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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Poor memory ability and small hippocampal volume measurements in magnetic resonance images co-occur in neurological patients.
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Caring for a family member with dementia is generally regarded as a chronically stressful process, with potentially negative physical health consequences.
Why it matters
This 2003 meta-analysis pooled 23 studies comparing people caring for a family member with dementia with demographically similar noncaregivers, across 11 health categories. Caregivers showed "a slightly greater risk for health problems", with stronger links for stress hormones, antibodies and self-rated ("global reported") health, but the link depended on the caregiver's sex and on which health measure was used. It shows an association, not that caregiving causes illness, and it does not test any treatment, cure or prevention for Alzheimer's disease.
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The ADL benefits in AD patients treated with donepezil were associated with less caregiving time and lower levels of caregiver stress.
Why it matters
This randomized controlled trial found that donepezil demonstrated a significantly slower decline than placebo in activities of daily living in patients with moderate to severe Alzheimer's disease. The benefits were associated with less caregiving time and lower levels of caregiver stress.
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The CHS has developed a methodology for longitudinal studies of dementia in large cohorts and represents the largest study of dementia including cognitive testing, MRI and genetic markers.
Why it matters
In 3,608 adults over 65 from the Cardiovascular Health Study who had a brain MRI in 1991, a panel of neurologists and psychiatrists reviewed detailed exams from 1998–2000 and classified 480 people (13.3%) as having developed dementia, 227 (6.3%) as already having dementia and 577 (16.0%) as having mild cognitive impairment; 69% of the new dementia cases were judged Alzheimer's disease, 11% vascular dementia and 16% both. Among people who survived to the end of the study, dementia was more frequent in Black men (22.2%) and women (23.4%) than in white men (13.5%) and women (14.5%), though the paper reports these as plain frequencies and does not explain the difference. It describes how dementia was identified and counted in this cohort, and does not test any treatment or prevention.
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64/100
Our study has identified not only risk factors associated with functional decline but also the interactions among these factors.
Why it matters
In this cohort of older people without dementia, conditions like diabetes, hypertension, heart disease, and depression were linked to worse functional outcomes, while exercise and moderate alcohol use were linked to better ones. It did not test any treatment for Alzheimer's disease.
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Patients were divided into a development (n = 3859) and validation (n = 1929) cohort.
Why it matters
This study developed a model to predict nursing home placement in people with dementia based on patient and caregiver characteristics. It does not test any treatment, cure, or prevention for Alzheimer's disease.
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Regular physical activity could represent an important and potent protective factor for cognitive decline and dementia in elderly persons.
Why it matters
In 4,615 Canadians aged 65 or older who had normal thinking at the start of the Canadian Study of Health and Aging, those with high physical activity were less likely to be diagnosed with cognitive impairment, Alzheimer disease or dementia five years later than those who did no exercise (age-, sex- and education-adjusted odds ratios 0.58, 0.50 and 0.63). More activity went with lower odds. This is an observational association, not proof that exercise prevents dementia. The authors conclude only that regular activity "could represent an important and potent protective factor".
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Selection criteria All unconfounded trials specified as randomized in which treatment with piracetam was administered for more than a day and compared with placebo in patients with dementia of Alzheimer type, vascular dementia,or mixed vascular and Alzheimer's disease, or unclassified dementia, or cognitive impairment not fulfilling the criteria for dementia.
Why it matters
Pooled data from randomized trials found that people taking piracetam were more likely to be rated as improved on a global impression of change than those taking placebo. However, many of the studies could not be fully analyzed because of their design, and the results varied between studies.
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MCI criteria perform poorly when applied to a representative population sample.
Why it matters
MCI criteria had been built from "small, selected clinical groups" and had never been tested in the general population. In this population study they "perform[ed] poorly": 3.2% of people met them, only 11.1% of those developed dementia within 3 years, and "almost all subjects" changed category from year to year. Unexpectedly, people labelled with age-associated cognitive decline (19.3%), a category assumed to reflect normal ageing, were a more stable group, and 28.6% of them developed dementia within 3 years, so the authors propose modifying the criteria rather than relying on them as they stood.
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Knowledge of the relationship between various clinical characteristics and cognitive functioning is advancing, but little is known about the cognitive response to treatment for geriatric depression.
Why it matters
In this small study, elderly depressed patients who were not demented showed a small improvement in cognitive test scores after 12 weeks of antidepressant treatment. It concerns depression rather than Alzheimer's disease and does not show any effect on treating, curing or preventing Alzheimer's.
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The study confirmed some previously reported risk factors but also suggested new ones.
Why it matters
This population study found that age, rural residence, living in an institution, diabetes, depression, the apolipoprotein E epsilon4 allele, hypertension in women, heart problems in men, taking aspirin, and occupational exposure to pesticides or fertilizers were associated with higher risk of vascular dementia, while eating shellfish and regular exercise in women were associated with lower risk. These are associations from a case-control study, not proof that changing any of these factors prevents vascular dementia.
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In this study, patients with advanced dementia and hip fracture or pneumonia had a very poor prognosis.
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Alzheimer's disease sufferers have been found to have a lack of the enzyme responsible for converting choline into acetylcholine within the brain.
Why it matters
This review of 12 randomized trials of lecithin for dementia and cognitive impairment found no clear benefit; the only statistically significant result favored placebo for adverse events. The authors note that a dramatic result in favor of lecithin was not supported by the overall evidence.
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Design prospective cohort study.
