A continuum of executive function deficits in early subcortical vascular cognitive impairment: A systematic review and meta-analysis

ABSTRACT. Background. Subcortical Vascular Cognitive Impairment (SVCI) is a clinical continuum of vascular-related cognitive impairment, including Vascular Mild Cognitive Impairment (VaMCI) and Vascular Dementia. Deficits in Executive Function (EF) are hallmarks of the disorder, but the best methods to assess this function have yet to be determined. The insidious and almost predictable course of SVCI and the multidimensional concept of EF suggest that a temporal dissociation of impairments in EF domains exists early in the disorder. Objective: This study aims to review and analyze data from the literature about performance of VaMCI patients on the most used EF tests through a meta-analytic approach. Methods: Medline, Web of Knowledge and PsycINFO were searched, using the terms: “vascular mild cognitive impairment” OR “vascular cognitive impairment no dementia” OR “vascular mild neurocognitive disorder” AND “dysexecutive” OR “executive function”. Meta-analyses were conducted for each of the selected tests, using random-effect models. Results: Systematic review showed major discrepancies among the results of the studies included. Meta-analyses evidenced poorer performance on the Trail-Making Test part B and the Stroop color test by VaMCI patients compared to controls. Conclusion: A continuum of EF impairments has been proposed in SVCI. Early deficits appear to occur in cognitive flexibility and inhibitory control.

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Prevalence of Mild Cognitive Impairment in Community-Dwelling Chinese Populations Aged over 55 years: A Meta-Analysis and Systematic Review

10.21203/rs.3.rs-38966/v1 ◽

2020 ◽

Author(s):

Yuan Lu ◽

Chaojie Liu ◽

Dehua Yu ◽

Sally Fawkes ◽

Jia Ma ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Intermediate Phase ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Community Dwelling ◽

Bibliographic Databases ◽

Meta Analyses

Abstract Background: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by subgroup analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.Results: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6%, 14.2%] for MCI and 10.9% [95% CI: 7.7%, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. Conclusion：Higher MCI prevalence was identified in community-dwelling populations in China compared with some other countries, possibly due to more relaxed criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.Systematic review registration number： PROSPERO CRD42019134686

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Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review

10.21203/rs.3.rs-38966/v2 ◽

2020 ◽

Author(s):

Yuan Lu ◽

Chaojie Liu ◽

Dehua Yu ◽

Sally Fawkes ◽

Jia Ma ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Intermediate Phase ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Community Dwelling ◽

Bibliographic Databases ◽

Meta Analyses

Abstract Background: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.Results: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6%, 14.2%] for MCI and 10.9% [95% CI: 7.7%, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. Conclusion：Higher MCI prevalence was identified in community-dwelling populations in China compared with some other countries, possibly due to more relaxed criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.Systematic review registration number：PROSPERO CRD42019134686

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Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review

BMC Geriatrics ◽

10.1186/s12877-020-01948-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuan Lu ◽

Chaojie Liu ◽

Dehua Yu ◽

Sally Fawkes ◽

Jia Ma ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Intermediate Phase ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Community Dwelling ◽

Bibliographic Databases ◽

Meta Analyses

Abstract Background Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review. Methods The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses. Results A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6, 14.2%] for MCI and 10.9% [95% CI, 7.7, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. Conclusion Higher MCI prevalence was identified in community-dwelling older adult populations in China compared with some other countries, possibly due to more broadened criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere. Systematic review registration number PROSPERO CRD42019134686.

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Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review

10.21203/rs.3.rs-38966/v3 ◽

2020 ◽

Author(s):

Yuan Lu ◽

Chaojie Liu ◽

Dehua Yu ◽

Sally Fawkes ◽

Jia Ma ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Intermediate Phase ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Community Dwelling ◽

Bibliographic Databases ◽

Meta Analyses

Abstract Background: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.Methods: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.Results: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6%, 14.2%] for MCI and 10.9% [95% CI: 7.7%, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association’s Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer’s Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. Conclusion: Higher MCI prevalence was identified in community-dwelling older adult populations in China compared with some other countries, possibly due to more relaxed criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.Systematic review registration number: PROSPERO CRD42019134686

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Effect of computerised cognitive training on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-027062 ◽

