scholarly journals Effect of revascularization on cognitive outcomes in intracranial steno-occlusive disease: a systematic review

2019 ◽  
Vol 46 (2) ◽  
pp. E14 ◽  
Author(s):  
Bradley Kolb ◽  
Hassan Fadel ◽  
Gary Rajah ◽  
Hamidreza Saber ◽  
Ali Luqman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Observational Studies ◽  
English Language ◽  
Randomized Trials ◽  
Occlusive Disease ◽  
Cognitive Outcomes ◽  
Thomson Reuters ◽  
Before And After

OBJECTIVESteno-occlusive diseases of the cerebral vasculature have been associated with cognitive decline. The authors performed a systematic review of the existing literature on intracranial steno-occlusive disease, including intracranial atherosclerosis and moyamoya disease (MMD), to determine the extent and quality of evidence for the effect of revascularization on cognitive performance.METHODSA systematic search of PubMed/MEDLINE, the Thomson Reuters Web of Science Core Collection, and the KCI Korean Journal Database was performed to identify randomized controlled trials (RCTs) in the English-language literature and observational studies that compared cognitive outcomes before and after revascularization in patients with steno-occlusive disease of the intracranial vasculature, from which data were extracted and analyzed.RESULTSNine papers were included, consisting of 2 RCTs and 7 observational cohort studies. Results from 2 randomized trials including 142 patients with symptomatic intracranial atherosclerotic steno-occlusion found no additional benefit to revascularization when added to maximal medical therapy. The certainty in the results of these trials was limited by concerns for bias and indirectness. Results from 7 observational trials including 282 patients found some cognitive benefit for revascularization for symptomatic atherosclerotic steno-occlusion and for steno-occlusion related to MMD in children. The certainty of these conclusions was low to very low, due to both inherent limitations in observational studies for inferring causality and concerns for added risk of bias and indirectness in some studies.CONCLUSIONSThe effects of revascularization on cognitive performance in intracranial steno-occlusive disease remain uncertain due to limitations in existing studies. More well-designed randomized trials and observational studies are needed to determine if revascularization can arrest or reverse cognitive decline in these patients.

scholarly journals Sleep Duration in Relation to Cognitive Function among Older Adults: A Systematic Review of Observational Studies

2016 ◽  
Vol 46 (1) ◽  
pp. 57-78 ◽  
Author(s):  
Elizabeth E. Devore ◽  
Francine Grodstein ◽  
Eva S. Schernhammer
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Function ◽  
Sleep Duration ◽  
Observational Studies ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Short Sleep ◽  
Sleep Parameters

Context: Increasing evidence suggests that circadian and sleep parameters influence cognitive function with aging. Objective: To evaluate observational studies of sleep duration and cognition in older adults. Data Sources: A systematic review of OVID Medline and PsycINFO through September 2015, and review of bibliographies from studies identified. Study Selection: English-language articles reporting observational studies of sleep duration and cognitive function in older populations. Data Extraction: Data extraction by 2 authors using predefined categories of desired information. Results: Thirty-two studies met our inclusion criteria, with nearly two-thirds published in the past 4 years. One-third of studies indicated that extreme sleep durations were associated with worse cognition in older adults. More studies favored an association with long vs. short sleep durations (35 vs. 26% of studies, respectively). Four studies found that greater changes in sleep duration over time were related to lower cognition. Study design and analytic methods were very heterogeneous across studies; therefore, meta-analysis was not undertaken. Limitations: We reviewed English-language manuscripts only, with a qualitative summary of studies identified. Conclusions and Implications of Key Findings: Observational studies of sleep duration and cognitive function in older adults have produced mixed results, with more studies suggesting that long (rather than short) sleep durations are related to worse cognition. Studies more consistently indicate that greater changes in sleep duration are associated with poor cognition. Future studies should be prospectively designed, with objective sleep assessment and longer follow-up periods; intervention studies are also needed to identify strategies for promoting cognitive health with aging.

scholarly journals Workplace neighbourhood built environment and workers’ physically-active and sedentary behaviour: a systematic review of observational studies

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chien-Yu Lin ◽  
Mohammad Javad Koohsari ◽  
Yung Liao ◽  
Kaori Ishii ◽  
Ai Shibata ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Built Environment ◽  
Sedentary Behaviour ◽  
Observational Studies ◽  
English Language ◽  
Research Priorities ◽  
Working Hours ◽  
Recreational Physical Activity ◽  
Domain Specific

Abstract Background Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies. Methods Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019. Results A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving). Conclusions The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships. Protocol registration The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

Adverse effects of ADT on cognitive function and dementia for men with prostate cancer: A meta-analysis and systematic review.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 150-150 ◽  
Author(s):  
Maxine Sun ◽  
Alexander Cole ◽  
Nawar Hanna ◽  
Adam S. Kibel ◽  
Toni K. Choueiri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
English Language ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
The Impact

