled trial.
Setting: Memory clinic, day clinic of a geriatrics department, and participants' homes. Patients 135 patients aged > or =65 with mild to moderate dementia living in the community and their primary care givers.
Intervention: 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision.
Main outcome measures: Incremental cost effectiveness ratio expressed as the difference in mean total care costs per successful treatment (that is, a combined patient a…
matched on Dementia (mesh), cognitive decline (text)
Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial.
Context: Many observational studies have shown that physical activity reduces the risk of cognitive decline; however, evidence from randomized trials is lacking.
Objective: To determine whether physical activity reduces the rate of cognitive decline among older adults at risk.
Design and setting: Randomized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth, Western Australia. Assessors of cognitive function were blinded to group membership.
Participants: We recruited volunteers who reported memory problems but did not meet criteria for dementia. Three hundred eleven individuals aged 50 years or older were screened for eligibility, 89 were not eligible, and 52 refused to participate. A total of 170 participants were randomized and 138 participants completed the 18-month assessment.
Intervention: Participants were randomly al…
matched on Alzheimer Disease (mesh), cognitive decline (text)
Aisen PS, Schneider LS, Sano M, Diaz-Arrastia R, van Dyck CH, Weiner MF, Bottiglieri T, Jin S, Stokes KT, Thomas RG, Thal LJ, Alzheimer Disease Cooperative Study (2008)randomised controlled trialMEDLINE-indexed journal, not yet read by usJAMA368 citations High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial.
Context: Blood levels of homocysteine may be increased in Alzheimer disease (AD) and hyperhomocysteinemia may contribute to disease pathophysiology by vascular and direct neurotoxic mechanisms. Even in the absence of vitamin deficiency, homocysteine levels can be reduced by administration of high-dose supplements of folic acid and vitamins B(6) and B(12). Prior studies of B vitamins to reduce homocysteine in AD have not had sufficient size or duration to assess their effect on cognitive decline.
Objective: To determine the efficacy and safety of B vitamin supplementation in the treatment of AD.
Design, setting, and patients: A multicenter, randomized, double-blind controlled clinical trial of high-dose folate, vitamin B(6), and vitamin B(12) supplementation in 409 (of 601 screened) individuals with mild to moderate AD (Mini-Mental State Examination scores between 14 and 26, inclusive) an…
matched on Alzheimer Disease (mesh), cognitive decline (text)
The effect of walking and vitamin B supplementation on quality of life in community-dwelling adults with mild cognitive impairment: a randomized, controlled trial.
Objectives: To examine the effect of walking and vitamin B supplementation on quality-of-life (QoL) in community-dwelling adults with mild cognitive impairment.
Methods: One year, double-blind, placebo-controlled trial. Participants were randomized to: (1) twice-weekly, group-based, moderate-intensity walking program (n = 77) or a light-intensity placebo activity program (n = 75); and (2) daily vitamin B pills containing 5 mg folic acid, 0.4 mg B12, 50 mg B6 (n = 78) or placebo pills (n = 74). QoL was measured at baseline, after six and 12 months using the population-specific Dementia Quality-of-Life (D-QoL) to assess overall QoL and the generic Short-Form 12 mental and physical component scales (SF12-MCS and SF12-PCS) to assess health-related QoL.
Results: Baseline levels of QoL were relatively high. Modified intention-to-treat analyses revealed no positive main intervention effect of w…
matched on Dementia (mesh), mild cognitive impairment (text)
Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial.
Objective: To determine the effectiveness of community based occupational therapy on daily functioning of patients with dementia and the sense of competence of their care givers.
Design: Single blind randomised controlled trial. Assessors were blinded for treatment allocation.
Setting: Memory clinic and day clinic of a geriatrics department and participants' homes.
Participants: 135 patients aged > or =65 with mild to moderate dementia living in the community and their primary care givers.
Interventions: 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision.
Main outcome measures: Patients' daily functioning assessed with the assessment of motor and process skills (AMPS) and the performance scale of the interview o…
matched on Dementia (mesh), cognitive decline (text)
Effect of immunotherapy with bapineuzumab on cerebrospinal fluid biomarker levels in patients with mild to moderate Alzheimer disease.
Background: Given the slow and variable clinical course of Alzheimer disease, very large and extended clinical trials are needed to identify a beneficial clinical effect of disease-modifying treatments. Therefore, biomarkers are essential to prove that an anti-β-amyloid (Aβ) drug candidate affects both Aβ metabolism and plaque load as well as downstream pathogenic mechanisms.
Objective: To evaluate the effect of the anti-Aβ monoclonal antibody bapineuzumab on cerebrospinal fluid (CSF) biomarkers reflecting Aβ homeostasis, neuronal degeneration, and tau-related pathology in patients with Alzheimer disease.
Design: Two phase 2, multicenter, randomized, double-blind, placebo-controlled clinical trials of 12-month duration.
Setting: Academic centers in the United States (Study 201) and England and Finland (Study 202).
