P.0415 Meta-analysis of cognitive performance in older adults with bipolar disorders

ABSTRACTBackgroundComputerized cognitive training (CCT) is a broad category of drill-and-practice interventions aims to maintain cognitive performance in older adults. Despite a supportive evidence base for general efficacy, it is unclear what types of CCT are most likely to be beneficial and what intervention design factors are essential for clinical implementation.MethodsWe searched MEDLINE, Embase, and PsycINFO to August 2019 for randomized controlled trials (RCTs) of any type of CCT in cognitively healthy older adults. Risk of bias within studies was assessed using the Cochrane Risk of Bias 2 tool. The primary outcome was change in overall cognitive performance between CCT and control groups. Secondary outcomes were individual cognitive domains. A series of meta-regressions were performed to estimates associations between key design factors and overall efficacy using robust variance estimation models. Network meta-analysis was used to compare the main approaches to CCT against passive or common active control conditions.ResultsNinety RCTs encompassing 7219 participants across 117 comparisons were included. The overall cognitive effect size across all trials was small (g=0.18, 95% CI 0.14 to 0.23) with considerable heterogeneity (τ2=0.074, 95% prediction interval −0.36 to 0.73), robust to small-study effect or risk of bias. Effect sizes for individual cognitive domains were small, heterogeneous and statistically significant apart from fluid intelligence and visual processing. Meta-regressions revealed significantly larger effect sizes in trials using supervised training or up to three times per week. Multidomain training was the most efficacious CCT approach against any type of control, with greater benefits in a subset of supervised training studies.ConclusionsThe efficacy of CCT varies substantially across designs, independent of the type of control. Multidomain supervised CCT appears to be the most efficacious approach, and should be developed to accommodate for individual needs and remote delivery settings. Future research should focus on identifying the intervention components and regimens that could attenuate aging-related cognitive decline.

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Effects of Meditation and Mind–Body Exercises on Older Adults’ Cognitive Performance: A Meta-analysis

The Gerontologist ◽

10.1093/geront/gnz022 ◽

2019 ◽

Vol 59 (6) ◽

pp. e782-e790 ◽

Cited By ~ 10

Author(s):

John S Y Chan ◽

Kanfeng Deng ◽

Jiamin Wu ◽

Jin H Yan

Keyword(s):

Older Adults ◽

Elderly People ◽

Cognitive Performance ◽

Tai Chi ◽

Meta Analysis ◽

The Elderly ◽

Cochrane Library ◽

Exercise Session ◽

Control Group ◽

Exercise Frequency

Abstract Background and Objectives Meditation and mind–body exercises are suggested to delay decline or enhance cognitive capabilities in older adults. However, their effectiveness remains uncertain. This study assessed the effectiveness of meditation and mind–body exercises to improve cognition in elderly people aged 60 years or above. Moderator variables were also explored. Research Design and Methods A databases search (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, CNKI, and Wangfang) was conducted from the first available date to January 10, 2018. Inclusion criteria include (a) human older adults aged 60 years or above, (b) meditation, Tai Chi, Qigong, or yoga intervention, (c) intervention should be structured, (d) inclusion of a control group, (e) at least one outcome measure of cognition was measured at baseline and post-training, and (f) peer-reviewed journal articles in English or Chinese. Results Forty-one studies (N = 3,551) were included in the meta-analysis. In general, meditation and mind–body exercises improve cognition in the elderly people (SMD = 0.34, 95% CI: 0.19 to 0.48), but the cognition-enhancing effects depend on the type of exercise. In addition, cognitive performance is only improved when the length of intervention is longer than 12 weeks, exercise frequency is 3–7 times/week, or duration of an exercise session is 45–60 min/session. Discussion and Implications This study suggests that meditation and mind–body exercises are effective to improve cognition of older adults aged 60 years or above, and exercise parameters should be considered for intervention planning.

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Effect of Tai Chi on Cognitive Performance in Older Adults: Systematic Review and Meta-Analysis

Journal of the American Geriatrics Society ◽

10.1111/jgs.12611 ◽

2014 ◽

Vol 62 (1) ◽

pp. 25-39 ◽

Cited By ~ 158

Author(s):

Peter M. Wayne ◽

Jacquelyn N. Walsh ◽

Ruth E. Taylor-Piliae ◽

Rebecca E. Wells ◽

Kathryn V. Papp ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Performance ◽

Tai Chi ◽

Meta Analysis

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Associations between self-reported sleep duration and cognitive performance in older adults: A systematic review and meta-analysis

Sleep Medicine ◽

10.1016/j.sleep.2015.02.078 ◽

2015 ◽

Vol 16 ◽

pp. S31-S32

Author(s):

J. Lo ◽

G. Cheng ◽

K. Loh ◽

R. Leong ◽

M. Chee

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Performance ◽

Sleep Duration ◽

Meta Analysis

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The effects of anticholinergic medications on cognition in children: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-020-80211-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Erica Ghezzi ◽

Michelle Chan ◽

Lisa M. Kalisch Ellett ◽

Tyler J. Ross ◽

Kathryn Richardson ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Performance ◽

Meta Analysis ◽

Experimental Studies ◽

Cognitive Outcomes ◽

Cognitive Domain ◽

Anticholinergic Medication ◽

Anticholinergic Medications ◽

Meta Analyses

AbstractCognitive side effects of anticholinergic medications in older adults are well documented. Whether these poor cognitive outcomes are observed in children has not been systematically investigated. We aimed to conduct a systematic review and meta-analysis on the associations between anticholinergic medication use and cognitive performance in children. Systematic review was conducted using Medline, PsychInfo, and Embase, identifying studies testing cognitive performance relative to the presence versus absence of anticholinergic medication(s) in children. We assessed effects overall, as well as relative to drug class, potency (low and high), cognitive domain, and duration of administration. The systematic search identified 46 articles suitable for meta-analysis. For the most part, random effects meta-analyses did not identify statistically significant associations between anticholinergic exposure and cognitive performance in children; the one exception was a small effect of anticholinergic anti-depressants being associated with better cognitive function (Hedges’ g = 0.24, 95% CI 0.06–0.42, p = 0.01). Anticholinergic medications do not appear to be associated with poor cognitive outcomes in children, as they do in older adults. The discrepancy in findings with older adults may be due to shorter durations of exposure in children, differences in study design (predominantly experimental studies in children rather than predominantly epidemiological in older adults), biological ageing (e.g. blood brain barrier integrity), along with less residual confounding due to minimal polypharmacy and comorbidity in children.

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