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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In elderly persons, antipsychotic drugs are clinically prescribed off-label for a number of disorders outside of their Food and Drug Administration (FDA)-approved indications (schizophrenia and bipolar disorder).
Why it matters
This white paper reports that a meta-analysis of 17 trials led the FDA to determine that atypical antipsychotics were associated with a 1.6 to 1.7 times greater mortality risk compared with placebo in elderly people with dementia. It notes there is a paucity of evidence-based treatment alternatives to antipsychotics for psychosis and severe agitation in this population.
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We aimed to determine prospectively whether rivastigmine, an inhibitor of acetylcholinesterase and butyrylcholinesterase, provided benefits in patients with and without visual hallucinations in a population with dementia associated with Parkinson's disease (PDD).
Why it matters
This 24-week double-blind placebo-controlled study tested rivastigmine in patients with dementia associated with Parkinson's disease, including those with and without visual hallucinations. It evaluates a drug for Parkinson's disease dementia, not a cure or prevention for Alzheimer's disease.
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The majority of patients with MCI progressed to dementia and a significant proportion died.
Why it matters
Among 327 people with mild cognitive impairment followed for an average of 3.1 years, 65% progressed to dementia and 24% died. Compared with amnestic mild cognitive impairment, single nonmemory or multiple domain subtypes were less likely to progress to dementia but more likely to die, though these results were of borderline statistical significance.
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All treatment groups showed improvement in measures of psychosis without significant differences between them when planned comparisons were performed.
Why it matters
In this 10-week trial of 284 patients with psychosis in Alzheimer disease, quetiapine showed no differential benefit on any psychosis measure compared with placebo or haloperidol. Some agitation scores improved with quetiapine versus placebo, but overall this addresses behavioral symptoms rather than treating, curing, or preventing the underlying disease.
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The trial did not show efficacy of GbE, however, the lack of decline of the placebo patients may have compromised the sensitivity of the trial to detect a treatment effect.
Why it matters
In this 26-week trial, Ginkgo biloba extract showed no significant benefit over placebo for the whole group of patients with mild to moderate Alzheimer dementia. A subgroup with neuropsychiatric symptoms showed better scores on Ginkgo, but this was not the main finding.
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When proper normative values are used, only age and education, and not race or ethnicity, are associated with higher frequency of MCI.
Why it matters
In 1,315 older adults without dementia in Northern Manhattan, about 5% (95% CI 3.8–6.2%) had amnestic mild cognitive impairment, with other MCI types ranging from 2.1% to 6.2%. MCI was more common after age 75 and among people with fewer than 9 years of schooling; the authors conclude that "when proper normative values are used," race or ethnicity was not associated with MCI frequency. APOE E4 was more frequent in amnestic MCI. This is a study of how often MCI occurs, not of treatment or prevention.
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Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms.
Why it matters
This systematic review found that only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for managing neuropsychiatric symptoms of dementia. Music therapy and Snoezelen, and possibly sensory stimulation, were useful during the treatment session but had no longer-term effects, so these approaches address symptoms rather than curing or preventing Alzheimer's disease.
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Future confirmation in a larger study is needed to fully demonstrate rosiglitazone's therapeutic potential.
Why it matters
In this small preliminary placebo-controlled pilot study of 30 people, those taking rosiglitazone showed better delayed recall and selective attention than the placebo group. The authors call this preliminary support only and state that a larger study is needed, so it is not yet evidence of an effective treatment.
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The majority of dementia-related deaths in the United States occurred in nursing homes (66.9%).
Why it matters
This study describes where older people with dementia die in the United States, finding most died in nursing homes, with state-level variation linked to bed availability and age. It concerns end-of-life care location, not treating, curing, or preventing Alzheimer's disease.
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65/100
Mild cognitive impairment (MCI) often represents an early form of Alzheimer disease (AD).
Why it matters
In 28 patients with mild cognitive impairment, prolonged treatment with galantamine increased brain activation during memory tasks and improved accuracy on a working memory task. This small study shows that brain imaging can detect drug effects on brain activity, but it did not test whether this translates into slower progression to Alzheimer's disease.
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These findings support the hypothesis that the metabolic syndrome contributes to cognitive impairment in elders, but primarily in those with high level of inflammation.
Why it matters
In 2,632 Black and white adults with an average age of 74, followed for 5 years, 26% of those with the metabolic syndrome had a drop of 5 or more points on a cognitive screening test, compared with 21% of those without it. The higher risk was seen only in people who also had above-median inflammation markers (interleukin 6 and C-reactive protein); people with the metabolic syndrome and lower inflammation showed no increase. This is an observational finding that does not show cause, did not measure dementia or Alzheimer's diagnoses, and did not test any treatment.
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Educational support for general practitioners should concentrate on epidemiological knowledge, disclosure of the diagnosis and management of behaviour problems in dementia.
Why it matters
This survey of 127 general practitioners found their knowledge of dementia diagnosis and management was good, but many lacked confidence in managing behavior and other problems and in coordinating support services. It is about doctors' knowledge and attitudes, not about treating, curing or preventing Alzheimer's disease.
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The recent availability of longitudinal data on the possible association of different lifestyles with dementia and Alzheimer's disease (AD) allow some preliminary conclusions on this topic.
Why it matters
This review of longitudinal studies suggests that social, mental and physical activity in late life have a beneficial effect on cognition and a protective effect against dementia. The authors present these as preliminary conclusions limited by the studies available, not as proven prevention.
