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Lecithin for dementia and cognitive impairment
Higgins JP, Flicker L.. The Cochrane database of systematic reviews, 2003-01-01
Topic: Risk, prevention and care in population studies
Background Alzheimer's disease sufferers have been found to have a lack of the enzyme responsible for converting choline into acetylcholine within the brain. Lecithin is a major dietary source of choline, so extra consumption may reduce the progression of dementia. Objectives To determine the efficacy of lecithin in the treatment of dementia or cognitive impairment. Search strategy The Cochrane Dementia and Cognitive Improvement Group's Specialized Register was searched on 15 May 2002 using the terms lecithin and phosphaditylcholine. This contains records from all major databases and many trials databases. Reference lists and relevant books have been examined. Selection criteria All unconfounded, randomized trials comparing lecithin with placebo in a treatment period longer than one day, in patients with dementia of the Alzheimer type, vascular dementia, mixed vascular and Alzheimer's disease, unclassified or other dementia or unclassified cognitive impairment not fulfilling the criteria for dementia are eligible for inclusion. Data collection and analysis Data were extracted by two independent reviewers and cross-checked. Meta-analyses were performed when more than one trial provided data on a comparable outcome on sufficiently similar patients. Random effects analyses were performed whenever heterogeneity between results appeared to be present. Standardised differences in mean outcome measures were used due do the use of different scales and periods of treatment. Odds ratios for dichotomous data were pooled using the Mantel-Haenszel or DerSimonian and Laird methods. Main results Twelve randomized trials have been identified involving patients with Alzheimer's disease (265 patients), Parkinsonian dementia (21 patients) and subjective memory problems (90 patients). No trials reported any clear clinical benefit of lecithin for Alzheimer's disease or Parkinsonian dementia. Few trials contributed data to meta-analyses. The only statistically significant result was in favour of placebo for adverse events, based on one trial, which appears likely to be a spurious result. A dramatic result in favour of lecithin was obtained in a trial of subjects with subjective memory problems. Reviewer's conclusions Evidence from randomized trials does not support the use of lecithin in the treatment of patients with dementia. A moderate effect cannot be ruled out, but results from the small trials to date do not indicate priority for a large randomized trial.
Key findings
- Random effects analyses were performed whenever heterogeneity between results appeared to be present.
- Main results Twelve randomized trials have been identified involving patients with Alzheimer's disease (265 patients), Parkinsonian dementia (21 patients) and subjective memory problems (90 patients).
- The only statistically significant result was in favour of placebo for adverse events, based on one trial, which appears likely to be a spurious result.
- A dramatic result in favour of lecithin was obtained in a trial of subjects with subjective memory problems.
- A moderate effect cannot be ruled out, but results from the small trials to date do not indicate priority for a large randomized trial.
Why it matters
Across 12 randomized trials, lecithin showed no clear benefit for dementia or cognitive impairment, and the only statistically significant result favoured placebo for adverse events. There is no good evidence that lecithin treats or prevents Alzheimer's disease.
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Study details
- Study designrandomized controlled trial
- Participants265
- Evidence strengthHigh
How this study scored 69/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for effect reported because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 44 of the 64 points we could judge it on, which is 69 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Cochrane database of systematic reviews) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 2 / 4 | 265 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | — / 7 | No citation count (OpenAlex dates this DOI to 2000, the record says 2003; OpenAlex values not used) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12917896) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 44 / 64 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 44 of the 64 points we could judge it on is 69 out of 100. |
| Total | 69 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Higgins, J. P., & Flicker, L. (2003). Lecithin for dementia and cognitive impairment. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd001015
Vancouver
Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. The Cochrane database of systematic reviews. 2003. doi:10.1002/14651858.cd001015. PMID: 12917896.
BibTeX
@article{higgins2003-12917896,
author = {Higgins, J. P. and Flicker, L.},
title = {{Lecithin for dementia and cognitive impairment}},
journal = {The Cochrane database of systematic reviews},
year = {2003},
doi = {10.1002/14651858.cd001015},
pmid = {12917896},
url = {https://doi.org/10.1002/14651858.cd001015}
}
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