scholarly journals “The Dichotic Digit Test” as an Index Indicator for Hearing Problem in Dementia: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Nattawan Utoomprurkporn ◽  
Chris J.D. Hardy ◽  
Joshua Stott ◽  
Sergi G. Costafreda ◽  
Jason Warren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Speech Processing ◽  
Test Performance ◽  
Meta Analysis ◽  
Control Group ◽  
People With Dementia ◽  
Ear Advantage ◽  
Right Ear Advantage ◽  
Dementia Onset

Abstract Background Patients with dementia commonly have problems processing speech in the presence of competing background speech or noise. This difficulty can be present from the very early stages of dementia, and may be a preclinical feature of Alzheimer's disease. Purpose This study investigates whether people with dementia perform worse on the dichotic digit test (DDT), an experimental probe of speech processing in the presence of competing speech, and whether test performance may predict dementia onset. Research Design Systematic review and meta-analysis. Data Collection and Analysis A literature search was conducted in Medline, Embase, Scopus, and Psycinfo. We included (1) studies that included people with a diagnosis of dementia and a healthy control group with no cognitive impairment; (2) studies that reported results from a DDT in a free-recall response task; and (3) studies that had the dichotic digit mean correct percentage score or right-ear advantage, as outcome measurements. Results People with dementia had a lower DDT total score, with a pooled mean difference of 18.6% (95% confidence interval [CI]: 21.2–15.9). Patients with dementia had an increased right-ear advantage relative to controls with a pooled difference of 24.4% (95% CI: 21.8–27.0). Conclusion The DDT total scores are lower and the right-ear advantage increased in cognitively impaired versus normal control participants. The findings also suggest that the reduction of dichotic digit total score and increase of right-ear advantage progress as cognitive impairment increases. Whether abnormalities in dichotic digit scores could predict subsequent dementia onset should be examined in further longitudinal studies.

Disease-modifying treatments and cognition in relapsing-remitting multiple sclerosis

Neurology ◽  
2020 ◽  
Vol 94 (22) ◽  
pp. e2373-e2383 ◽  
Author(s):  
Nils C. Landmeyer ◽  
Paul-Christian Bürkner ◽  
Heinz Wiendl ◽  
Tobias Ruck ◽  
Hans-Peter Hartung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Test Performance ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Current Evidence ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Cognitive Test Performance

ObjectiveDisease-modifying treatments (DMTs) are the gold standard for slowing disability progression in multiple sclerosis (MS), but their effects on cognitive impairment, a key symptom of the disease, are mostly unknown. We conducted a systematic review and meta-analysis to evaluate the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS).MethodsPubMed, Scopus, and Cochrane Library were searched for studies reporting longitudinal cognitive performance data related to all major DMTs. The standardized mean difference (Hedges g) between baseline and follow-up cognitive assessment was used as the main effect size measure.ResultsForty-four studies, including 55 distinct MS patient samples, were found eligible for the systematic review. Twenty-five studies were related to platform therapies (mainly β-interferon [n = 17] and glatiramer acetate [n = 4]), whereas 22 studies were related to escalation therapies (mainly natalizumab [n = 14] and fingolimod [n = 6]). Reported data were mostly confined to the cognitive domain processing speed. A meta-analysis including 41 studies and 7,131 patients revealed a small to moderate positive effect on cognitive test performance of DMTs in general (g = 0.27, 95% confidence interval [CI] = [0.21–0.33]), but no statistically significant differences between platform (g = 0.27, 95% CI = [0.18–0.35]) and escalation therapies (g = 0.28, 95% CI = [0.19–0.37]) or between any single DMT and β-interferon.ConclusionsDMTs are effective in improving cognitive test performance in RRMS, but a treatment escalation mainly to amend cognition is not supported by the current evidence. Given the multitude of DMTs and their widespread use, the available data regarding differential treatment effects on cognitive impairment are remarkably scant. Clinical drug trials that use more extensive cognitive outcome measures are urgently needed.

scholarly journals Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: Systematic review and meta-analysis

2015 ◽  
Vol 207 (4) ◽  
pp. 293-298 ◽  
Author(s):  
Vasiliki Orgeta ◽  
Afifa Qazi ◽  
Aimee Spector ◽  
Martin Orrell
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Psychological Treatments ◽  
People With Dementia

BackgroundAnxiety and depression are common in people with dementia and mild cognitive impairment (MCI), but there is uncertainty about the effectiveness of both pharmacological and psychological therapies.AimsTo evaluate the evidence of effectiveness of psychological treatments in treating depression and anxiety in people with dementia and MCI.MethodWe carried out a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological treatment versus usual care in people with dementia and MCI. Primary outcomes were symptoms of anxiety and depression. Secondary outcomes were quality of life, ability to perform daily activities, neuropsychiatric symptoms, cognition and caregivers' self-rated depressive symptoms.ResultsWe included six RCTs, involving 439 participants with dementia, which used cognitive–behavioural therapy, interpersonal therapy, counselling or multimodal interventions including a specific psychological therapy. We found beneficial effects for both depression and anxiety. Overall, the quality of the evidence was moderate for depression and low for anxiety, due to the methodological limitations of the studies we identified and the limited number of trials.ConclusionsThe evidence from six RCTs suggests that psychological treatments are effective in reducing symptoms of depression and anxiety for people with dementia. There is a need for high-quality, multicentre trials including standardised, well-defined interventions.Declarations of interestA.Q., A.S. and M.O. are investigators in one of the included studies.

