Every row of the evidence table

A pilot designed to test feasibility; 68 carers and a 2-week outcome.

No difference from waitlist control on the primary burden outcome or on mood, WHOQOL-Bref or productivity; only the CarerQoL-VAS quality-of-life score was higher in the intervention group. The trial recruited 93 of a 194 target.

At the 1-month comparison the automated self-guided programme reduced depression and burden and increased positive gains versus waitlist; anxiety did not differ. Group differences mostly disappeared once controls received the programme.

A factorial trial of components: the mindfulness component carried the benefit and amplified the others.

Burden fell in both arms with no significant difference between the two platforms. There was no untreated control, so the within-arm improvement cannot be separated from time or attention.

Direction is for NIDUS-Family: an 89% probability of cost-effectiveness from a health and social care perspective (87% societal) and £8,934 (37%) lower average costs, though the cost difference's confidence interval includes zero.

The outcome is how prepared carers felt to decide about firearm access, not whether any injury was avoided.

Benefit in Hispanic and White caregivers and in Black spousal caregivers; not in Black non-spousal caregivers.

Direction is for value for money: APPLE-Tree had a 96% probability of being cost-effective per cognition point at a £30 000 threshold but only 12% on QALYs, which were slightly lower in the intervention arm. Post hoc subgroups suggested better value in non-White and socioeconomically disadvantaged participants.

The community health worker programme achieved verified linkage to medical care in 16.7% of dyads versus none in the control arm. Caregiver outcomes were largely unchanged, with self-efficacy favouring control.

No difference between health-system care, community-based care or usual care on either primary outcome. Caregiver self-efficacy did improve in both active arms.

Direction is for the extended nursing role intervention: 74% fewer unmet needs and higher quality of life at six months, with a small QALY gain at about 1,425 EUR added cost; no effect on caregiver burden.

The two perspectives disagree: the digitally supported care management system dominated usual care for the public payer (lower costs, marginally more QALYs, 72-79% probability of cost-effectiveness) but cost €331,000 per QALY from a societal perspective (33-35% probability).

Direction is for collaborative dementia care management: fewer neuropsychiatric symptoms, lower caregiver burden, better mental health and 0.137 QALYs gained at no significant added cost (3186€ per QALY) over 36 months; no difference in antidementia drug use, overall quality of life or inappropriate medication.

No benefit and no harm: screening did not change family-member quality of life, preparedness or self-efficacy, and did not raise depression or anxiety. Only 5.1% screened positive.

The outcome is how many diagnoses were made, not whether anyone was better off. The passive digital marker alone did not raise detection (AOR 0.84, 95% CI 0.63-1.11).

The primary outcome did not improve. Emergency department visits and hospitalisations were lower (RR 0.45, 95% CI 0.31-0.65), which is a secondary outcome.

The outcome is how prepared carers felt to decide about firearm access, not whether any injury was avoided.

Direction is for DREAMS START against treatment as usual: a 78% probability of being cost-effective at £20,000 per QALY, with cost and QALY differences individually non-significant. The clinical sleep result is in the table under its own row.

Neither the combined package nor risk-factor modification beat health advice.

The control arm also received diet counselling and mild caloric restriction, so this is MIND against another active diet, not against usual eating. It is the only randomised test of the MIND diet here and it disagrees with the cohort evidence.

Controls declined while the olive-oil arm held steady; the nut arm fell between the two. Cognitive follow-up was available for 334 of 447 enrolled.

The control arm also received diet counselling and mild caloric restriction, so this is MIND against another active diet, not against usual eating. It is the only randomised test of the MIND diet here and it disagrees with the cohort evidence.

Controls declined while the olive-oil arm held steady; the nut arm fell between the two. Cognitive follow-up was available for 334 of 447 enrolled.

Compared with flexible health advice, not with nothing; both groups improved.

The intervention did not change any brain biomarker trajectory. Participants with lower baseline hippocampal volume did show a greater cognitive benefit.

Both groups improved; the structured programme improved more. The trial compares two active interventions, so there is no untreated comparison.

A small improvement that did not reach significance (adjusted difference 0.06, 95% CI -0.001 to 0.128, p=0.055).

Neither the combined package nor risk-factor modification beat health advice.

The primary cognitive outcome was significantly WORSE in the exercise arm (adjusted difference -1.4, 95% CI -2.6 to -0.2, favouring usual care). The authors conclude the programme does not slow cognitive impairment and treat the difference as of uncertain clinical importance. Fitness did improve. This is the sharpest counterweight to the observational exercise evidence.

The primary outcome did not move between groups. Attention and inhibitory control did improve (SMD 0.43), as did muscular strength.

The authors call the effect small (-0.18 points). Significant in women, not in men, on 91 randomised and 76 completing.

The intervention-control cognitive difference was statistically significant in the higher-genetic-risk halves and not in the lower halves, but neither genetic score significantly modified the intervention effect overall (P > 0.46); an exploratory sex difference emerged for the Alzheimer score.

Null in the primary analysis of the whole cohort. The prespecified analysis of the higher-risk ARIC subgroup found less decline, which the authors present as hypothesis-generating rather than as a result.

Phase 1 dose-finding. The outcome is amyloid clearance; no cognitive outcome was measured.

Significant for MCI and for the MCI-or-dementia composite; not significant for probable dementia alone (HR 0.86, 95% CI 0.72-1.02).

A large drop in blood pressure (22/9 mmHg) and fewer serious adverse events in the intervention villages.

No difference from placebo on the primary agitation outcome or other main behavioural outcomes. As-needed psychotropic use was lower during the active period, and no serious drug-related adverse events occurred.

A feasibility trial in 29 residents: designed to test whether the trial can be run, not powered for efficacy, and it reports no efficacy estimate.

Neither choir singing nor group music therapy beat standard care. Country was the strongest predictor of the differences between sites.

Direction is for normal sleep versus sleep deprivation, on a clearance measure — not on cognition, which this trial did not measure.