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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We performed a systematic review of studies focusing on the automatic prediction of the progression of mild cognitive impairment to Alzheimer's disease (AD) dementia, and a quantitative analysis of the methodological choices impacting performance.
Why it matters
This review of 172 articles found that using cognitive, fluorodeoxyglucose-positron emission tomography, or potentially electroencephalography and magnetoencephalography variables significantly improved prediction of progression from mild cognitive impairment to Alzheimer's dementia, whereas including T1 magnetic resonance imaging did not show a significant effect. It also identified methodological issues in many papers and concerns prediction, not treating, curing, or preventing Alzheimer's disease.
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Low-dose aspirin did not prevent depression in this large-scale study of otherwise healthy older adults.
Why it matters
This large randomized trial found no significant differences in the proportions of older adults with elevated depression scores between those taking low-dose aspirin and those taking placebo. It tested aspirin for prevention of depression, not for treating, curing, or preventing Alzheimer's disease.
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Dementia is a severe neurodegenerative disorder and it can be categorized into several subtypes by different pathogenic causes.
Why it matters
This review found that dementia prevalence rises steeply with age and is greater in women than men overall, with Alzheimer's disease more common in women and vascular dementia more common in men at ages 60 to 69. It describes how common dementia is but does not test any treatment, cure, or prevention.
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The most prominent results indicated that high total intake of fruits and vegetables, and some of their specific subgroups including berries, citrus, and green leafy vegetables, may promote higher levels of optimism and self-efficacy, as well as reduce the level of psychological distress, ambiguity, and cancer fatalism, and protect against depressive symptoms.
Why it matters
This systematic review found that high total intake of fruits and vegetables, and some specific subgroups including berries, citrus, and green leafy vegetables, may protect against depressive symptoms and improve aspects of mental health. The included studies used various methodologies and different populations, so their results were not always sufficiently comparable.
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Multimorbidity (hazard ratio [HR] 4·12 [95% CI 3·41-4·98]), frailty (HR 2·38 [95% CI 1·93-2·93]), and disability (HR 1·73 [95% CI 1·34-2·22]) were associated with increased risk of mortality; these associations were not modified by socioeconomic status.
Why it matters
This 24-year follow-up of the Whitehall II cohort found that multimorbidity, frailty, and disability were associated with increased risk of mortality, and that occupation was the socioeconomic indicator most strongly linked to transitions into these states. It concerns social inequalities in health transitions and mortality and provides no information on treating, curing, or preventing Alzheimer's disease.
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Letters18 February 2020Geographic Variation in Prevalence of Adult Obesity in China: Results From the 2013–2014 National Chronic Disease and Risk Factor SurveillanceXiao Zhang, MD, PhD, Mei Zhang, MD, PhD, Zhenping Zhao, MD, Zhengjing Huang, MPH, Qian Deng, MD, PhD, Yichong Li, MD, PhD, An Pan, MD, PhD, Chun Li, MD, Zhihua Chen, MD, Maigeng Zhou, MD, PhD, Chao Yu, PhD, Alfred Stein, PhD, Peng Jia, PhD*, and Limin Wang, MPH*Xiao Zhang, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Mei Zhang, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhenping Zhao, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhengjing Huang, MPHNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Qian Deng, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Yichong Li, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), An Pan, MD, PhDSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.), Chun Li, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhihua Chen, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Maigeng Zhou, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and
Why it matters
This letter reports on geographic variation in adult obesity prevalence in China. It has no relevance to treating, curing, or preventing Alzheimer's disease.
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The strength of evidence for an association between gait speed and cognition was demonstrated by the number and consistency of results, as well as quality of the studies.
Why it matters
This systematic review and meta-analysis found that slower gait speed was significantly associated with worse cognitive function in older people, with clinically meaningful reductions in gait speed ranging from 0.11 m/s in cognitive impairment to 0.41 m/s in moderate dementia. The association may help identify preclinical markers and improve diagnostic assessments.
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Dementia was associated with mortality in 70% of older adults with DS.
Why it matters
In 211 adults with Down syndrome over 35, 66 (31.3%) had a dementia diagnosis, and the authors report that "dementia was associated with mortality in 70% of older adults with DS." APOE ε4 carriers were diagnosed with dementia significantly earlier (HR 4.91), as were people with multiple other health conditions (HR 1.956). Among those with dementia, ε4 carriers had a higher risk of death, though the estimate is imprecise (HR 6.91, 95% CI 1.756–27.195). These are associations from one group of 211 people, and the authors' takeaway is "the need for good health care", not a treatment.
