scholarly journals The Effects of Cognitive-Based Interventions in Older Adults: A Systematic Review and Meta-Analysis

2022 ◽  
Author(s):  
Sunweon Yun ◽  
Seang Ryu
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Rehabilitation ◽  
Nursing Practice ◽  
Meta Analysis ◽  
Cognitive Stimulation ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Ovid Medline

Background: Cognitive-based intervention is divided into three types: Cognitive Stimulation (CS), Cognitive Training (CT), and Cognitive Rehabilitation (CR). This study was conducted to identify systematically the effects of cognitive-based interventions in randomized controlled trials (RCTs) applied to older adults in the following three groups: cognitively healthy, mild cognitive impairment (MCI), and dementia. Methods: This search was carried out using the Ovid-MEDLINE, EMBASE, Cochrane library, CINAHL, ProQuest, and Korea databases. The effectiveness of the intervention was verified using the CMA 2.0 program. Results: A total of 54 RCTs were included in systematic reviews and 38 studies were analyzed by meta-analysis. Meta-analysis showed that cognitive-based interventions were effective in improving the cognitive function (SMD=0.39, 95% CI=0.32-0.44) of older adults. The subgroup analysis of cognitive function revealed that CT was the most effective in the cognitively healthy (SMD=0.40, 95% CI=0.33-0.46) and the MCI (SMD=0.45, 95% CI=0.27-0.63) groups, and CS was the most effective in the dementia group (SMD=0.57, 95% CI=0.43-0.70). Conclusion: In order to improve the cognitive function of older adults in each group, the most effective intervention type needs to be considered first. Evidence on the appropriate type of Cognitive-based intervention will be helpful in nursing practice.

scholarly journals Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (14) ◽  
pp. 3184
Author(s):  
João Gustavo Claudino ◽  
José Afonso ◽  
Javad Sarvestan ◽  
Marcel Bahia Lanza ◽  
Juliana Pennone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Strength Training ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled ◽  
Falls In Older Adults

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.

scholarly journals Effects of soy isoflavones on cognitive function: a systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol 78 (2) ◽  
pp. 134-144 ◽  
Author(s):  
Chendi Cui ◽  
Rahel L Birru ◽  
Beth E Snitz ◽  
Masafumi Ihara ◽  
Chikage Kakuta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Randomized Controlled Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Soy Isoflavones ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Design Characteristics

Abstract Context The results of preclinical and observational studies support the beneficial effect of soy isoflavones on cognition. Objective This review aimed to evaluate the effects of soy isoflavones on cognition in adults. Data Sources The PUBMED, EMBASE, Ovid Medline, Cochrane Library, and clinicaltrials.gov databases were searched. Study Selection Two researchers independently screened 1955 records, using the PICOS criteria: participants were adults; intervention was dietary sources with soy isoflavones or isolated soy isoflavones; comparator was any comparator; outcome was cognitive function; study type was randomized controlled trials (RCTs). A third researcher was consulted to resolve any discrepancies. Sixteen RCTs were included and their quality assessed. Data Extraction Information on study design, characteristics of participants, and outcomes was extracted. PRISMA guidelines were followed. Data Analysis A random-effects meta-analysis was used to pool estimates across studies. In the 16 RCTs (1386 participants, mean age = 60 y), soy isoflavones were found to improve overall cognitive function (standardized mean difference [SMD], 0.19; 95% confidence interval [CI], 0.07–0.32) and memory (SMD, 0.15; 95%CI, 0.03–0.26). Conclusion The results showed that soy isoflavones may improve cognitive function in adults. Systematic Review Registration PROSPERO registration no. CRD42018082070.

scholarly journals Effects of Tai Chi on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Run Lin ◽  
Shaoyang Cui ◽  
Juan Yang ◽  
Huijun Yang ◽  
Zitong Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Randomized Controlled Trials ◽  
Methodological Quality ◽  
Tai Chi ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

Background and Purpose. Mild cognitive impairment (MCI) is a common condition, which threatens the quality of life of older adults. Tai Chi (TC) is growing in popularity among patients with MCI. This study is aimed at evaluating the effectiveness and safety of TC in older adults with MCI. Design. Randomized controlled trials (RCTs) from multiple databases from inception to December 2020 published in English were searched. Two researchers independently performed eligible study screening and data extraction. The methodological quality was assessed with the Jadad score. Meta-analysis of RCTs on TC in the treatment of MCI was performed with RevMan Version 5.4.1. Results. Seven RCTs with 1265 participants were included. For most RCTs, the overall reporting of methodological quality was high. Results of the meta-analysis indicate that TC improved MCI patients’ cognitive function significantly, including overall cognitive function ( MD = − 2.24 , 95% CI -3.51 to -0.97, P = 0.0005 ), memory and learning ( SMD = 0.83 , 95% CI 0.22 to 1.45, P = 0.008 ), visuospatial ability ( MD = 3.15 , 95% CI 0.74 to 5.56, P = 0.01 ), executive functions ( MD = 0.32 , 95% CI 0.03 to 0.61, P = 0.03 ), and physical activity ( MD = 18.78 , 95% CI 10.80 to 26.76, P < 0.00001 ). However, no significant benefit was found for TC on psychological activity ( MD = 0.17 , 95% CI -0.62 to 0.96, P = 0.36 ) and biomarker improvement. Conclusion. The meta-analysis confirmed the clinical therapeutic effect of TC for MCI. More rigorous and long-term follow-up RCTs should be conducted in the future.

