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Journal of the American Heart... Jul 2022Background Recent studies have identified an increased risk of dementia in patients with atrial fibrillation (AF). However, both AF and dementia usually manifest late in... (Meta-Analysis)
Meta-Analysis Review
Background Recent studies have identified an increased risk of dementia in patients with atrial fibrillation (AF). However, both AF and dementia usually manifest late in life. Few studies have investigated this association in adults with early-onset dementia. The aim of this study was to investigate the relationship between AF and early-onset dementia. Methods and Results We searched the PubMed/MEDLINE, Embase, and Scopus databases through April 15, 2022, for studies reporting on the association between AF and dementia in adults aged <70 years, without language restrictions. Two reviewers independently performed the study selection, assessed the risk of bias, and extracted the study data. We performed a meta-analysis of early-onset dementia risk according to occurrence of AF using a random-effects model. We retrieved and screened 1006 potentially eligible studies. We examined the full text of 33 studies and selected the 6 studies that met our inclusion criteria. The pooled analysis of their results showed an increased risk of developing dementia in individuals with AF, with a summary relative risk of 1.50 (95% CI, 1.00-2.26) in patients aged <70 years, and 1.06 (95% CI, 0.55-2.06) in those aged <65 years. Conclusions In this systematic review and meta-analysis, AF was a risk factor for dementia in adults aged <70 years, with an indication of a slight and statistically imprecise excess risk already at ages <65 years. Further research is needed to assess which characteristics of the arrhythmia and which mechanisms play a role in this relationship.
Topics: Adult; Atrial Fibrillation; Databases, Factual; Dementia; Humans; Risk Factors
PubMed: 35861843
DOI: 10.1161/JAHA.122.025653 -
BMC Medicine Nov 2023Sex difference exists in the prevalence of dementia and cognitive decline. The impacts of sex-specific reproductive risk factors across the lifespan on the risk of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sex difference exists in the prevalence of dementia and cognitive decline. The impacts of sex-specific reproductive risk factors across the lifespan on the risk of dementia or cognitive decline are still unclear. Herein, we conducted this systemic review and meta-analysis to finely depict the longitudinal associations between sex-specific reproductive factors and dementia or cognitive decline.
METHODS
PubMed, EMBASE, and Cochrane Library were searched up to January 2023. Studies focused on the associations of female- and male-specific reproductive factors with dementia or cognitive decline were included. Multivariable-adjusted effects were pooled via the random effect models. Evidence credibility was scored by the GRADE system. The study protocol was pre-registered in PROSPERO and the registration number is CRD42021278732.
RESULTS
A total of 94 studies were identified for evidence synthesis, comprising 9,839,964 females and 3,436,520 males. Among the identified studies, 63 of them were included in the meta-analysis. According to the results, seven female-specific reproductive factors including late menarche (risk increase by 15%), nulliparous (11%), grand parity (32%), bilateral oophorectomy (8%), short reproductive period (14%), early menopause (22%), increased estradiol level (46%), and two male-specific reproductive factors, androgen deprivation therapy (18%), and serum sex hormone-binding globulin (22%) were associated with an elevated risk of dementia or cognitive decline.
CONCLUSIONS
These findings potentially reflect sex hormone-driven discrepancy in the occurrence of dementia and could help build sex-based precise strategies for preventing dementia.
Topics: Pregnancy; Female; Male; Humans; Dementia; Longevity; Androgen Antagonists; Prostatic Neoplasms; Cognitive Dysfunction; Risk Factors; Parity
PubMed: 37996855
DOI: 10.1186/s12916-023-03159-0 -
Clinical and Experimental Nephrology Jan 2022To identify the association between albuminuria and dementia or cognitive impairment. (Meta-Analysis)
Meta-Analysis
BACKGROUND
To identify the association between albuminuria and dementia or cognitive impairment.
METHODS
The literature search was performed to identify relevant scientific studies through August 2019, including PubMed/Medline and EMBASE. For inclusion, the studies had to fulfil the following criteria: population-based cohort, case-control or cross-sectional studies; quantifying an association of albuminuria with cognitive impairment or dementia; and reported odds ratio (OR), and the corresponding 95% confidential interval (95% CI). Random effects model was used to yield pooled estimates.
