scholarly journals ANTIOXIDANT SUPPLEMENTS IN ALZHEIMER’S DEMENTIA AND MILD COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW

2016 ◽  
pp. 1-8
Author(s):  
E.J. Pegg
Keyword(s):  
Oxidative Stress ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Effect ◽  
Risk Of Bias ◽  
Positive Treatment Effect ◽  
Positive Treatment ◽  
Antioxidant Supplements ◽  
Overall Risk

Objective: Current treatments have only a modest effect on impairment in Alzheimer’s Dementia (AD) and there is no treatment currently licensed for Mild Cognitive Impairment (MCI). Oxidative stress is postulated to play a role in the pathogenesis of AD and MCI and this provides a rationale for treatment with antioxidant supplements. The aim of this review is to evaluate the effect of antioxidant supplements in people with AD and MCI. Methods: A systematic review of published randomised controlled trials was carried out. 4 electronic databases were searched. Studies were included if they compared the use of a placebo with the following antioxidant supplements in people with AD or MCI: Vitamin e, vitamin c, selenium, alpha lipoic acid, phenols, zinc, curcumin, beta carotene, coenzyme Q10, melatonin. The primary outcome measure was cognitive impairment. Secondary outcome measures included functional impairment, behavioural disturbance and safety. Results: 10 trials were identified which met the inclusion criteria. Outcome data was not suitable for meta-analysis. 5 studies reported a small positive treatment effect on cognition and 1 reported a negative effect. 2 reported a positive treatment effect on functional ability and 1 on behaviour. There were no consistent adverse effects found overall however two studies raised concern of possible worsening of cognition in certain circumstances. Conclusions: The findings of this systematic review do not support the use of antioxidant supplements to slow cognitive, functional or behavioural deterioration in people with AD or MCI. However the majority of included studies had a high or unknown risk of bias. In the one study which had a low overall risk of bias, there was evidence that antioxidant supplements may have a positive effect on functional decline in AD. The overall risk of harm associated with short term antioxidant supplementation appears to be low however caution is warranted. Further studies evaluating the role of oxidative stress in the pathogenesis of AD are suggested.

scholarly journals Effectiveness of Exergaming in Improving Cognitive and Physical Function in People With Mild Cognitive Impairment or Dementia: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Yinan Zhao ◽  
Hui Feng ◽  
Xinyin Wu ◽  
Yan Du ◽  
Xiufen Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Functions ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Gaming Environment

BACKGROUND Individuals with mild cognitive impairment and dementia have impaired physical and cognitive functions, leading to a reduced quality of life compared with those without such impairment. Exergaming, which is defined as a combination of exercise and gaming, is an innovative, fun, and relatively safe way to exercise in a virtual reality or gaming environment. Therefore, exergaming may help people living with mild cognitive impairment or dementia to overcome obstacles that they may experience regarding regular exercise and activities. OBJECTIVE The aim of this systematic review was to review studies on exergaming interventions administered to elderly individuals with mild cognitive impairment and dementia, and to summarize the results related to physical and cognitive functions such as balance, gait, executive function, and episodic memory. METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, PsycINFO, Amed, and Nursing Database for articles published from the inception of the respective databases to January 2019. We included all clinical trials of exergaming interventions in individuals with mild cognitive impairment and dementia for review. The risk of bias was independently evaluated by two reviewers using the Cochrane Collaboration and Risk of Bias in Non-randomized Studies of Interventions tools. RESULTS Ten studies involving 702 participants were included for review. There was consistent evidence from 7 studies with a low risk of bias showing statistically significant effects of exergaming on cognitive functioning in people with mild cognitive impairment and dementia. With respect to physical function, 3 of 5 full-scale studies found positive results, and the intensity of most games was classified as moderate. CONCLUSIONS Overall, exergaming is an innovative tool for improving physical and cognitive function in people with mild cognitive impairment or dementia, although there is high heterogeneity among studies in terms of the duration, frequency, and gaming platform used. The quality of the included articles was moderate to high. More high-quality studies with more accurate outcome indicators are needed for further exploration and validation of the benefits of exergaming for this population.

scholarly journals Effectiveness of Exergaming in Improving Cognitive and Physical Function in People With Mild Cognitive Impairment or Dementia: Systematic Review

10.2196/16841 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16841
Author(s):  
Yinan Zhao ◽  
Hui Feng ◽  
Xinyin Wu ◽  
Yan Du ◽  
Xiufen Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Functions ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Gaming Environment

