Each study has a usefulness score out of 100 (rubric version 4.0). Tap a score to see what makes it up.
Highest usefulness score first. Studies without a score come last.
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Inflammatory mechanisms have been implicated in Alzheimer's disease (AD) and might be mediated via the COX-2 enzyme.
Why it matters
In this double-blind trial, 1,457 people aged 65 or over with mild cognitive impairment took rofecoxib 25 mg (725) or a placebo (732) daily for up to 4 years to test whether the drug "could delay a diagnosis of AD." It did not: the estimated yearly rate of an Alzheimer's diagnosis was 6.4% on rofecoxib versus 4.5% on placebo (hazard ratio 1.46, 95% CI 1.09–1.94), and memory-and-thinking and global-function scores "did not demonstrate differences between treatment groups." Together with earlier negative trials in people who already had Alzheimer's, the authors say the findings "suggest that inhibition of COX-2 is not a useful therapeutic approach in AD."
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Hippocampal volume is reduced in patients with unipolar depression, maybe as a consequence of repeated periods of major depressive disorder.
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The mean (SD) time between the date of randomization into WHI and the last Modified Mini-Mental State Examination (3MSE) for all WHIMS participants was 4.05 (1.19) years.
Why it matters
In this randomized, placebo-controlled trial within the Women's Health Initiative, 61 postmenopausal women were diagnosed with probable dementia over an average of about 4 years: 40 in the estrogen-plus-progestin group and 21 in the placebo group. The authors estimate this means "an additional 23 cases of dementia per 10 000 women per year", and say that these findings, "coupled with previously reported WHI data", support the conclusion that the risks of estrogen plus progestin outweigh the benefits. The record does not report results for mild cognitive impairment or for estrogen taken alone.
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72/100
Main results Effect of memantine in patients with moderate to severe Alzheimer's disease: analysis of the change from baseline at 28 weeks gave statistically significant results in favour of memantine for 20 mg/day on cognition (MD: 6.1. 95% CI 2.99 to 9.21, P=0.0001) activities of daily living (MD 2.10, 95% CI 0.46 to 3.74, p=0.01) and in the global clinical impression of change measured by the CIBIC-Plus at 28 weeks (MD -0.30, 95% CI -0.58 to -0.02, p=0.04), in all cases the analysis was the ITT-LOCF population (Reisberg 2000).
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Multifactorial intervention was not effective in preventing falls in older people with cognitive impairment and dementia presenting to the accident and emergency department after a fall.
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Treatment of acutely sick, frail, older patients in a GEMU substantially reduced mortality.
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Compared with the reference standard for diagnosing delirium, 2 study nurses using the CAM-ICU had sensitivities of 100% and 93%, specificities of 98% and 100%, and high interrater reliability (kappa = 0.96; 95% confidence interval, 0.92-0.99).
Why it matters
This study validated the Confusion Assessment Method for the ICU (CAM-ICU) for detecting delirium in mechanically ventilated patients, finding high sensitivity and specificity compared with delirium experts using DSM-IV criteria. It concerns delirium assessment in intensive care, not the treatment, cure, or prevention of Alzheimer's disease.
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The diabetes attributable risk for dementia of 8.8% suggests that diabetes may have contributed to the clinical syndrome in a substantial proportion of all dementia patients.
Why it matters
This population study found that type 2 diabetes almost doubled the risk of dementia and Alzheimer's disease, with the highest risk in patients treated with insulin. It identifies diabetes as a possible contributor to dementia but does not test whether treating diabetes prevents or cures Alzheimer's disease.
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72/100
Mean ADAQ scores were: Dialysis Living Will, 71%; Centre for Bioethics Living Will, 70%; and Medical Directive, 60% (F = 8.27, P < 0.001 (repeat measures analysis of variance); the Dialysis Living Will and Centre for Bioethics Living Will scored significantly higher than the Medical Directive).
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Across the cohorts, each 10-year increase in BAI was associated with a 39% higher risk of incident dementia (hazard ratio [HR], 1.39 [95% CI, 1.21-1.59]; P Conclusions and relevance In this IPD meta-analysis, a higher sleep EEG-based BAI was associated with a higher risk of incident dementia.
Why it matters
In this pooled analysis of over 7,000 people, each 10-year increase in a sleep EEG-based brain age index was linked to a 39% higher risk of developing dementia. The authors say this noninvasive digital marker needs further evaluation before it can be used for early detection in the community.
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The most significant adverse events associated with these therapies are infusion-related reactions and amyloid-related imaging abnormalities (ARIA) with edema/effusion (ARIA-E) and/or hemorrhage/hemosiderin deposition (ARIA-H).
Why it matters
In this memory clinic cohort of 234 patients treated with lecanemab, the frequency of significant adverse events, including ARIA, was manageable. These results may inform discussions about the risks of anti-amyloid treatments.