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Socioeconomic differences in dementia risk can be partly explained by differences in modifiable health conditions and lifestyle factors.
Why it matters
Among 6,346 older adults in the English Longitudinal Study of Ageing followed for a median of 6 years, wealthier people had lower dementia risk (HR 0.58). The study estimated that 52% of the risk difference between the highest and lowest wealth tertiles ran through differences in a score of twelve modifiable health and lifestyle factors (LIBRA). Education had no direct link but worked indirectly through wealth and LIBRA, and the authors conclude only that such factors "partly" explain socioeconomic differences, which is an association, not evidence that changing them prevents dementia.
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In this cohort study of more than 350 000 veterans, even mild TBI without LOC was associated with more than a 2-fold increase in the risk of dementia diagnosis.
Why it matters
In a study of more than 350,000 US veterans, 6.1% of those diagnosed with a traumatic brain injury were later diagnosed with dementia, compared with 2.6% of a matched group without one. The authors report that even mild TBI without loss of consciousness "was associated with more than a 2-fold increase in the risk of dementia diagnosis." This is an observational link in veterans, not proof that head injury causes dementia or that avoiding it lowers risk.
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Stroke is a strong, independent, and potentially modifiable risk factor for all-cause dementia.
Why it matters
This meta-analysis of 36 studies of prevalent stroke and 12 studies of incident stroke found that stroke was linked to a higher risk of all-cause dementia. It identifies stroke as a strong and potentially modifiable risk factor, but does not test any treatment or cure.
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Although mixed, the results indicate a positive response for the use of internet-based interventions by caregivers.
Why it matters
This review of 40 studies found that internet-based interventions may benefit family caregiver well-being, including depression, anxiety, and burden, but the overall study quality was low and results were mixed. It concerns caregiver support and does not test any treatment, cure, or prevention for Alzheimer's disease itself.
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Dementia diagnosis recording in general hospitals is increasing but remains less likely in some groups.
Why it matters
This study found that dementia diagnosis recording in general hospitals increased over time but was less accurate in some groups, including ethnic minority groups. It does not test any treatment, cure, or prevention for Alzheimer's disease.
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Our findings suggest that clinicians should consider sedative-associated, hypoxic, and septic delirium, which often co-occur, as distinct indicators of acute brain injury and seek to identify all potential risk factors that may impact on long-term cognitive impairment, especially those that are iatrogenic and potentially modifiable such as sedation.
Why it matters
In a prospective cohort of critically ill patients, the authors concluded that sedative-associated, hypoxic and septic delirium — which "often co-occur" — should each be treated as a distinct indicator of acute brain injury linked to later long-term cognitive impairment. They single out sedation as a risk factor that is "iatrogenic and potentially modifiable", but the study is observational, tested no treatment, and does not address Alzheimer's disease directly.
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Neuropathology was ubiquitous, with 94% of participants having 1+, 78% having 2+, 58% having 3+, and 35% having 4+.
Why it matters
This study followed 1,079 older people from two long-running aging studies with repeated memory and thinking tests (2 to 22 each), then examined their brains after death. Brain disease was nearly universal: 94% had at least one pathology, 78% had two or more and 35% had four or more. Alzheimer's disease was the most common (65%) but appeared alone in only 9%, and more than 230 different combinations were seen. The study set out to estimate how much each pathology contributed to each person's cognitive decline, but those results are not included in this record. It is an observational study and tests no treatment.
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Despite differences in CVR management within the countries considered, it was possible to design and implement the HATICE multidomain intervention.
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70/100
The findings of this review provide insight into catalysing the paradigm shift from 'reducing stress' to 'optimising positive experience' in developing caregiving support services for dementia, and may guide future empirical study to explain this unique dimension of caregiving experience.
Why it matters
Pooling 41 studies of family caregivers of people with dementia, this review described the positive side of caregiving as four parts: a sense of accomplishment, closeness with the person cared for, stronger family ties, and personal growth and purpose. It found these tend to emerge when the caregiving role is affirmed by the caregiver and others, when caregivers can regulate their emotions effectively, and when circumstances help them find meaning in caregiving. The authors argue that support services should aim to build these experiences, not only reduce stress, but this is a narrative review that tested no intervention.
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Those reporting depressive symptoms in 1985 (mean follow-up, 27 years) did not have significantly increased risk for dementia (hazard ratio [HR], 1.21; 95% CI, 0.95-1.54) in Cox regression adjusted for sociodemographic covariates, health behaviors, and chronic conditions.