RESULTS
A total of 16 studies (11 cohort studies and five cross-sectional studies) were included in the meta-analyses. Based on the fully adjusted estimates, albuminuria was associated with a significant higher risk of cognitive impairment or dementia. Furthermore, the same trend existed for cognitive impairment and dementia, respectively. In addition, both of Alzheimer's diseases (AD) and vascular dementia (VaD) were significantly associated with albuminuria.
CONCLUSION
Albuminuria was significantly associated with cognitive impairment and dementia. Corresponding to an earlier subclinical time-point in kidney disease progress, albuminuria may be a potential factor predicting the future occurrence of dementia.
Topics: Albuminuria; Alzheimer Disease; Cognitive Dysfunction; Cross-Sectional Studies; Dementia; Humans
PubMed: 34468878
DOI: 10.1007/s10157-021-02127-3 -
Alzheimer Disease and Associated... 2014Help-seeking (HS) for dementia presents a great challenge, especially because a timely and appropriate HS process might be associated with better outcomes for the person... (Review)
Review
BACKGROUND
Help-seeking (HS) for dementia presents a great challenge, especially because a timely and appropriate HS process might be associated with better outcomes for the person with dementia, their caregivers, and society. A clear understanding of the HS concept and its measurement in the area of dementia might improve the effectiveness of the process.
AIMS
The aims of our systematic review were: (1) to systematically obtain and evaluate the relevant literature on HS and dementia; and (2) to summarize current research findings and draw conclusions for future research and clinical care in this area.
METHOD
A systematic review of the literature on HS and dementia was conducted up till June 2013.
RESULTS
From the 478 retrieved articles, 48 were included in the review. Conceptually, the studies examined professional and nonprofessional sources of help; showed preference for seeking help from close relatives followed by primary health caregivers; and identified inadequate knowledge and stigmatic beliefs as the main barriers to HS. The majority of the studies did not rely on a theoretical framework.
CONCLUSIONS
Although the body of literature in the area of HS and dementia is growing, several conceptual and methodological limitations still have to be resolved to advance knowledge in the area.
Topics: Dementia; Early Diagnosis; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Nuclear Family; Patient Acceptance of Health Care; Physician-Patient Relations
PubMed: 25321607
DOI: 10.1097/WAD.0000000000000065 -
Drugs & Aging Jan 2015Infections frequently occur in patients with dementia and antibiotics are often prescribed, but may also be withheld. (Review)
Review
BACKGROUND
Infections frequently occur in patients with dementia and antibiotics are often prescribed, but may also be withheld.
OBJECTIVES
The aim of this systematic review is to provide a systematic overview of the prevalence of antibiotic use, and factors associated with prescribing antibiotics in patients with dementia.
DATA SOURCES
A systematic search of MEDLINE, EMBASE, PSYCINFO, CINAHL, and the Cochrane library databases until February 13, 2014 was performed, using both controlled terms and free-text terms.
RESULTS
Thirty-seven articles were included. The point prevalence of antibiotic use in patients with dementia ranged from 3.3 to 16.6%. The period prevalence ranged from 4.4 to 88% overall, and from 23.5 to 94% in variable time frames before death; the median use was 52% (median period 14 days) and 48% (median period 22 days), respectively. Most patients with lower respiratory tract infections or urinary tract infections (77-91%) received antibiotic treatment. Factors associated with antibiotic use related to patients, families, physicians, and the healthcare context. More severe dementia and a poor prognosis were associated with less antibiotic use in various countries. Associations with aspiration and illness severity differed by country.
CONCLUSIONS AND IMPLICATIONS
Antibiotic use in patients with dementia is substantial, and probably highly associated with the particular healthcare context. Future studies may report antibiotic use by infection type and stage of dementia, and compare cross-nationally.
Topics: Anti-Bacterial Agents; Dementia; Humans; Practice Patterns, Physicians'; Respiratory Tract Infections; Urinary Tract Infections
PubMed: 25385686
DOI: 10.1007/s40266-014-0223-z -
The British Journal of Psychiatry : the... Nov 2016More information about the pattern of behavioural and psychological symptoms of dementia (BPSD) in the course of dementia is needed to inform patients and clinicians and... (Review)
Review
BACKGROUND
More information about the pattern of behavioural and psychological symptoms of dementia (BPSD) in the course of dementia is needed to inform patients and clinicians and to design future interventions.