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The mortality rates for the derivation cohort and validation cohort, respectively, were 8.9% and 8.2% in hospital, 10.7% and 10.4% at 30 days, and 32.9% and 30.5% at 1 year.
Why it matters
This study built and validated a model that predicts death within 30 days and 1 year for patients hospitalized with heart failure, using information available when they arrive at the hospital. It concerns heart failure outcomes and does not address treating, curing, or preventing Alzheimer's disease.
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Significant main effects in the expected direction were found for changes in most of these measures.
Why it matters
This study found that anger management and depression management interventions significantly reduced anger, hostility, and depression in women caregivers compared to a wait-list control group. It suggests that these types of skill training programs may help improve caregiver mental health.
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Post-MI Hosp-CR and Home-CR are similarly effective in the short term and improve TWC and HRQL in each age group.
Why it matters
This trial tested cardiac rehabilitation after heart attack in older patients, including some over 75, and found improved exercise tolerance and quality of life. People with dementia were excluded, so it does not address Alzheimer's treatment or prevention.
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High intake of total, saturated, and trans fat and cholesterol and low intake of MUFA, PUFA, n-6 PUFA, and n-3 PUFA were not associated with increased risk of dementia or its subtypes.
Why it matters
In 5,395 older adults in the Rotterdam Study who were cognitively normal when their diet was recorded, 197 developed dementia over an average of 6.0 years. Higher intake of total, saturated or trans fat or cholesterol, and lower intake of mono- or polyunsaturated fats (including n-3), were not associated with higher risk of dementia or its subtypes; every rate ratio's 95% interval included 1. Because diet was measured once by questionnaire and the study was observational, this finds no link in this cohort rather than proving that dietary fat has no effect.
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The aim of the reported trial was to investigate the safety and efficacy of memantine in mild to moderate vascular dementia (VaD).
Why it matters
This randomized controlled trial tested memantine 20 mg daily versus placebo in mild to moderate vascular dementia, not Alzheimer's disease. It provides no information on treating, curing or preventing Alzheimer's disease.
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Delirium in a patient with preexisting dementia is a common problem that may have serious complications and poor prognostic implications.
Why it matters
This systematic review notes that delirium superimposed on dementia is a common problem with serious complications and poor prognostic implications, and that adverse events are associated with delirium in persons with dementia, including accelerated and long-term cognitive decline. It highlights that only one reported study systematically identified associated factors and interventions for this condition.
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Based on the hypothesis of glutamate-induced neurotoxicity (excitotoxicity) in cerebral ischemia, this study examined the efficacy and tolerability of memantine, an uncompetitive N-methyl-D-aspartate antagonist, in the treatment of mild to moderate vascular dementia.
Why it matters
This randomized, placebo-controlled trial examined the efficacy and tolerability of memantine in patients with mild to moderate vascular dementia. The record does not state the trial's results, so no conclusion about memantine's effect can be drawn from this text.
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Most healthy elderly people did not experience cognitive decline.
Why it matters
In this cohort, several cardiovascular and diabetes measures were linked to declines in cognitive test scores. The study examined how APOE genotype might modify these links, but it does not show that treating these conditions prevents dementia.
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Delirium is an important independent prognostic determinant of hospital outcomes including new nursing home placement, death or new nursing home placement, and functional decline-even after controlling for age, gender, dementia, illness severity, and functional status.
Why it matters
This study found that delirium present at hospital admission in older patients predicted new nursing home placement and functional decline, but was not significantly associated with death alone or length of stay. It is about hospital outcomes of delirium and does not test any treatment, cure, or prevention for Alzheimer's disease.
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Global assessments are Food and Drug Administration-required primary outcome measures in trials of putative antidementia drugs.
Why it matters
This study examined the Clinician Interview-Based Impression (CIBI) in the placebo group of a tacrine trial and found it was modestly reliable and weakly correlated with cognitive assessments. It suggests that modifications to the CIBI might improve its reliability and acceptance as a global change rating scale.
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Delirium developed in 27 of 107 patients (25%) in the development cohort.
Why it matters
This study developed a model based on admission characteristics to predict which hospitalized elderly patients would develop delirium. It is a prediction tool, not a treatment or prevention for Alzheimer's disease.
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Among 283,772 participants (mean [SD] age 64.62 [8.96] years; 56.7% women), 60.3% identified as non-Hispanic White and 13.3% as Hispanic/Latino.
Why it matters
This cohort study found that people with type 1 diabetes had a higher incidence of dementia than those without diabetes, and those with type 2 diabetes also had elevated risk. It highlights the need to better understand the mechanisms linking type 1 diabetes to dementia.
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.
- Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies
- Digital dementia in the internet generation: excessive screen time during brain development will increase the risk of Alzheimer's disease and related dementias in adulthood
- Association Between Long-Term Care Insurance Certification and Early Home-Visit Nursing Frequency in Older Patients With Heart Failure in Japan
- Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia
- Type 2 diabetes and risk of cognitive impairment and dementia
- Multidomain lifestyle intervention for the prevention of cognitive decline in at-risk older adults in Latin America (LatAm-FINGERS): a single-blind, multicentre, randomised controlled trial
- Differential effects of childhood neglect and abuse during sensitive exposure periods on male and female hippocampus
- Risk of Discharge to Lower-Quality Nursing Homes Among Hospitalized Older Adults With Alzheimer Disease and Related Dementias
- Alzheimer's disease and related dementias among Medicare beneficiaries aged ≥ 65 years in rural America, by Census region and select demographic characteristics: 2020
- Menopause hormone therapy and risk of mild cognitive impairment or dementia: a systematic review and meta-analysis