The effects of Huperzine A on dementia and mild cognitive impairment: An overview of systematic reviews

ObjectiveTo summarise evidence on the preventive effects of continuing education on mild cognitive impairment and Alzheimer’s-type dementia in adults 45 years or older.DesignSystematic review and overview of systematic reviews.Data sourcesWe systematically searched MEDLINE, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Scopus for published studies and grey literature databases for unpublished studies from January 1990 to April 2018.MethodsTo assess evidence directly addressing our objectives, we conducted a systematic review. Because we were aware of a dearth of direct evidence, we also performed an overview of systematic reviews on leisure activities that mimic formal continuing education. We a priori established the inclusion and exclusion criteria. Two authors independently assessed inclusion and exclusion at the abstract and full-text level, rated the risk of bias, and determined the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation. We resolved all discrepancies by consensus. We synthesised the available evidence narratively.ResultsOur searches identified 4933 citations. For the systematic review, only two publications on the same prospective cohort study (Tasmanian Healthy Brain Project) met the inclusion criteria; for the overview of reviews, we included five systematic reviews. Based on 459 participants, preliminary data of the ongoing cohort study indicated that cognitive reserve statistically significantly increased in persons attending university classes compared with the control group (92.5% vs 55.7%, p<0.01). Likewise, language processing capacities statistically significantly improved (p<0.01). Episodic memory, working memory and executive function did not differ significantly between groups. Systematic reviews consistently reported a positive association between participation in cognitively stimulating leisure activities and reduced incidence of dementia and improved cognitive test performance.ConclusionAvailable results demonstrate that cognitive reserve increases through continuing education and show a positive association of cognitive leisure activities with both improved cognitive function and lower dementia incidence.PROSPERO registration numberCRD42017063944.

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Faculty of 1000 evaluation for Huperzine A for mild cognitive impairment.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.717969334.793471271 ◽

2013 ◽

Author(s):

Brandy Matthews

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Huperzine A

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Huperzine A for mild cognitive impairment

10.1002/14651858.cd008827 ◽

2010 ◽

Cited By ~ 1

Author(s):

Jirong Yue ◽

Bi Rong Dong ◽

Xiufang Lin ◽

Ming Yang ◽

Hong Mei Wu ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Huperzine A

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Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

10.31234/osf.io/y5f89 ◽

2019 ◽

Cited By ~ 2

Author(s):

Hanna Malmberg Gavelin ◽

Amit Lampit ◽

Harry Hallock ◽

Julieta Sabates ◽

Alex Bahar-Fuchs

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Training ◽

Systematic Reviews ◽

Cognitive Stimulation ◽

Cognitive Outcomes ◽

Effect Estimate ◽

Systematic Overview ◽

Overview Of Systematic Reviews ◽

Meta Analyses

Cognition-oriented treatments (COTs) – commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation – are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of COTs on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by AMSTAR 2. We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were “moderate” for 9 (20%), “low” for 13 (28%) and “critically low” for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (Hedge’s g 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (Hedge’s g 0.40, range 0.32-0.60, five reviews), and dementia (Hedge’s g 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (Hedge’s g 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of COTs improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards.PROSPERO registration number: CRD42018084490.Gavelin, H.M., Lampit, A., Hallock, H. et al. Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews. Neuropsychol Rev (2020). https://doi.org/10.1007/s11065-020-09434-8

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