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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The number of people with dementia from minority ethnic (ME) groups in western countries is projected to rise dramatically, and they may be less able to access dementia services.
Why it matters
This review found that minority ethnic people with dementia were more cognitively impaired at referral, that African Americans were less likely to be prescribed cholinesterase inhibitors, and that minority groups were underrepresented in drug trials. It is about disparities in dementia care and research, not about treating, curing, or preventing the disease itself.
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This large cohort of 85 year olds showed good levels of both self rated health and functional ability despite significant levels of disease and impairment.
Why it matters
This cohort study of 85-year-olds found that most rated their health as good despite significant levels of disease and impairment, and women had higher disease counts and disability scores than men. It does not report anything about treating, curing, or preventing Alzheimer's disease.
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The Montreal Cognitive Assessment, but not the Mini-Mental State Examination, has adequate psychometric properties as a screening instrument for the detection of mild cognitive impairment or dementia in Parkinson disease.
Why it matters
In 132 people with Parkinson disease at two movement disorders centres, about one in three met criteria for a cognitive disorder (12.9% dementia, 17.4% mild cognitive impairment). The MoCA and MMSE separated impaired from unimpaired patients about equally well overall (AUC 0.79 vs 0.76), but as a screening test the MoCA did better: 64% correctly classified at its best cutoff (26/27) with no ceiling effect, against 54% for the MMSE, whose scores bunched near the top. The authors caution that a positive screen on either test needs further assessment because specificity was suboptimal, so this is about screening, not diagnosis by itself or treatment.
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Main results Four trials including 15,936 hypertensive subjects were identified.
Why it matters
This meta-analysis of four trials in nearly 16,000 people with high blood pressure found no significant difference between blood pressure-lowering treatment and placebo in the incidence of dementia. It also found no benefit on Mini Mental State Examination scores, so it does not support blood pressure lowering as a way to prevent dementia in people without prior cerebrovascular disease.
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67/100
Dementia is a growing public health problem for which early detection may be beneficial.
Why it matters
This 2009 systematic review of primary-care studies concluded that "the true prevalence of missed and delayed diagnoses of dementia is unknown but seems to be high," and that how often providers recognised dementia varied between studies, partly depending on dementia severity, degree of impairment, dementia subtype and how often the patient saw the provider. The main contributing factors it identified were problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. Rather than recommending screening, the authors advised that "until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis"; the review concerns detection only and reports no treatment, cure or prevention.
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Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03).
Why it matters
In 756 people with memory-type mild cognitive impairment from a 3-year placebo-controlled trial of donepezil and vitamin E, those with more depressive symptoms at the start were more likely to progress to Alzheimer's disease (p = 0.03). Within the 208 participants who scored as depressed (Beck Depression Inventory ≥10), the authors report that donepezil "delayed progression to AD", and conclude it "appears to modulate" the extra risk tied to depressive symptoms. This is a subgroup finding from a single trial; it does not show that donepezil prevents Alzheimer's or helps people with MCI who are not depressed.
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Several results seemed to challenge conventional assumptions of what precipitates NHA among persons with dementia.
Why it matters
This systematic review found that the most consistent predictors of nursing home admission in persons with dementia included severity of cognitive impairment, Alzheimer disease diagnosis, basic activity of daily living dependencies, behavioral symptoms, and depression. Caregiver stressors such as greater emotional stress, a desire to institutionalize the care recipient, and feelings of being trapped in care responsibilities were also important to consider.
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Using VBM-DARTEL, when corrected for multiple comparisons, significant volume differences were detected between groups in different regions and more specifically in hippocampus with ROI analyses.
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Multivariate logistic regression analyses were conducted after adjusting for age, sex, and educational status.
Why it matters
This study estimated how common neuropsychiatric symptoms were in people with mild cognitive impairment compared with normal cognitive aging, finding apathy among the most distinguishing features. It describes symptoms and does not address treating, curing or preventing Alzheimer's disease.
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Societal investment in building and maintaining cognitive reserve through formal education in childhood and continued cognitive stimulation during work and leisure in adulthood might help limit the burden of dementia among the growing number of older adults worldwide.
Why it matters
In a nationally representative US survey (Health and Retirement Study), 12.2% of people aged 70 or older had cognitive impairment consistent with dementia in 1993, compared with 8.7% in 2002. The authors read this as a "compression of cognitive morbidity": fewer older Americans reached significant impairment, and those who did declined to death more rapidly. They propose, but did not test, that education and lifelong cognitive stimulation might help limit the burden of dementia.
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Cognitive impairment without dementia is more prevalent in the United States than dementia, and its subtypes vary in prevalence and outcomes.
Why it matters
Using in-home assessments of a nationally representative sample, this study estimated that "5.4 million people (22.2%) in the United States age 71 years or older had cognitive impairment without dementia" in 2002, and concluded the condition "is more prevalent in the United States than dementia." Among those followed up, 11.7% a year progressed to dementia, rising to 17% to 20% for the prodromal Alzheimer disease and stroke subtypes. The estimates come from a sample in which only 56% took part, describe people 71 and older in 2002, and say nothing about causes or treatment.