150 Background: Nearly 50% of men diagnosed with prostate cancer may receive treatment with some form of androgen deprivation therapy (ADT). While some side effects of ADT are well acknowledged, the specific impact of ADT on cognitive function is uncertain. Our objective was to perform a systematic review and meta-analysis assessing the impact of ADT on overall cognitive decline, and the risks of Alzheimers, Parkinson’s disease. Methods: Relevant studies were identified through search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science. First, we assessed rates of cognitive decline in five cohorts from three studies. Second, we assessed rates of Alzheimer’s or Parkinson disease using three large retrospective studies. A pooled-analysis was conducted using a meta-analysis. Weighted averages were reported as odds ratios (OR) with 95% confidence intervals (CI) using RevMan and a DerSimonian and Laird random-effects model. The heterogeneity test was measured using the Q-Mantel-Haenszel ( P< 0.10 was considered of significant heterogeneity). Results: With respect to overall cognitive decline (defined as scoring 1.5 standard deviations [SD] in two or more objective cognitive tests), patients receiving ADT had higher odds of overall cognitive decline than patients with prostate cancer not treated with ADT or health controls (OR: 2.03, 95% CI: 1.42–2.90). Furthermore, men with a history of ADT for prostate cancer had higher odds of developing Alzheimer’s and Parkinson dementia compared to men with prostate cancer not treated with ADT (OR: 1.32, 95% CI: 1.27–1.37). Conclusions: Men receiving ADT for prostate cancer performed significantly worse on measures of overall cognitive function. Additionally, results from the three large observational trials included suggest men exposed to ADT for prostate cancer have higher rates of Parkinson/Alzheimer’s compared to men without ADT.

scholarly journals Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Syed Ghulam Sarwar Shah ◽  
David Nogueras ◽  
Hugo Cornelis van Woerden ◽  
Vasiliki Kiparoglou
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Trials ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Future Research ◽  
Before And After ◽  
Quasi Experimental

Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

scholarly journals Cognitive performance before and after the onset of subjective cognitive decline in old age

2015 ◽  
Vol 1 (2) ◽  
pp. 194-205 ◽  
Author(s):  
Alexander Koppara ◽  
Michael Wagner ◽  
Carolin Lange ◽  
Annette Ernst ◽  
Birgitt Wiese ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Cognitive Performance ◽  
Old Age ◽  
Subjective Cognitive Decline ◽  
Before And After

Cognitive Performance Trajectories Before and After Sleep Treatment Initiation in Middle-Aged and Older Adults: Results from the Health and Retirement Study

2021 ◽  
Author(s):  
Christopher N Kaufmann ◽  
Mark W Bondi ◽  
Wesley K Thompson ◽  
Adam P Spira ◽  
Sonia Ancoli-Israel ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Cognitive Performance ◽  
Treatment Initiation ◽  
Health And Retirement Study ◽  
Middle Aged ◽  
Before And After ◽  
Sleep Treatment ◽  
Retirement Study

Abstract BACKGROUND Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHODS Data came from the 2006-2014 Health and Retirement Study. At each of five waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=3,957) included individuals who at HRS 2006 were &gt;50 years, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving vs. not receiving treatment in subsequent waves, and among those treated (N=1,247), compared cognitive trajectories before and after treatment. RESULTS At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher BMI, and more depressive symptoms (all p’s≤0.015). Decline in cognitive performance was mitigated in periods after sleep treatment vs. periods before (B=-0.20, 95% CI=-0.25, -0.15, p&lt;0.001; vs., B=-0.26, 95% CI=-0.32, -0.20, p&lt;0.001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance—those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.

Fish intake, n-3 fatty acid body status, and risk of cognitive decline: a systematic review and a dose–response meta-analysis of observational and experimental studies

2021 ◽  
Author(s):  
Rena I Kosti ◽  
Maria I Kasdagli ◽  
Andreas Kyrozis ◽  
Nicola Orsini ◽  
Pagona Lagiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fatty Acid ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Dose Response ◽  
Experimental Studies ◽  
Fish Intake ◽  
Risk Of Bias ◽  
The Impact

Abstract Context Randomized controlled trials (RCTs) testing supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have failed to provide evidence supporting a suggested inverse association between fish intake and dementia risk. Objective Dose–response analyses were conducted to evaluate associations between fish intake, all-cause dementia or Alzheimer’s Disease (AD), and the effect of EPA/DHA supplementation on cognitive performance. Data Sources PubMed, Scopus and Web of Science databases were searched for original research evaluating either associations between fish intake and dementia or AD, or the impact of EPA and/or DHA supplementation on the risk of cognitive decline. Data Extraction Data were collected on study characteristics and methods; number of cases/deaths (for observational studies); categories of exposure; model covariates; risk estimates from the most-adjusted model; type and dosage of supplementation (from RCTs); fatty acid levels in blood; and differences in cognition test results before and after supplementation. Risk of bias was assessed through the ROBINS-E and RoB2.0 tools for observational and experimental studies, respectively. Data Analysis Weighted mixed-effects models were applied, allowing for the inclusion of studies with 2 levels of exposure. Based on findings with low/moderate risk of bias, fish intake of up to 2 portions (250 g) per week was associated with a 10% reduction (95% confidence interval [CI]: 0.79, 1.02, Ν = 5) in all-cause dementia and a 30% reduction (95% CI: 0.54, 0.89, Ν = 3) in AD risk. Changes in EPA and DHA body status had a positive impact on participants’ executive functions, but not on their overall cognitive performance. Conclusion The protection offered by fish intake against cognitive decline levels off at intakes higher than 2 portions/week and likely relates to the impact of EPA and DHA on the individual’s executive functions, although there remain questions about the mechanisms linking the short- and long-term effects. Systematic Review Registration PROSPERO registration no. CRD42019139528.

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