Why it matters
Depressive symptoms in midlife, even when chronic or recurring, did not significantly increase dementia risk, while symptoms closer to diagnosis did. This suggests depression may be an early sign of dementia rather than a cause that could be treated to prevent it.
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This review suggests a substantial proportion of patients with heart failure have concomitant cognitive problems.
Why it matters
This meta-analysis found that people with heart failure had higher odds of cognitive impairment than those without it, and some cohort data suggested greater cognitive decline over the longer term. It describes an association and does not test any treatment for Alzheimer's disease.
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There were 987 participants (290 from Vantaa 85+, 241 from the Cambridge City Over-75s Cohort, and 456 from the Cognitive Function and Ageing Study) with neuropathologic data; mean (SD) age at death was 90 (6.4) years, including 682 women (69%).
Why it matters
In 987 brain donors (average age at death 90) from three population-based cohorts, people who had ever had delirium already scored 2.8 MMSE points lower six years before death, and delirium occurring alongside dementia-type brain changes was linked to faster decline than either one alone would predict. The authors conclude delirium appears to act "independently and multiplicatively" with classic dementia pathology, possibly through brain processes they did not measure. It is an observational study: it shows an association and does not test whether preventing or treating delirium changes the course of dementia.
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Between 2001, and 2012, we identified 243 611 incident cases of dementia, 31 577 cases of Parkinson's disease, and 9247 cases of multiple sclerosis.
Why it matters
This population-based cohort study found that living closer to major roads was associated with a slightly higher incidence of dementia, with the risk decreasing as distance from the road increased. It shows an association and does not prove that traffic exposure causes dementia or that moving away would prevent it.
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Pooled clinical and neuropathologic data from 3 prospective cohort studies indicate that TBI with LOC is associated with risk for Lewy body accumulation, progression of parkinsonism, and PD, but not dementia, AD, neuritic plaques, or neurofibrillary tangles.
Why it matters
In 7,130 older adults from three pooled long-term studies with brain autopsy data, a self-reported head injury with loss of consciousness was linked to Lewy bodies, worsening parkinsonism and Parkinson disease. The researchers had expected to find more Alzheimer's disease and tangles, but found no association with dementia, Alzheimer's, plaques or tangles. These are associations, not proof of cause, and the study tested no treatment or prevention.
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We found no evidence to suggest that the current assumption of constant age-specific prevalence of dementia over time is ill-founded.
Why it matters
This systematic review found moderately consistent evidence that dementia incidence may be declining in high-income countries, while evidence on prevalence trends was inconsistent and showed no clear overall effect. It reports no treatment, cure or prevention of Alzheimer's disease.
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The patients receiving regular PPI medication (n = 2950; mean [SD] age, 83.8 [5.4] years; 77.9% female) had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication (n = 70,729; mean [SD] age, 83.0 [5.6] years; 73.6% female) (hazard ratio, 1.44 [95% CI, 1.36-1.52]; P Conclusions and relevance The avoidance of PPI medication may prevent the development of dementia.
Why it matters
In this cohort of people aged 75 and older, those taking proton pump inhibitors regularly had a significantly higher risk of being diagnosed with dementia than those who did not take them. Because this is observational data, it cannot show that the medications cause dementia, only that the two are linked.
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When compared with propofol, dexmedetomidine sedation reduced incidence, delayed onset, and shortened duration of POD in elderly patients after cardiac surgery.
Why it matters
In this randomized controlled trial of patients aged 60 and older undergoing cardiac surgery, postoperative delirium occurred in 17.5% of the dexmedetomidine group versus 31.5% of the propofol group. Dexmedetomidine sedation reduced the incidence, delayed the onset, and shortened the duration of postoperative delirium compared with propofol.
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.
- Study partner-reported decline identifies cognitive decline and dementia risk
- The Cognitive Abilities Screening Instrument (CASI): A Practical Test for Cross-Cultural Epidemiological Studies of Dementia
- Subjective cognitive decline: The first clinical manifestation of Alzheimer's disease?
- How to measure the effects and potential adverse events of palliative sedation? An integrative review
- Health effects of particulate matter air pollution in underground railway systems - a critical review of the evidence
- Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?
- Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop
- Alternate Level of Care Patients in Hospitals: What Does Dementia Have To Do With This?
- Synergistic impacts of physical activity and sleep on risk of dementia and all-cause mortality in Chinese older stroke survivors
- An epidemiological study of dementia in a rural community in Kerala, India