2019 ◽

Vol 9 (8) ◽

pp. e027062 ◽

Cited By ~ 14

Author(s):

Haifeng Zhang ◽

Jonathan Huntley ◽

Rohan Bhome ◽

Benjamin Holmes ◽

Jack Cahill ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Training ◽

Meta Analysis ◽

Statistical Significance ◽

Cochrane Library ◽

Future Research

ObjectivesTo determine the effect of computerised cognitive training (CCT) on improving cognitive function for older adults with mild cognitive impairment (MCI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Web of Science and the Cochrane Library were searched through January 2018.Eligibility criteriaRandomised controlled trials comparing CCT with control conditions in those with MCI aged 55+ were included.Data extraction and synthesisTwo 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.Results18 studies met the inclusion criteria and were included in the analyses, involving 690 participants. Meta-analysis revealed small to moderate positive treatment effects compared with control interventions in four domains as follows: global cognitive function (g=0.23, 95% CI 0.03 to 0.44), memory (g=0.30, 95% CI 0.11 to 0.50), working memory (g=0.39, 95% CI 0.12 to 0.66) and executive function (g=0.20, 95% CI −0.03 to 0.43). Statistical significance was reached in all domains apart from executive function.ConclusionsThis meta-analysis provides evidence that CCT improves cognitive function in older people with MCI. However, the long-term transfer of these improvements and the potential to reduce dementia prevalence remains unknown. Various methodological issues such as heterogeneity in outcome measures, interventions and MCI symptoms and lack of intention-to-treat analyses limit the quality of the literature and represent areas for future research.

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The Association between Carotid Intima-Media Thickness and Cognitive Impairment: A Systematic Review and Meta-Analysis

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000518295 ◽

2021 ◽

pp. 1-13

Author(s):

David Fresnais ◽

Mats B. Humble ◽

Susanne Bejerot ◽

Adrian Meehan ◽

Brynjar Fure

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Meta Analysis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Vascular Cognitive Impairment ◽

Cochrane Library ◽

Media Thickness ◽

Significant Difference ◽

Meta Analyses

Background: Emerging evidence suggests that cognitive impairment (CI) and different etiologies of dementia, including Alzheimer’s disease (AD), are associated with vascular risk factors and atherosclerosis. In clinical practice, carotid intima-media thickness (CIMT) measured by ultrasonography may be a marker of atherosclerosis. Many studies report increased CIMT in patients with dementia and CI although a firm association has not yet been established. Aim: This systematic review and meta-analysis were conducted to study the relationship between CIMT, dementia, and CI. Methods: The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included the following databases: Medline, Embase, Cochrane Library, and Epistemonikos. The search spanned from 2000 to 2020 and was limited to English and Scandinavian languages. Results: The main analysis of CIMT in subjects with CI compared to subjects with no cognitive impairment (NCI) included 12 studies; 1,089 subjects with CI and 5,223 with NCI. There was no significant difference in CIMT between the CI and NCI groups. However, subgroup analyses revealed significantly higher CIMT in the mild cognitive impairment (MCI) and dementia groups than the NCI group. In addition, patients with dementia had increased CIMT compared to patients with MCI, and patients with AD demonstrated higher CIMT than those with vascular cognitive impairment (VCI). Conclusion: CIMT may be higher in subjects with CI than in cognitively healthy subjects although no significant difference was observed in our main analysis. CIMT was higher in the dementia group than the MCI group and in the AD group compared to the VCI group.

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Cognitive leisure activities and future risk of cognitive impairment and dementia: systematic review and meta-analysis

International Psychogeriatrics ◽

10.1017/s1041610216001137 ◽

2016 ◽

Vol 28 (11) ◽

pp. 1791-1806 ◽

Cited By ~ 74

Author(s):