The Effect of Unsupervised Home-Based Exercise Training on Physical Functioning Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 109980042198943
Author(s):  
Mahdi Mahjur ◽  
Ali Asghar Norasteh
Keyword(s):  
Older Adults ◽  
Exercise Training ◽  
Randomized Controlled Trials ◽  
Physical Functioning ◽  
Meta Analysis ◽  
Upper Body ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Home Based ◽  
Body Strength

Background: Exercise training such as balance, aerobic, and resistance training is able to improve physical functioning of older adults. Delivering such exercise regimes at home without supervision may be useful for older adults because they do not have to leave their homes. Objective: This systematic review and meta-analysis of randomized controlled trials aimed to establish the effect of unsupervised home-based exercise training regimes on physical functioning (balance and muscle strength) in older adults. Data sources: PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included investigations were searched. Study selection: Thirteen randomized controlled trials (RCTs) of exercise training impact on balance and upper body strength with concurrent control groups were included in the analysis. Results: Our analyses revealed that in older adults, unsupervised home-based various exercise training was effective in improving measures of proactive balance (mean difference (MD) = −1.37 s; 95% confidence interval (CI), −2.24, −0.51 s; p = 0.002) and balance test battery (MD: 1.80; 95% CI, 0.46, 3.14 s; p = 0.009). There were no significant differences between the experimental and control groups for upper body strength ( p > 0.05). Conclusion: Unsupervised home-based exercise training improves balance in older adults. Future investigations are needed to clarify the mechanisms underlying unsupervised home-based exercise training’s effect on this population’s physical functioning outcomes.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

2021 ◽  
Author(s):  
Rahele Tavakoly ◽  
Amir Hadi ◽  
Nahid Rafie ◽  
Behrouz Talaei ◽  
Wolfgang Marx ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Monocyte Count ◽  
Randomized Controlled ◽  
Immunological Markers ◽  
Online Databases ◽  
Immunological Effects

AbstractThe possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×109/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I 2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×109/L; 95% CI: −0.16 to −0.001; I 2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I 2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

Early Versus Routine Stoma Closure in Patients With Colorectal Resection: A Meta-Analysis of 7 Randomized Controlled Trials

2020 ◽  
Vol 27 (3) ◽  
pp. 291-298
Author(s):  
Yinyin Guo ◽  
Yanxin Luo ◽  
Hui Zhao ◽  
Liangliang Bai ◽  
Juan Li ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Randomized Controlled Trials ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Wound Complications ◽  
Controlled Trials ◽  
Stoma Closure ◽  
Randomized Controlled ◽  
Significant Difference

Background. A substantial proportion of patients undergoing colorectal surgery receive a temporary stoma, and the timing for stoma closure remains unclear. The aim of this study was to evaluate the safety and feasibility of early stoma closure (ESC) compared with routine stoma closure (RSC) after colorectal surgery. Methods. We comprehensively searched PubMed, Embase, and the Cochrane Library for randomized controlled trials that compared ESC and RSC after colorectal surgery. Results. A total of 7 randomized controlled trials with 814 enrolled patients were identified for this meta-analysis. There were no significant differences between the ESC and RSC groups regarding the complications of stoma closure (26.8% and 16.6%, respectively; odds ratio [OR]: 1.30; 95% confidence interval [CI]: 0.89-1.90; P = .17). A subgroup analysis was conducted by Clavien-Dindo grade of complication, and no significant difference was observed in any subgroup ( P > .05). However, the ESC group had a significantly higher risk of wound complications than the RSC group (17.6% and 7.8%, respectively; OR: 2.61; 95% CI: 1.43-4.76; P = .002), and the RSC group had more cases of small bowel obstruction than the ESC group (3.1% and 8.4%, respectively; OR: 0.37; 95% CI: 0.15-0.87; P = .02). Conclusions. ESC is a safe and effective therapeutic approach in patients who have undergone colorectal surgery; it is associated with a reduced risk of bowel obstruction but a higher risk of wound complications.

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