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 detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care.
Why it matters
This systematic review estimated global dementia prevalence and projected rising numbers, especially in low- and middle-income countries. It offers a basis for planning care resources but does not evaluate any treatment or cure.
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Hypertension significantly increases the risk of vascular dementia.
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78/100
We sought to determine the frequency and prognosis of persistent delirium (PerD) in older hospital patients by systematically reviewing original research on this topic.
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The outcomes were better among patients treated with rivastigmine than among those who received placebo; however, the differences between these two groups were moderate and similar to those reported in trials of rivastigmine for Alzheimer's disease.
Why it matters
In this 24-week trial, 541 people with Parkinson's disease who developed mild-to-moderate dementia at least 2 years after diagnosis (not Alzheimer's disease) were randomly assigned to rivastigmine or placebo, and 410 completed it. On the 70-point ADAS-cog thinking scale, the rivastigmine group improved by 2.1 points on average while the placebo group worsened by 0.7. The authors call the benefit "moderate" and similar to rivastigmine trials in Alzheimer's disease, and they report "higher rates of nausea, vomiting, and tremor".
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However, some (like tacrine) are associated with adverse effects such as hepatotoxicity, but donepezil (E2020, Aricept) is safer.
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Dementia and MCI are associated with neuropsychiatric symptoms in clinical samples.
Why it matters
This study found that many people with mild cognitive impairment and dementia had neuropsychiatric symptoms such as depression, apathy and irritability in the previous month. It is a descriptive count of symptoms and does not test any treatment, cure or prevention for Alzheimer's disease.
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Among community-dwelling patients with moderate to severe dementia and their caregivers, dementia palliative care, compared with usual care, did not significantly improve patients' neuropsychiatric symptoms through 24 months.
Why it matters
Integrated dementia palliative care did not significantly improve patients' neuropsychiatric symptoms over 24 months compared with usual care, though there were fewer combined emergency department and hospitalization events. This is a null result for symptom improvement, with a possible benefit in reducing hospital use.
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Older adults with higher triglyceride levels within the normal to high-normal range had a lower dementia risk and slower cognitive decline over time compared with individuals with lower triglyceride levels.
Why it matters
In this cohort of older adults, higher triglyceride levels within the normal to high-normal range were associated with lower dementia risk and slower cognitive decline. This is an observational association and does not show that raising triglycerides prevents dementia.
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Then, voxel-wise brainwide association analyses were used to identify gray matter volumes (GMVs) associated with social isolation and with loneliness.
Why it matters
In 462,619 middle-aged and older adults, people who were socially isolated had a 1.26-fold higher risk of later dementia (95% CI 1.15–1.37), even after adjusting for loneliness, depression and other risk factors. Brain scans showed gray-matter differences that partly accounted for the link between isolation and later thinking scores. The authors call isolation a possible "early indicator" of dementia risk. The study did not test whether reducing isolation lowers that risk.
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The Vivifrail exercise programme provided significant benefits in functional capacity over usual-care.
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Decades of research have revealed numerous risk factors for mental disorders beyond genetics, but their consistency and magnitude remain uncer-tain.
Why it matters
This meta-analysis states that decades of research have revealed numerous non-genetic risk factors for mental disorders but that their consistency and magnitude remain uncertain. It reports no findings on treating, curing or preventing Alzheimer's disease.
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A total of 95 unique studies were included in this systematic review, of which 74 with 2 760 379 unique patients were also included in 5-year age band meta-analyses.
Why it matters
Drawing on 95 studies, this review estimates that 119 per 100,000 people aged 30 to 64 worldwide live with young-onset dementia, about 3.9 million people. Prevalence was similar in men and women and lower in high-income than in middle-income countries. The authors say the figures should help policymakers plan enough care for this group, while noting that data from low-income countries and younger age ranges remain scarce.
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Among 10 095 participants (67.3% men; aged 35-55 years in 1985-1988), a total of 1710 cases of diabetes and 639 cases of dementia were recorded over a median follow-up of 31.7 years.
Why it matters
This cohort study examined whether younger age at type 2 diabetes onset is more strongly associated with the incidence of dementia. It reports dementia rates and a hazard ratio comparing participants with diabetes onset more than 10 years earlier to those without diabetes at age 70.
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Vascular cognitive impairment (VCI) describes a broad spectrum of cognitive impairments caused by cerebrovascular disease, ranging from mild cognitive impairment to dementia.
Why it matters
This network meta-analysis examined whether three cholinesterase inhibitors (donepezil, galantamine, and rivastigmine) improve cognition or function in people with vascular cognitive impairment. It addresses treatment of vascular cognitive impairment, not Alzheimer's disease, and does not establish a cure or prevention.
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No clinically important adverse events were associated with treatment.
Why it matters
This randomized clinical trial of 289 participants found no clinically important adverse events associated with intranasal insulin treatment. The available text reports only safety information, not whether the treatment improved cognition.
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One randomized clinical trial (RCT) (n = 4005) examined the direct effect of screening for cognitive impairment on patient outcomes, including potential harms, finding no significant differences in health-related quality of life at 12 months (effect size, 0.009 [95% CI, -0.063 to 0.080]).