AIMS
To determine the persistence and incidence of BPSD and their relation to cognitive function, in individuals with dementia or in cohorts investigated for dementia onset.
METHOD
A systematic literature review analysed the baseline prevalence, persistence and incidence of 11 symptoms. The review was conducted according to established guidelines with the exception that we could not exclude the possibilities of bias in the studies examined.
RESULTS
The 59 included studies showed considerable heterogeneity in their objectives and methods. The symptoms hyperactivity and apathy showed high persistence and incidence; depression and anxiety low or moderate persistence and moderate incidence; and psychotic symptoms low persistence with moderate or low incidence.
CONCLUSIONS
Despite heterogeneity across studies in terms of setting, focus and length of follow-up, there were clinically relevant differences in the longitudinal courses of different BPSD. Apathy was the only symptom with high baseline prevalence, persistence and incidence during the course of dementia.
Topics: Behavioral Symptoms; Dementia; Disease Progression; Humans
PubMed: 27491532
DOI: 10.1192/bjp.bp.114.148403 -
BMC Geriatrics Jul 2017The need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review... (Review)
Review
BACKGROUND
The need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review was to give an overview of the state of the evidence on implementation and dissemination of dementia care, and create a systematic evidence map.
METHODS
We sought studies that addressed dissemination and implementation strategies or described barriers and facilitators to implementation across dementia stages and care settings. Twelve databases were searched from inception to October 2015 followed by forward citation and grey literature searches. Quantitative studies with a comparative research design and qualitative studies with recognised methods of data collection were included. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. Strategies were mapped according to the ERIC compilation.
RESULTS
Eighty-eight studies were included (30 quantitative, 34 qualitative and 24 mixed-methods studies). Approximately 60% of studies reported implementation strategies to improve practice: training and education of professionals (94%), promotion of stakeholder interrelationships (69%) and evaluative strategies (46%) were common; financial strategies were rare (15%). Nearly 70% of studies reported barriers or facilitators of care practices primarily within residential care settings. Organisational factors, including time constraints and increased workload, were recurrent barriers, whereas leadership and managerial support were often reported to promote implementation. Less is known about implementation activities in primary care and hospital settings, or the views and experiences of people with dementia and their family caregivers.
CONCLUSION
This scoping review and mapping of the evidence reveals a paucity of robust evidence to inform the successful dissemination and implementation of evidence-based dementia care. Further exploration of the most appropriate methods to evaluate and report initiatives to bring about change and of the effectiveness of implementation strategies is necessary if we are to make changes in practice that improve dementia care.
Topics: Caregivers; Databases, Factual; Dementia; Evidence-Based Medicine; Humans; Qualitative Research
PubMed: 28709402
DOI: 10.1186/s12877-017-0528-y -
Advances in Experimental Medicine and... 2023According to the World Health Organization (WHO), around 55 million people worldwide have dementia, and Alzheimer's Disease International (2019) estimates that by 2050...
According to the World Health Organization (WHO), around 55 million people worldwide have dementia, and Alzheimer's Disease International (2019) estimates that by 2050 this number is expected to rise to 152 million. With no available cure (WHO, 2021), non-pharmacological interventions have become a popular alternative in the treatment of the cognitive, behavioral, and psychological symptoms of dementia (Dementia Australia, 2020). A widely adopted option that come in different forms is music interventions and while the basic means remains music, some choose a more personalized approach and even less deliver music through over-ear headphones. A number of studies regarding the latter approach report positive outcomes; however, solid evidence on its benefits is scarce.The aim of this literature review was to locate the organizations and initiatives around the world that use the specific approach, explore the different methodologies, search for existing evidence on the interventions' efficacy and the symptoms they address, and look for any ongoing research on the subject. Furthermore, we aimed at investigating if there are any relevant initiatives in Greece.We systematically searched 16 databases and from 276 eligible records, we located 18 relevant studies that met our inclusion criteria and 1 literature review on music interventions for people with dementia. Our examination and analysis of those studies suggested that music interventions utilizing personalized music playlists and headphones result in positive outcomes, including mood improvement and a significant decrease of behavioral and psychological symptoms of dementia. However, our analysis also pointed the need for further and more focused research.