Background Individuals with mild cognitive impairment and dementia have impaired physical and cognitive functions, leading to a reduced quality of life compared with those without such impairment. Exergaming, which is defined as a combination of exercise and gaming, is an innovative, fun, and relatively safe way to exercise in a virtual reality or gaming environment. Therefore, exergaming may help people living with mild cognitive impairment or dementia to overcome obstacles that they may experience regarding regular exercise and activities. Objective The aim of this systematic review was to review studies on exergaming interventions administered to elderly individuals with mild cognitive impairment and dementia, and to summarize the results related to physical and cognitive functions such as balance, gait, executive function, and episodic memory. Methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, PsycINFO, Amed, and Nursing Database for articles published from the inception of the respective databases to January 2019. We included all clinical trials of exergaming interventions in individuals with mild cognitive impairment and dementia for review. The risk of bias was independently evaluated by two reviewers using the Cochrane Collaboration and Risk of Bias in Non-randomized Studies of Interventions tools. Results Ten studies involving 702 participants were included for review. There was consistent evidence from 7 studies with a low risk of bias showing statistically significant effects of exergaming on cognitive functioning in people with mild cognitive impairment and dementia. With respect to physical function, 3 of 5 full-scale studies found positive results, and the intensity of most games was classified as moderate. Conclusions Overall, exergaming is an innovative tool for improving physical and cognitive function in people with mild cognitive impairment or dementia, although there is high heterogeneity among studies in terms of the duration, frequency, and gaming platform used. The quality of the included articles was moderate to high. More high-quality studies with more accurate outcome indicators are needed for further exploration and validation of the benefits of exergaming for this population.

scholarly journals A Systematic Review of Intervention Studies Examining Nutritional and Herbal Therapies for Mild Cognitive Impairment and Dementia Using Neuroimaging Methods: Study Characteristics and Intervention Efficacy

2017 ◽  
Vol 2017 ◽  
pp. 1-21 ◽  
Author(s):  
Genevieve Z. Steiner ◽  
Danielle C. Mathersul ◽  
Freya MacMillan ◽  
David A. Camfield ◽  
Nerida L. Klupp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Neuroimaging ◽  
Photon Emission ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Emission Tomography ◽  
Intervention Efficacy ◽  
Study Characteristics

Neuroimaging facilitates the assessment of complementary medicines (CMs) by providing a noninvasive insight into their mechanisms of action in the human brain. This is important for identifying the potential treatment options for target disease cohorts with complex pathophysiologies. The aim of this systematic review was to evaluate study characteristics, intervention efficacy, and the structural and functional neuroimaging methods used in research assessing nutritional and herbal medicines for mild cognitive impairment (MCI) and dementia. Six databases were searched for articles reporting on CMs, dementia, and neuroimaging methods. Data were extracted from 21/2,742 eligible full text articles and risk of bias was assessed. Nine studies examined people with Alzheimer’s disease, 7 MCI, 4 vascular dementia, and 1 all-cause dementia. Ten studies tested herbal medicines, 8 vitamins and supplements, and 3 nootropics. Ten studies used electroencephalography (EEG), 5 structural magnetic resonance imaging (MRI), 2 functional MRI (fMRI), 3 cerebral blood flow (CBF), 1 single photon emission tomography (SPECT), and 1 positron emission tomography (PET). Four studies had a low risk of bias, with the majority consistently demonstrating inadequate reporting on randomisation, allocation concealment, blinding, and power calculations. A narrative synthesis approach was assumed due to heterogeneity in study methods, interventions, target cohorts, and quality. Eleven key recommendations are suggested to advance future work in this area.

scholarly journals Protocol for a systematic review on interventions for caregivers of persons with mild cognitive impairment and early dementia: does early stage intervention improve caregiver well-being and ability to provide care?

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028441
Author(s):  
Melanie Bayly ◽  
Debra Morgan ◽  
Julie Kosteniuk ◽  
Valerie Elliot ◽  
Amanda Froehlich Chow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Early Stage ◽  
Grey Literature ◽  
Well Being ◽  
Risk Of Bias ◽  
Care Recipient ◽  
Caregiver Interventions

IntroductionCaregivers of persons with dementia and mild cognitive impairment (MCI) are at risk of decreased well-being. While many interventions for caregivers exist, evidence is sparse regarding intervention timing and effectiveness at an early stage of cognitive decline. Our systematic review aims to answer the following questions: (1) Do interventions for caregivers of persons with early stage dementia or MCI affect their well-being and ability to provide care? (2) Are particular types of caregiver interventions most effective during early stage cognitive decline? (3) How does effectiveness differ when early and later interventions are directly compared? (4) Do effects of early stage caregiver intervention vary based on care recipient and caregiver characteristics (eg, sex, type of dementia)?Methods and analysisThe databases MEDLINE, EMBASE, PSYCINFO and CINAHL, as well as grey literature databases, will be searched for English language studies using search terms related to caregiver interventions and dementia/MCI. Abstracts and full texts will be screened by two independent reviewers; included studies must assess the effects of an intervention for caregivers of persons with early stage dementia or MCI on caregiver well-being or ability to provide care. Intervention, study and participant characteristics will be extracted by two independent reviewers, along with outcome data. Risk of bias will be assessed using the Cochrane risk of bias tool (for controlled trials with and without randomisation). Interventions will be grouped by type (eg, psychoeducational) and a narrative synthesis is planned due to expected heterogeneity, but a meta-analysis will be performed where possible. The Grading of Recommendations, Assessment, Development and Evaluations approach will be used to inform conclusions regarding the quality of evidence for each type of intervention.Ethics and disseminationFindings from this review will be disseminated via conferences and peer-reviewed publication, and a summary will be provided to the Alzheimer Society.PROSPERO registration numberCRD42018114960.