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This 3-year randomized clinical trial tested the effectiveness of an interdisciplinary psychoeducational family group intervention in decreasing the caregivers' perceptions of the frequency and severity of behavioral problems in persons with dementia and their reactions to those problems, and in decreasing caregiver burden and depression.
Why it matters
In this randomized clinical trial of 94 primary caregivers, a psychoeducational family group intervention reduced caregivers' negative reactions to disruptive behaviours and reduced caregiver burden over time. The intervention did not address treating, curing, or preventing Alzheimer's disease itself.
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Schizophrenia is associated with a bilateral volumetric reduction of the hippocampus and probably of the amygdala as well.
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To assess age-, sex-, and subtype-specific incidence rates of dementia and to calculate the risk of dementia, the authors performed a large, community-based, prospective cohort study on dementia as part of the Rotterdam Study.
Why it matters
This Rotterdam Study paper set out "to assess age-, sex-, and subtype-specific incidence rates of dementia" in residents of a Rotterdam suburb aged 55 and older, who were first examined in 1990–1993. People were screened with a three-stage protocol, and medical records were checked for those who died or could not be seen in person. The summary we hold does not include the results, so see the original paper for the rates. Like all incidence studies, it describes how often dementia appears and does not test any treatment or prevention.
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The overall PAF for dementia in Denmark was 37·8% (95% CI 35·6-40·0) for the assessed risk factors.
Why it matters
This nationwide Danish cohort study estimated that the assessed risk factors accounted for 37.8% of dementia cases, with a higher proportion in males, certain birth cohorts and people with low education. The findings support tailored dementia interventions and highlight interactions between risk factors, but they are observational.
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Varicella-zoster virus (VZV) is a neurotropic virus that establishes lifelong latency in humans.
Why it matters
In health records from more than 100 million individuals, recurrent herpes zoster was associated with increased dementia risk compared with a single episode, and exposure to herpes zoster vaccines was associated with reduced dementia risk compared with a control vaccine. The reduced risk after the live-attenuated zoster vaccine waned over time in line with waning protection against herpes zoster, and the authors say their findings strongly implicate varicella-zoster virus reactivation.
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Critical outcomes were rate of falls (number of falls per unit time) and number of fallers (risk of experiencing one or more falls).
Why it matters
Multifactorial interventions probably have little or no effect on the rate of falls in care facilities, but probably reduce the risk of falling. A subgroup analysis suggested that interventions delivered in a tailored manner according to resident individual circumstances with facility staff engagement have greater effects.
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This article summarizes the top 20 research studies of 2024 identified as POEMs (patient-oriented evidence that matters).
Why it matters
This article summarizes the top 20 research studies of 2024 identified as patient-oriented evidence that matters for primary care physicians. Its findings concern antibiotics for community-acquired pneumonia, oral antivirals for COVID-19 and nirsevimab in infants, and do not address Alzheimer's disease treatment, cure or prevention.
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In those aged 65 years or older, delirium was overall associated (all p<0·001, age and sex adjusted) with dementia ( adj OR 3·63 [95% CI 2·65–4·98]), pre-admission dependency (2·63 [2·02–3·43]), comorbidity burden (1·04 [1·02–1·05]), and frailty (moderate vs low risk 3·62 [2·70–4·85] and high vs low risk 11·85 [7·24–19·42]), with stronger associations in patients without comorbid dementia than in those with comorbid dementia.
Why it matters
This 10-year observational study found that delirium in older general medicine patients was associated with dementia, pre-admission dependency, comorbidity burden, and frailty, and with increased risk of death maintained for up to 10 years. The findings support current guidelines for routine on-admission delirium screening from age 65 years.
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Distinct associations between different traffic noise exposures and incident dementia subtypes were found in this large UK prospective cohort study.
Why it matters
No association was found between all-cause dementia and road or railway noise, but a 10-decibel higher annual mean road traffic noise was significantly associated with incident Alzheimer's disease. Railway noise was significantly associated with incident Parkinson's disease related dementia, though the effect estimate was slightly reduced after adjustment.
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Among 2946 participants (mean [SD] age, 74.9 [4.6] years; 1751 [59.4] female; 637 Black [21.6%] and 2309 White [78.4%] individuals), 1947 participants (66.1%) had audiometric hearing loss, and 1097 (37.2%) had self-reported hearing loss.
Why it matters
In this cohort study, the population attributable fraction of dementia from any audiometric hearing loss was 32.0%, while self-reported hearing loss was not associated with increased dementia risk. The authors suggest that treating hearing loss might delay dementia for many older adults and that public health interventions targeting clinically significant audiometric hearing loss might have broad benefits for dementia prevention.
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While sex differences were not apparent at asymptomatic stages, females showed more rapid declines across all outcomes in symptomatic stages compared to males.
Why it matters
In genetic FTD, females showed cognitive resilience in early disease stages but steeper clinical declines once symptomatic compared to males. Baseline NfL may be a less sensitive prognostic tool for clinical progression in females with FTD-causing mutations.
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.
- The incidence of dementia: a meta-analysis
- Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
- Environment, lifestyle, and cancer in women
- Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment
- Infection Control in Africa South of the Sahara
- Thyroid function and the risk of dementia: The Rotterdam Study
- Adherence to multidomain interventions for dementia prevention: Data from the FINGER and MAPT trials
- A Live Video Dyadic Resiliency Intervention to Prevent Chronic Emotional Distress Early After Dementia Diagnoses: Protocol for a Dyadic Mixed Methods Study
- Obstructive sleep apnoea and risk of dementia: a Danish population-based cohort study
- Relationship Between Social Support and Global Cognition by Level of Neighborhood Disadvantage in the HABS‐HD Cohort