scholarly journals Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Renjun Gu ◽  
Yujia Gao ◽  
Chunbing Zhang ◽  
Xiaojuan Liu ◽  
Zhiguang Sun
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Tai Chi ◽  
Digit Span ◽  
Meta Analysis ◽  
Control Group ◽  
Clinical Dementia Rating

Background. Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others’ results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi. Methods. A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software. Results. The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = −0.55, 95% CI [−0.80, −0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [−0.65, 1.71]; and digit span backward WMD = −0.1, 95% CI [−0.38, 0.19]. No adverse events were reported in the included articles. Conclusion. There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.

scholarly journals Cognitive Gains of Aerobic Exercise in Patients With Ischemic Cerebrovascular Disorder: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 8 ◽  
Author(s):  
Yimei Shu ◽  
Qing He ◽  
Yi Xie ◽  
Wanrong Zhang ◽  
Shuang Zhai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Aerobic Exercise ◽  
Meta Analysis ◽  
Moderate Intensity ◽  
Cochrane Library ◽  
Control Group ◽  
Healthy Population ◽  
Cerebrovascular Disorder

Background: Cognitive impairment has become an important problem in ischemic cerebrovascular disorder survivors as disease related deaths have been significantly reduced. Aerobic exercise, the most prevalent mode of physical activity, positively contributes to cognition in both healthy population and people with cognitive impairment. However, studies on its associations with cognitive gains in patients with ischemic cerebrovascular disease showed mixed findings.Objective: To explore the cognitive effects of aerobic exercise on ischemic cerebrovascular disorder survivors and investigate the possible moderators on exercise benefits.Method: Randomized controlled trials investigating the effects of sole aerobic exercise on cognitive function in population with ischemic intracranial vascular disorder compared to any control group who did not receive the intervention were enrolled in this systematic review and meta-analysis. Four online database (Pubmed, Cochrane Library, Embase, and Web of Science) were searched.Results: The initial search returned 1,522 citations and ultimately 11 studies were included in the systematic review. Analysis of seven studies showed the beneficial but not statistically significant impact of aerobic exercise on global cognitive function (0.13; 95% Cl −0.09 to 0.35; p = 0.25). Participants already with cognitive impairment benefited more from this intervention (0.31; 95% Cl 0.07–0.55; p = 0.01) and moderate intensity might be the optimal choice (0.34; 95% Cl −0.01 to 0.69; p = 0.06). The program duration and initiation time after stroke occurrence did not predict better cognitive outcome. Aerobic exercise was not associated with improvement of processing speed and executive function, the two subdomains of cognitive function.Conclusions: Aerobic exercise may contribute to cognitive gains in survivors of ischemic cerebrovascular disorder, especially for population already with cognitive decline. Our findings suggest that the adoption of moderate intensity aerobic exercise might improve cognition in such population.

Interventions for Attitudes and Empathy Toward People With Dementia and Positive Aspects of Caregiving: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 42 (2) ◽  
pp. 72-82
Author(s):  
Areum Han
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Control Group ◽  
Eligibility Criteria ◽  
People With Dementia ◽  
Positive Aspects Of Caregiving ◽  
Meta Analyses ◽  
And Coping ◽  
Skill Building ◽  
Psychoeducational Interventions

Objective: This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of interventions on three outcomes among caregivers of people with dementia and health professionals, including positive aspects of caregiving, attitudes toward people with dementia, and empathy. Methods: Three electronic databases were searched to find RCTs published in peer-reviewed journals until January 7, 2019. A total of 13 studies met the eligibility criteria and were included in meta-analysis. Results: The included studies compared psychoeducational interventions, a combination of education, skill-building, and coping strategies, to control group. Meta-analyses of the included studies found that the overall effects of psychoeducational interventions on three outcomes were not statistically significant compared to control groups. Conclusions: The findings indicate that there is no evidence for the positive effect of psychoeducational interventions on these outcomes, warranting further RCT studies designed to target on these outcomes.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Effect of consumption of animal milk compared to infant formula for non-breastfed/mixed-fed infants 6–11 months of age: a systematic review (protocol)

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e046370
Author(s):  
Aamer Imdad ◽  
Julie Melissa Ehrlich ◽  
Joseph Catania ◽  
Emily Tanner-Smith ◽  
Abigail Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infant Formula ◽  
Breast Feeding ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
World Health ◽  
Control Group ◽  
Breastfed Infants ◽  
Evaluation Approach ◽  
Animal Milk

IntroductionPrevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children’s health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal’s milk. The objective of this review is therefore to synthesise the most recent evidence on the effects of the consumption of animal milk compared with infant formula in non-breastfed or mixed breastfed infants aged 6–11 months.Methods and analysisWe will conduct a systematic review and meta-analysis of studies that assessed the effect of animal milk compared with formula or mixed-fed (breastmilk and formula) on infants aged 6–11 months. The primary outcomes of interest include anaemia, gastrointestinal blood loss, weight for age, height for age and weight for height. We will include randomised and non-randomised studies with a control group. We will use the Cochrane risk of bias tools to assess the risk of bias. We will use meta-analysis to pool findings if the identified studies are conceptually homogenous and data are available from more than one study. We will assess the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Ethics and disseminationThis is a systematic review, so no patients will be directly involved in the design or development of this study. The findings from this systematic review will be disseminated to relevant patient populations and caregivers and will guide the WHO’s recommendations on formula consumption versus animal milk in infants aged 6–11 months.Trial registration numberCRD42020210925.

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