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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65/100
The heterogeneous patterns and severity of conditions produce distinctive cumulative effects for each individual.5 Multimorbidity is associated with many adverse consequences, including death, disability, institutionalization, greater use of healthcare resources, poorer quality of life, and higher rates of adverse effects of treatment or interventions.1 Comprehensive strategies for healthcare delivery that are not disease specific, as well as interventions that target geriatric syndromes common in older adults with multimorbidity, show promise for this population,5-9 although the best approaches to decision-making and clinical management of older adults with multimorbidity remain unclear.
Why it matters
This article presents guiding principles for caring for older adults with multiple chronic conditions, noting that single-disease guidelines may be impractical or harmful in this group. It is about general care approaches for multimorbidity rather than treating, curing or preventing Alzheimer's disease.
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The successful interventions identified included approximately nine to 12 sessions tailored to the needs of the person with dementia and the caregiver and were delivered individually in the home using multiple components over 3-6 months with periodic follow-up.
Why it matters
This meta-analysis found that nonpharmacological interventions delivered by family caregivers reduced the frequency and severity of behavioral and psychological symptoms of dementia, with effect sizes at least equal to those of drug treatment. It supports using these approaches to help both patients and their caregivers.
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Nine studies with a total of 44,004 participants met the inclusion criteria.
Why it matters
This systematic review of cohort studies found that higher vegetable consumption, but not fruit, was associated with lower risk of dementia or cognitive decline. It reports an association only and does not show that eating vegetables prevents dementia.
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Regular exercise, especially mind-body exercise with integrated cognitive and motor coordination, may help with preservation of global ability in elders at risk of cognitive decline; however, logistics to promote long-term practice and optimize adherence needs to be revisited.
Why it matters
This randomized controlled trial compared Tai Chi with stretching and toning exercise in older Chinese adults at risk of cognitive decline. The Tai Chi group had a trend for lower risk of progression to clinical dementia, but the study was limited by high dropout rates and the results were not definitive.
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Our objective was to evaluate the epidemiological evidence linking cognitive impairment and fall risk.
Why it matters
This systematic review and meta-analysis of 27 studies found that impairment on global measures of cognition was associated with any fall, serious injuries and distal radius fractures in community-dwelling older adults, and that executive function impairment was associated with increased fall risk. It addresses fall risk in people with cognitive impairment and does not test any treatment, cure or prevention of Alzheimer's disease.
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Higher intake of omega-3 fatty acids (n-3 FAs) is associated with a reduced risk of Alzheimer's disease (AD) and milder forms of cognitive impairment (e.g. cognitive impairment no dementia [CIND]); however, findings from interventional trials are inconsistent.
Why it matters
This meta-analysis pooled randomized placebo-controlled trials to examine whether omega-3 fatty acids improve cognitive performance in healthy, cognitively impaired, or Alzheimer's disease subjects. It tests a possible intervention for cognition, not a proven treatment, cure or prevention for Alzheimer's disease.
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Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly.
Why it matters
In this 40-week trial of 120 non-demented Chinese elders, Tai Chi and social interaction groups showed increased brain volume compared with no intervention, and the Tai Chi group improved on several cognitive measures. It was a small trial in non-demented elders and did not test prevention or treatment of Alzheimer's disease.
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This study is based on a population-based cohort of 7,839 subjects over 65 years with 7 years of follow-up.
Why it matters
This large population study of 7,839 people over 65 followed for 7 years examined whether chronic kidney disease and related measures were linked to later cognitive decline and dementia. It looks at a possible risk relationship over time, not at treating, curing or preventing Alzheimer's disease.
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Older, healthy women with decreased circadian activity rhythm amplitude and robustness, and delayed rhythms have increased odds of developing dementia and MCI.
Why it matters
In this cohort of older women, weaker circadian activity rhythms were linked to a higher chance of later developing dementia or mild cognitive impairment. This shows an association only, so it does not prove that activity rhythms cause or prevent these conditions.