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These findings suggest medication-specific educational mailings targeting patients with AD or ADRD and their clinicians are not effective in reducing the use of high-risk medications.
Why it matters
Mailing educational materials to patients and their prescribers did not reduce dispensing of high-risk medications such as antipsychotics, sedative-hypnotics, or strong anticholinergics. This means this type of educational mailing alone did not change prescribing for people with Alzheimer's disease or related dementias.
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Participants receiving CDCM showed significantly fewer behavioral and psychological symptoms (adjusted mean difference [AMD] in NPI score, -10.26 [95% CI, -16.95 to -3.58]; P = .003; Cohen d, -0.78 [95% CI, -1.09 to -0.46]), better mental health (AMD in SF-12 Mental Component Summary score, 2.26 [95% CI, 0.31-4.21]; P = .02; Cohen d, 0.26 [95% CI, -0.11 to 0.51]), and lower caregiver burden (AMD in BIZA-D score, -0.59 [95% CI, -0.81 to -0.37]; P Conclusions and relevance In this secondary analysis of a cluster randomized clinical trial, CDCM was associated with improved patient, caregiver, and health system-relevant outcomes over 36 months beyond the intervention period.
Why it matters
In this secondary analysis of a cluster randomized clinical trial, participants receiving collaborative dementia care management showed significantly fewer behavioral and psychological symptoms, better mental health, and lower caregiver burden over 36 months. It addresses care outcomes and cost-effectiveness rather than curing or preventing Alzheimer's disease.
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71/100
The literature has several methodological limitations including lack of sufficient algorithm development descriptions and standard definitions.
Why it matters
This review of 255 studies on AI and brain imaging for dementia found that most (71%) relied on a single research dataset (ADNI) and that few tested their models on an independent group of patients. Discriminative models performed best at telling Alzheimer's disease apart from healthy controls, but accuracy varied with the patients, scan types and methods used. The authors call for clearer reporting and independent validation before these tools reach practice. The review concerns diagnosis and prognosis only, not treatment or prevention.
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After multivariable adjustment, patients showed an odds ratio (OR) of 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·76 (1·05-2·96) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·87 (0·68-1·11) for scale 4 versus scale 3 and 2·75 (1·61-4·69) for scale 5-6 versus scale 3 for fatigue or muscle weakness.
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ICT-based cognitive intervention had a positive effect on cognitive function, depression, and quality of life in older adults with MCI or mild dementia.
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The mean (SD) age of the study population sample (N = 3496) was 76.4 (7.6) years, and 2095 participants (60%) were female.
Why it matters
In this nationally representative sample, every 5-year increase in age was associated with higher risk of dementia and mild cognitive impairment, and each additional year of education was associated with a decrease in risk of both. Dementia was more common among non-Hispanic Black individuals and mild cognitive impairment was more common among Hispanic individuals compared with non-Hispanic White individuals.
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This review highlights the complexities of pain in NH residents and has implications for both clinical practice and future research.
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This systematic review demonstrated that adherence to the Mediterranean diet and other healthy dietary patterns in middle age can protect neurocognition later in life.
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71/100
The non-linear function indicates that a higher dose is not necessarily better in multidomain interventions.
Why it matters
This analysis of a 3-year multidomain prevention trial found that benefits rose up to about 12 to 14 training hours or 15 to 20 sessions, then leveled off. Doing more sessions than that was not better, so more intervention is not always more helpful for older adults at risk of dementia.
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Whether dietary and nutrition and dietary patterns are associated with the development of dementia is an interesting research question.
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Main results Eighteen studies were included.
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The optimal management of post-stroke cognitive impairment remains controversial.
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Medicare beneficiaries with a diagnosis of dementia receiving postacute care in HH or SNF experienced similar rates of readmission and mortality across settings.
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End-of-life care and research that focuses only on cognitive and functional decline may fail to recognise the complexities and unmet needs relevant to dementia and end of life.
From across this topic
10 of the 7,967 studies in this topic, picked by a fixed rule (a hash of each study's address), not by score or date; each page of this list shows a different 10. The same 10 appear here every time.
- Brain Aging Among Racially and Ethnically Diverse Middle-Aged and Older Adults
- Use of lecanemab and donanemab in the Canadian healthcare system: Evidence, challenges, and areas for future research
- Dementia diagnostic deserts: workforce and geographic inequities in the diagnostic pathway for cognitive impairment
- Cerebral white matter lesions and the risk of dementia
- Effects of computerized cognitive training on neuroimaging outcomes in older adults: a systematic review
- Beliefs and attitudes of family caregivers of People with dementia toward advance care planning: A Q methodology study
- Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies
- Long-term care placement of dementia patients and caregiver health and well-being
- Association of a wide range of chronic diseases and apolipoprotein E4 genotype with subsequent risk of dementia in community-dwelling adults: A retrospective cohort study
- 15 years of longitudinal genetic, clinical, cognitive, imaging, and biochemical measures in DIAN