Why it matters
This review of 287 studies found that one randomized clinical trial of 4005 older adults examined the direct effect of screening for cognitive impairment on patient outcomes and found no significant differences in health-related quality of life at 12 months. The evidence does not show that screening improves patient outcomes.
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Concerning deceased residents, we collected 551 of 610 questionnaires from staff at baseline and 984 of 1178 postintervention in 37 intervention and 36 control homes.
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The 780 PWDs (56.3% female; mean [SD] age, 78.1 [9.9] years) and 780 caregivers (70.9% female; mean [SD] age, 64.7 [12.0] years) lived in California (n = 452), Nebraska (n = 284), or Iowa (n = 44).
Why it matters
In this randomized trial of 780 people with dementia and 780 caregivers, a telephone and internet collaborative care program improved patient quality of life, reduced emergency department visits, and decreased caregiver depression and burden compared with usual care. It improves care and well-being but does not treat, cure or prevent Alzheimer's disease itself.
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With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority.
Why it matters
Pooling data from 48,522 people across 20 cohorts, this study found age, APOE*4, depression, diabetes, and current smoking among the factors linked to worse cognitive outcomes. It identifies modifiable risk factors for cognitive decline but does not test any treatment or cure.
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The FINGER MRI exploratory sub-study did not show significant differences between the intervention and control groups on changes in regional brain volumes, regional cortical thicknesses, or WML volume after 2 years in at-risk elderly without substantial impairment.
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Among ambulatory adults with hypertension, treating to a systolic blood pressure goal of less than 120 mm Hg compared with a goal of less than 140 mm Hg did not result in a significant reduction in the risk of probable dementia.
Why it matters
In 9,361 adults aged 50+ with hypertension (but no diabetes or prior stroke), aiming for a systolic blood pressure below 120 mm Hg instead of below 140 did not significantly reduce probable dementia, the trial's main cognitive outcome (7.2 vs 8.6 cases per 1000 person-years; HR 0.83, 95% CI 0.67–1.04). The intensive target did reduce mild cognitive impairment (HR 0.81, 95% CI 0.69–0.95), a secondary outcome. The authors note the trial was stopped early with fewer dementia cases than expected and "may have been underpowered" for dementia, so the dementia result is unresolved rather than negative.
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The FINGER intervention was beneficial regardless of participants' characteristics and can thus be implemented in a large elderly population at increased risk for dementia.
Why it matters
This is a follow-up analysis of the FINGER trial, which randomly assigned 1,260 Finnish adults aged 60–77 at risk for dementia to either a 2-year programme of diet, exercise, cognitive training and vascular risk management or regular health advice. Pre-planned tests found that sex, age, education, income, baseline MMSE score, cardiovascular factors and cardiovascular disease did not detectably change how participants' cognitive test scores responded to the programme (all interaction P-values > .05). The authors conclude the programme can be offered to a broad at-risk older population, but the study measured cognitive test scores rather than dementia, and finding no difference between groups does not prove the benefit is equal for everyone.
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Because of the significant ramifications of falls, many interventions have been proposed, but few have aimed to prevent falls via an integrated approach targeting both motor and cognitive function.
Why it matters
In older adults at high risk of falls, treadmill training combined with a non-immersive virtual reality component reduced fall rates more than treadmill training alone. This is about preventing falls, not about treating, curing, or preventing Alzheimer's disease.
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Main results We included 39 trials that recruited 16,082 participants, assessing 22 different interventions or comparisons.
Why it matters
This review found that multi-component interventions reduced the incidence of delirium in hospitalized non-ICU patients compared with usual care. In the subgroup of patients with pre-existing dementia the effect remained uncertain, and there was no clear evidence that cholinesterase inhibitors, antipsychotics as a group, or melatonin reduced delirium; delirium is not Alzheimer's disease.
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Points• UK Biobank is a very large and detailed prospective study with over 500,000 participants aged 40-69 years when recruited in 2006-2010.• The study has collected and continues to collect extensive phenotypic and genotypic detail about its participants, including data from questionnaires, physical measures, sample assays, accelerometry, multimodal imaging, genome-wide genotyping and longitudinal follow-up for a wide range of health-related outcomes.• Wide consultation; input from scientific, management, legal, and ethical partners; and industrial-scale, centralised processes have been essential to the development of this resource.• UK Biobank is available for open access, without the need for collaboration, to any bona fide researcher who wishes to use it to conduct health-related research for the benefit of the public.
Why it matters
UK Biobank is a large prospective study with over 500,000 participants that collects extensive health data and is openly available to researchers. It provides a resource for studying the causes of complex diseases of middle and old age, including Alzheimer's.
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.
- Barriers to self-management engagement among community-dwelling older adults with mild cognitive impairment: a qualitative study
- Cognitive performance and cerebrospinal fluid biomarkers of neurodegeneration: a study of patients with bipolar disorder and healthy controls
- Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consortium on Dementia with Lewy Bodies
- Loneliness and social isolation correlate with multiple modifiable risk factors for chronic diseases including dementia
- The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition
- Hypoglycemia as a risk factor for dementia in diabetes: A systematic review
- Mortality and cancer incidence among individuals with Down syndrome
- Mild cognitive impairment: current research and clinical implications
- Dementia classification using two-channel electroencephalography features
- Dendrites, dementia and the Down syndrome