scholarly journals Cognitive Impairment in Transient Ischemic Attack Patients: A Systematic Review

2016 ◽  
Vol 42 (1-2) ◽  
pp. 1-9 ◽  
Author(s):  
Frank G. van Rooij ◽  
Roy P.C. Kessels ◽  
Edo Richard ◽  
Frank-Erik De Leeuw ◽  
Ewoud J. van Dijk
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Transient Ischemic Attack ◽  
Risk Of Bias ◽  
Screening Tools ◽  
Insufficient Data ◽  
Cognitive Screening ◽  
Considerable Heterogeneity ◽  
Ischemic Attack

Background: Although by definition a transient ischemic attack (TIA) lasts less than 24 h, many patients experience cognitive complaints beyond focal symptom resolution. However, their prevalence, causes and profile are unclear. We therefore performed a systematic review on cognitive impairment after TIA. Summary: Medline and Embase were searched for relevant studies. Risk of bias was assessed, and data synthesis was performed according to the severity of cognitive impairment. Thirteen studies were included, with considerable heterogeneity concerning methods and timing of cognitive testing. Confounding, detection bias and attrition were the main causes of a high risk of bias in several studies. The prevalence of post-TIA mild cognitive impairment ranged from 29 to 68%. Severe cognitive impairment was found in 8-22% of patients. Studies using a cognitive screening instrument and those performed shortly after TIA or several years later, reported the highest frequencies of impairment. Patients evaluated with a screening tool were substantially older than those who underwent a full neuropsychological assessment (weighted mean age difference 10.9 years). Based on limited data, the post-TIA cognitive profile showed prominent executive function deficits. Insufficient data refrained us from drawing conclusions on causality. The few studies that reported neuroimaging results found a minor correlation with cognitive impairment. Key Messages: Mild cognitive impairment is present in more than a third of the TIA patients and has a profile comparable with vascular cognitive impairment. Reported rates of post-TIA cognitive impairment are highly variable and higher frequencies are found with cognitive screening tools. Considerable heterogeneity and insufficient data limit further conclusions about potential causative factors.

Incidence of mild cognitive impairment - a systematic review

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
T Luck ◽  
M Luppa ◽  
S Briel ◽  
SG Riedel-Heller
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment

scholarly journals Prevalence of Mild Cognitive Impairment in Latin America and the Caribbean: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 897-898
Author(s):  
Fabiana Ribeiro ◽  
Ana Carolina Teixeira-Santos ◽  
Anja Leist
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
English Language ◽  
Prevalence Data ◽  
Gender And Education ◽  
Precise Diagnosis ◽  
Normal Ageing ◽  
The Caribbean

Abstract Background. The population of Latin America and the Caribbean (LAC) is ageing rapidly, presenting the highest prevalence rates of dementia in the world. In this context, mild cognitive impairment (MCI) is an intermediate condition between normal ageing and dementia. However, very few studies verified the prevalence of MCI in LAC countries; earlier global systematic reviews only considered prevalence reports published in English language. Method. We conducted a systematic review to evaluate the prevalence of MCI in LAC countries and to explore the factors associated with MCI (i.e., age, gender, and education). A database search was conducted in February 2020 using PubMed, Web of Science, Scopus, Lilacs, SciELO, and EMBASE, for population-or community-based studies with MCI data for countries in LAC, published in English, Spanish, or Portuguese language. From k=2,168 identified and k=1,684 screened studies, only articles were selected that included subjects with a precise diagnosis of MCI. The studies were qualitatively assessed using the JBI critical appraisal checklist for studies reporting prevalence data tool. Results. A total of nine studies met the criteria, published between 2007 and 2019, including a total of 17,812 participants in nine countries Brazil, Mexico, Argentina, Colombia, Peru, Cuba, Dominican Republic, Venezuela, and Costa Rica. Estimates for MCI prevalence ranged from 1.2% to 34%, with most estimates between 1.2% and 6.45%. Estimates differed by age group, gender, and educational level. Discussion. This is the first systematic review of the prevalence of MCI in LAC countries, considering only high-quality studies adopting rigorous diagnostic criteria.

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