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65/100
Patients who failed to meet revised criteria were significantly older and most had atypical presentations with marked memory impairment.
Why it matters
This study found that revised criteria for behavioural variant frontotemporal dementia improved diagnostic accuracy compared with older criteria in a sample with known frontotemporal lobar degeneration. It concerns diagnosis of a different dementia type and does not report a treatment or cure.
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Rural subjects with higher health literacy were more likely to want comfort care compared to those with lower levels of health literacy.
Why it matters
In this small randomized trial of 76 rural primary care patients, those who watched a video about advanced dementia were more likely to choose comfort care than those who only heard a verbal description. This concerns end-of-life care preferences, not treating, curing or preventing Alzheimer's disease itself.
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Lipid-lowering medications (LLMs) and especially statin drugs can delay cognitive decline and dementia onset in individuals with and without mild cognitive impairment (MCI) at baseline.
Why it matters
This observational analysis of 3069 cognitively healthy elderly people in the Ginkgo Evaluation of Memory Study examined whether statin use was related to time to dementia and to changes in cognitive function. The provided text does not report the results, so it is unknown whether statins affected dementia risk or cognition.
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GOF indices were highest in normal controls, intermediate in MCI, and lowest in AD (p Conclusions fMRI connectivity indices distinguish patients with MCI who undergo cognitive decline and conversion to AD from those who remain stable over a 2- to 3-year follow-up period.
Why it matters
In 68 participants, a measure of default mode network connectivity was lower in Alzheimer disease than in mild cognitive impairment and lowest overall, and it distinguished those with mild cognitive impairment who declined over two to three years from those who stayed stable. This is an observational imaging study and does not show that any treatment can change this connectivity or prevent decline.
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MCI is common in patients with PD without dementia, affecting a range of cognitive domains, including memory, visual-spatial, and attention/executive abilities.
Why it matters
In this pooled analysis of patients with Parkinson disease, about one quarter had mild cognitive impairment, most commonly memory impairment. This describes how common cognitive impairment is in Parkinson disease but does not test any treatment or prevention.
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At 16 weeks, 67.5% of intervention caregivers reported improvement in targeted problem behavior, compared with 45.8% of caregivers in a no-treatment control group (P=.002), and reduced upset with (P=.03) and enhanced confidence managing (P=.01) the behavior.
Why it matters
In this randomized trial of 272 caregivers and people with dementia, an intervention of up to 11 home and telephone contacts over 16 weeks led to 67.5% of intervention caregivers reporting improvement in targeted problem behavior versus 45.8% of controls, along with reduced upset and enhanced confidence managing the behavior. The intervention trained caregivers to identify and modify triggers of patient behaviors, including communication, environmental factors, and undiagnosed medical conditions.
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The mean baseline age of the veterans was 68.8 years, and 174 806 (96.5%) were men.
Why it matters
Among 181,093 US veterans aged 55 or older treated at VA medical centers (96.5% men), those with a PTSD diagnosis were more likely to be diagnosed with dementia over about 7 years: 10.6% versus 6.6% of those without PTSD. The authors describe this as a nearly 2-fold higher risk. It is an association from health records, not proof that PTSD causes dementia, and the authors say the mechanisms still need to be found.
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In this population-based case-control study, any frequency of moderate exercise performed in midlife or late life was associated with a reduced odds of having MCI.
Why it matters
In this population-based case-control study, any frequency of moderate exercise in midlife or late life was associated with reduced odds of having mild cognitive impairment. Light exercise and vigorous exercise were not significantly associated with decreased risk of mild cognitive impairment.
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A structured, multicomponent skills training intervention that targeted CG self-care behaviors as one of five target areas, improved self-reported health status, and decreased burden and bother in racially and ethnically diverse CGs of people with dementia.
Why it matters
In this randomized multisite trial of 495 dementia caregiver and care recipient dyads, caregivers who received the REACH intervention reported better self-rated health, sleep quality, physical health, and emotional health, and less burden and bother, than controls. Changes in depression appeared to mediate these relationships.