Lauren A Yates ◽

Shier Ziser ◽

Aimee Spector ◽

Martin Orrell

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Executive Functioning ◽

Cognitive Decline ◽

Meta Analysis ◽

Leisure Activities ◽

Later Life ◽

Pooled Analysis ◽

Meta Analyses

ABSTRACTBackground:As life expectancies continue to rise, modifiable lifestyle factors that may prevent cognitive decline and dementia in later life become increasingly important in order to maintain quality of life in old age.Methods:Five meta-analyses were conducted on data from papers identified in a systematic review. Studies were grouped according to outcomes (dementia, cognitive impairment including amnestic Mild Cognitive Impairment (aMCI), Mild Cognitive Impairment (MCI), and cognitive decline) and output (risk (RR), odds (OR), or hazard ratios (HR)).Results:Nineteen studies met our inclusion criteria and quality assessments. Four of five meta-analyses showed significant associations between participation in cognitive leisure activities and reduced risk of cognitive impairment (OR = 0.69, 95% CI: 0.56–0.85) and dementia (HR = 0.58, 95% CI: 0.46–0.74; RR = 0.61, 95% CI: 0.42–0.90; OR = 0.78, 95% CI: 0.67–0.90). However, one pooled analysis of cognitive impairment studies did not reach significance (HR = 0.85, 95% CI: 0.71–1.02). Mentally stimulating leisure activities were significantly associated with later life cognition (β = 0.11, p = 0.05), better memory (β = 0.20, 95% CI: 0.11–0.29), speed of processing (β = 0.37, 95% CI: 0.29–0.45), and executive functioning (β = 0.23, 95% CI: 0.15–0.29), and less decline in overall cognition (β = −0.23, p < 0.01), language (β = −0.11, p < 0.05), and executive functioning (β = −0.13, p < 0.05). Activities were also shown to reduce rate of cognitive decline (estimate = 0.03, SE = 0.01, p = 0.00).Conclusions:There is increasing evidence that participation in cognitively stimulating leisure activities may contribute to a reduction of risk of dementia and cognitive impairment in later life. Promoting involvement in such activities across lifespan could be an important focus for primary prevention strategies for governments and health services.

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Prevalence of mild cognitive impairment in patients with hypertension: a systematic review and meta-analysis

Hypertension Research ◽

10.1038/s41440-021-00704-3 ◽

2021 ◽

Author(s):

Jiawei Qin ◽

Zexiang He ◽

Lijian Wu ◽

Wanting Wang ◽

Qiuxiang Lin ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Meta Analysis

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The Prevalence of Mild Cognitive Impairment among Chinese People: A Meta-Analysis

Neuroepidemiology ◽

10.1159/000512597 ◽

2021 ◽

Vol 55 (2) ◽

pp. 79-91

Author(s):

Yan Deng ◽

Siqi Zhao ◽

Guangwen Cheng ◽

Jiajia Yang ◽

Benchao Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Internal Validity ◽

Screening Tools ◽

Chinese Elderly ◽

Pooled Prevalence

Background: Mild cognitive impairment (MCI) induced the majority number of dementia patients. The prevalence of MCI in China varied across studies with different screening tools and diagnostic criteria. Objective: A systematic review and meta-analysis was conducted to estimate the pooled MCI prevalence among the population aged 55 years and older in China. Methods: PubMed, EMBASE, CNKI, Wanfang, CQVIP, and CBMdisc were searched for studies on prevalence of MCI among Chinese elderly between January 1, 1980, and February 10, 2020. The quality assessment was conducted via external validity, internal validity, and informativity, the pooled prevalence was calculated through the random-effect model, and the homogeneity was evaluated by Cochran’s Q test and I2. Results: Fifty-three studies with 123,766 subjects were included. The pooled prevalence of MCI among Chinese elderly was 15.4% (95% CI: 13.5–17.4%). Subgroup analyses indicated that the prevalence calculated with different screening tools was 20.2% (95% CI: 15.1–25.9%) for Montreal Cognitive Assessment (MoCA) and 13.0% (95% CI: 10.7–15.5%) for Mini-Mental State Examination (MMSE). According to different diagnostic criteria, the prevalence was 14.8% (95% CI: 12.2–17.6%) for Petersen criteria, 15.0% (95% CI: 12.7–17.5%) for DSM-IV, and 21.2% (95% CI: 17.5–25.2%) for Chinese Expert Consensus on Cognitive Impairment (CECCI). Besides, women, older adults, illiterate people, rural residents, and those who lived with unhealthy lifestyles and morbidity showed higher prevalence. Conclusions: The prevalence of MCI in China was 15.4%, which varied by demographics, lifestyles, morbidity, screening tools, and diagnostic criteria. In further studies, screening tools and diagnosis criteria should be considered when estimating MCI prevalence.

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