Patients: Forty-six patients with mild to moderate Alzheimer disease.
Inte…
matched on Alzheimer Disease (mesh), Amyloid beta-Peptides (mesh)
Digital tools for delivery of dementia education for caregivers of persons with dementia: A systematic review and meta-analysis of impact on caregiver distress and depressive symptoms.
Continuing education for dementia has been shown to be beneficial by improving informal caregiver knowledge, dementia care, management, and caregiver physical and mental health. Technology-based dementia education has been noted to have equivalent effects as in-person education, but with the added benefit of asynchronous and/or remote delivery, which increases accessibility. Using Cochrane review methodology, this study systematically reviewed the literature on technology-based dementia education and its impacts on caregivers. Technology-based delivery included dementia education delivered via the Internet, telephone, telehealth, videophone, computer, or digital video device (DVD). In the review, twenty-eight studies were identified with fourteen included in a meta-analysis, and these data revealed a significant small effect of technologically based dementia education on reducing caregiv…
matched on Dementia (mesh)
Remotely delivered information, training and support for informal caregivers of people with dementia.
Background: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow…
matched on Dementia (mesh)
A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers.
Background: Many reviews with conflicting findings on dementia caregiver interventions have been published. A meta-review was conducted to synthesize the findings of systematic reviews and meta-analyses.
Methods: MEDLINE, PsycINFO, CINAHL and Cochrane Library were searched to identify reviews published during 2006-2018.
Results: Sixty reviews covering > 500 intervention studies were selected and appraised with Assessment of Multiple Systematic Reviews (AMSTAR) II. The great majority of studies were of low quality according to AMSTAR II, but quality factors appeared unrelated to the conclusions obtained. Depression was most modifiable, with effects found across a spectrum of interventions (psychoeducation, counseling/psychotherapy, occupational therapy, mindfulness-based interventions, multicomponent interventions, etc.). Evidence of intervention effect was also found for quality of life …
matched on Dementia (mesh)
How Effective Are Dementia Caregiver Interventions? An Updated Comprehensive Meta-Analysis.
Background and objectives: Caring for a person with dementia places a significant burden upon informal caregivers and leads to decreased psychological and physical health, which is why dementia caregiver interventions have been developed. However, empirical evidence for the efficacy of those interventions is inconclusive and the last comprehensive meta-analysis (Pinquart & Sörensen. Helping caregivers of persons with dementia: Which interventions work and how large are their effects? International Psychogeriatrics. 2006;18(4), 577-595.) was published more than 10 years ago.
Research design and method: This meta-analysis aims to update the meta-analysis conducted by Pinquart and Sörensen. Based on a systematic search in electronic data bases, effects of 282 controlled studies were integrated. The effectiveness of different intervention types and influences of study characteristics were ev…
matched on Dementia (mesh)
Yu JT, Xu W, Tan CC, Andrieu S, Suckling J, Evangelou E, Pan A, Zhang C, Jia J, Feng L, Kua EH, Wang YJ, Wang HF, Tan MS, Li JQ, Hou XH, Wan Y, Tan L, Mok V, Tan L, Dong Q, Touchon J, Gauthier S, Aisen PS, Vellas B (2020)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of neurology, neurosurgery, and psychiatry346 citations Evidence-based prevention of Alzheimer's disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials.
Background: Evidence on preventing Alzheimer's disease (AD) is challenging to interpret due to varying study designs with heterogeneous endpoints and credibility. We completed a systematic review and meta-analysis of current evidence with prospective designs to propose evidence-based suggestions on AD prevention.
Methods: Electronic databases and relevant websites were searched from inception to 1 March 2019. Both observational prospective studies (OPSs) and randomised controlled trials (RCTs) were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment according to its risk of bias, inconsistency and imprecision. Levels of evidence and classes of suggestions were summarised.
Results: A total of 44 676 reports were identified, and 243 OPSs and 153 RCTs were eligible for analysis after exclusion based on pre-decided criteria,…
matched on Alzheimer Disease (mesh)
The effectiveness of nonpharmacological interventions for informal dementia caregivers: An updated systematic review and meta-analysis.
This systematic review and meta-analysis compared the effects of 131 randomized controlled trials, published between 2006 and mid-2018, for dementia caregivers with community-dwelling care-recipients. A new classification of interventions was proposed to enable a more detailed examination of the effectiveness of psychological interventions; 350 postintervention effect sizes in 128 studies and 155 follow-up effect sizes in 55 studies were computed. Postintervention effects were significant for all outcomes when all interventions are pooled together. Follow-up effects were found for all outcomes, except physical health and positive aspects of caregiving. Educational programs with psychotherapeutic components, counseling/psychotherapy, and mindfulness-based interventions had the strongest effects on reducing depressive symptoms. Multicomponent and miscellaneous interventions had the largest…
matched on Dementia (mesh)
Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis.
Background: Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care.
Objective: This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients.
Methods: An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted u…
matched on Dementia (mesh)