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This study provides a systematic review of predictors of NHP in the general population of developed countries.
Why it matters
This systematic review found that predictors of nursing home placement with strong evidence were increased age, low self-rated health, functional and cognitive impairment, dementia, prior nursing home placement, and a high number of prescriptions. It addresses care planning, not treating, curing, or preventing Alzheimer's disease.
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65/100
We aimed to verify the association between diabetes and the risk of dementia, Alzheimer's disease, and vascular dementia in twins and to explore whether genetic and early-life environmental factors could contribute to this association.
Why it matters
This population-based twin study examined the association between mid- and late-life diabetes and the risk of dementia, Alzheimer's disease, and vascular dementia. It investigates a risk factor and does not test a treatment, cure, or prevention.
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Cerebrovascular disease is a significant and potentially preventable cause of dementia in the Baltimore Longitudinal Study of Aging.
Why it matters
In 179 subjects from the Baltimore Longitudinal Study of Aging, both symptomatic and asymptomatic brain infarcts significantly increased the odds of dementia, and microscopic infarcts contributed as much as macroscopic ones. The findings indicate that cerebrovascular disease is a significant contributor to dementia alongside Alzheimer's disease pathology.
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The MMSE is the most widely used cognitive test but its accuracy and clinical utility in diagnosing cognitive disorders is not fully known.
Why it matters
This meta-analysis found that the Mini-Mental State Examination offers modest accuracy, working best to confirm a suspected dementia diagnosis in specialist settings and best to rule out dementia in community and primary care. It concerns detection and diagnosis only and reports no treatment, cure, or prevention.
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65/100
We calculated pooled relative risk (RR) using a random effects model.
Why it matters
Pooling 16 prospective studies that followed 163,797 people without dementia, this 2009 review found that people in the highest physical activity category had a lower relative risk of dementia than those in the lowest: RR 0.72 (95% CI 0.60-0.86). The authors conclude only that activity "is inversely associated with risk of dementia". Because the review pools observational studies, it shows an association, not that exercise prevents dementia, and the authors say the "optimal dose … presently remains unclear". This record's text gives no separate result for Alzheimer's disease.
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Vascular risk factors, such as type 2 diabetes, hypertension, obesity and dyslipidaemia often co-occur.
Why it matters
This systematic review of longitudinal population studies found that diabetes, high blood pressure, obesity and high cholesterol were each linked to a higher risk of dementia, with odds ratios "around 1.5". The findings for diabetes and obesity were the most consistent. Timing mattered: for blood pressure, obesity and cholesterol the link was generally strongest when measured in midlife, and midlife high blood pressure accounted for "up to 30%" of late-life dementia at the population level, while in later life diabetes "appears to convey the highest risk". These are associations, not proof that treating these factors prevents dementia; the authors conclude that vascular risk factors are a major target for prevention but that "timing of such measures appears to be critical".
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Rates of hippocampal atrophy (%/year) were 0.0 +/- 0.8 in the absent, 1.7 +/- 0.4 in the moderate, and 3.6 +/- 1.0 in the severe (mean +/- SD) tertile.
Why it matters
In this cohort of people with mild cognitive impairment, older age, poorer general cognition, hippocampal atrophy, and the APOE epsilon 4 allele predicted faster subsequent hippocampal atrophy. These markers may help identify people with mild cognitive impairment at risk for Alzheimer's disease, but the study does not test a treatment, cure, or prevention.
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.
- Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death
- Left ventricular dysfunction: a clue to cognitive impairment in older patients with heart failure
- Time to routinely perform 4AT at the ‘front door’; evidence informing policy and practice
- How common are complications of Parkinson's disease?
- Assisted Living Staff Perspectives on End-Of-Life Care for Residents Living With Dementia: A Qualitative Study
- Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey
- Survival in hospice patients with dementia: the effect of home hospice and nurse visits
- Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
- The 'natural' endpoint of dementia: death from cachexia or dehydration following palliative care?
- Mind your nose: A randomized controlled trial of olfactory‐based memory training for older people with subjective cognitive decline