Topics: Humans; Music; Music Therapy; Dementia; Alzheimer Disease; Australia
PubMed: 37581840
DOI: 10.1007/978-3-031-31986-0_65 -
Frontiers in Public Health 2022Evidence is scarce about the effect of noise exposure on the risk of dementia. We conducted a systematic review and dose-response meta-analysis, aiming to explore the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Evidence is scarce about the effect of noise exposure on the risk of dementia. We conducted a systematic review and dose-response meta-analysis, aiming to explore the association between noise exposure and the risk of dementia.
METHODS
We searched PubMed, EMBASE and the Cochrane Library to collect studies on chronic noise exposure and the risk of dementia from database inception to September 18, 2021 without language limitations. Two authors independently screened the literature, extracted data and assessed the risk of bias of the included studies. A dose-response meta-analysis and subgroup analysis were then conducted to detect the association between noise exposure and the risk of dementia by using Stata 14.0 software. This study is registered on PROSPERO (CRD42021249243).
RESULTS
A total of 11 studies were eligible for qualitative synthesis, and nine were eligible for quantitative data synthesis. All of them showed moderate to high quality scores in the assessment of risk of bias. We found a positive linear association between the noise increment and dementia risk ( = 0.58). When noise exposure increased 57 dB, the RR of dementia was 1.47 (95% CI: 1.21-1.78). From the outcome subgroup of AD, AD and dementia, VaD and NAD, we also found a positive association ( = 0.68, 0.68, 0.58, respectively). When noise exposure increased by 25 dB, the RRs were 1.18 (95% CI: 1.14-1.23), 1.19 (95% CI: 1.14-1.23) and 1.17 (95% CI: 1.06-1.30), respectively. We found a nonlinear association between the noise increment and dementia risk when only cohort studies were included ( = 0.58). When noise exposure increased by 25 dB, the RR of dementia was 1.16 (95% CI: 1.12-1.20). From the subgroup of AD, AD and dementia, VaD and NAD of cohort studies, the regression curve showed a nonlinear positive association ( = 0.74, 0.71, 0.43, respectively). When noise exposure increased by 25 dB, the RRs were 1.17 (95% CI: 1.12-1.21), 1.17 (95% CI: 1.12-1.22) and 1.13 (95% CI: 0.99-1.28), respectively.
CONCLUSION
Based on the current evidence, exposure to noise may be a specific risk factor for dementia. To better prevent dementia, more rigorously designed studies are needed to explore the etiological mechanism of noise and dementia.
Topics: Cohort Studies; Databases, Factual; Dementia; Humans; NAD; Risk Factors
PubMed: 35795699
DOI: 10.3389/fpubh.2022.832881 -
Nutrients Mar 2016In recent years, the possibility of favorably influencing the cognitive trajectory through promotion of lifestyle modifications has been increasingly investigated. In... (Review)
Review
In recent years, the possibility of favorably influencing the cognitive trajectory through promotion of lifestyle modifications has been increasingly investigated. In particular, the relationship between nutritional habits and cognitive health has attracted special attention. The present review is designed to retrieve and discuss recent evidence (published over the last 3 years) coming from randomized controlled trials (RCTs) investigating the efficacy of nutritional interventions aimed at improving cognitive functioning and/or preventing cognitive decline in non-demented older individuals. A systematic review of literature was conducted, leading to the identification of 11 studies of interest. Overall, most of the nutritional interventions tested by the selected RCTs were found to produce statistically significant cognitive benefits (defined as improved neuropsychological test scores). Nevertheless, the clinical meaningfulness of such findings was not adequately discussed and appears controversial. In parallel, only 2 studies investigated between-group differences concerning incident dementia and mild cognitive impairment cases, reporting conflicting results. Results of the present review suggest that several dietary patterns and nutritional components may constitute promising strategies in postponing, slowing, and preventing cognitive decline. However, supporting evidence is overall weak and further studies are needed.
Topics: Aged; Cognition; Cognition Disorders; Dementia; Diet; Dietary Supplements; Feeding Behavior; Female; Humans; Male; Middle Aged; Nutritional Status; Protective Factors; Recovery of Function; Risk Assessment; Risk Factors; Risk Reduction Behavior; Treatment Outcome
PubMed: 26959055
DOI: 10.3390/nu8030144