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Evidence was weak for improving caregiver burdens in cancer and was absent for heart failure.
Why it matters
This systematic review found strong to moderate evidence supporting interventions to improve important aspects of end-of-life care, but evidence was weak for improving caregiver burdens in cancer and absent for heart failure. It concludes that many critical issues lack high-quality evidence, and it does not address treating, curing or preventing Alzheimer's disease.
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As the availability and quality of imaging techniques improve, doctors are identifying more patients with no history of transient ischaemic attack or stroke in whom imaging shows brain infarcts.
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67/100
Decrease in delirium scores were not significantly different comparing the effect of low dose haloperidol (< 3.0 mg per day) with the atypical antipsychotics olanzapine and risperidone (Odds ratio 0.63 (95% CI 10.29 - 1.38; p = 0.25).
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We conducted a systematic review of the use of quality of life (QoL) measures as outcome in pharmacological and nonpharmacologic intervention trials in patients with Mild Cognitive Impairment or dementia, and their proxies.
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Brain abnormalities are present in nonpsychotic first-degree relatives of patients with schizophrenia and are most pronounced in the hippocampus.
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The aim of this international guideline on dementia was to present a peer-reviewed evidence-based statement for the guidance of practice for clinical neurologists, geriatricians, psychiatrists, and other specialist physicians responsible for the care of patients with dementia.
Why it matters
This international guideline reviews evidence published before January 2006 and gives graded recommendations for diagnosing and managing Alzheimer's disease and other dementias. It is a guidance document for clinicians rather than a study of a new treatment or cure.
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67/100
A randomized, controlled trial.
Why it matters
In this small trial of 36 patients, a sleep education program with daily walking and increased light exposure improved sleep in people with Alzheimer's disease living at home. This suggests behavioral techniques may help manage sleep problems in dementia, though the study was small.
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Nondemented individuals exhibit a slow rate of whole-brain atrophy from early in adulthood with white-matter loss beginning in middle age; in older adults, the onset of dementia of the Alzheimer type is associated with a markedly accelerated atrophy rate.
Why it matters
In 370 adults aged 18 to 97, this MRI study found that whole-brain volume declines slowly with normal aging, starting in early adulthood (differences were "detected by age 30"). In older people without dementia the loss averaged about 0.45% of brain volume per year. In people with very mild Alzheimer-type dementia it was 0.98% per year, "more than doubled". These are group averages for a reference baseline, not a diagnostic test for one person, and the study tested no treatment.
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The techniques evaluated were person-centered showering and the towel bath (a person-centered, in-bed bag-bath with no-rinse soap).
Why it matters
Person-centered showering and the towel bath significantly reduced agitation and aggression during bathing in nursing home residents with dementia, while the control group did not improve. These are nonpharmacological techniques for managing bathing-related behavior, not treatments for the disease itself.
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Hospice enrollment correlates with reduced Medicare expenditures among younger decedents with cancer but increased expenditures among decedents without cancer and those older than 84 years of age.
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67/100
End-of-life care for patients with dementia was extremely demanding of family caregivers.
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During 3697 person-years of follow-up (mean per person, 3.6 years), dementia developed in 30 of the 1015 participants.
Why it matters
This study found that silent brain infarcts in elderly people were associated with more than double the risk of dementia and a steeper decline in cognitive function. It does not test a treatment or cure, but identifies a possible risk factor for dementia.
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Cognitive impairment short of dementia affects nearly one in four community-dwelling elders and is a major risk factor for later development of dementia.
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67/100
Patients with AD continue to show detectable disease progression over time, but treatment with donepezil for 1 year was associated with a 38% reduction in the risk of functional decline compared with placebo.
Why it matters
In this 1-year trial, donepezil extended the time to functional decline by about 5 months compared with placebo and reduced the risk of functional decline by 38%. It does not cure or prevent Alzheimer's disease, but it may help preserve everyday function for a period in patients with mild to moderate disease.
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.
- Vascular dementia : incidence and risk factors in the Canadian study of health and aging
- Mapping the Trajectories of Social Relations for White, Black, and Hispanic/Latino Individuals Approaching Death With Dementia
- Machine Learning Prediction of Agitation in Dementia Patients Using Sleep and Physiological Data
- Performance of a smell identification test versus the Mini-Mental Status Exam for the detection of dementia and cognitive impairment among persons with cognitive concerns in primary care
- Machine learning models to predict onset of dementia: A label learning approach
- Assessment of end-of-life care needs among patients with incurable diseases in Bangladesh: A multicenter study
- Nurses' recognition of delirium in the hospitalized older adult
- Middle-age cerebral small vessel disease and cognitive function in later life: a population-based prospective cohort study
- An Overview of Cognitive Impairment
- Identifying dementia risk profiles for targeted interventions: A latent class analysis of at‐risk middle‐aged Australians