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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 -
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 -
Metabolic Brain Disease Feb 2019Studies have showed that high clusterin (CLU) concentration was associated with increased risk of dementia. However, the results based on small samples remained... (Meta-Analysis)
Meta-Analysis
Studies have showed that high clusterin (CLU) concentration was associated with increased risk of dementia. However, the results based on small samples remained controversial. The aim of our study was to determine the relationship between CLU concentration and the late-life cognitive outcomes including mild cognitive impairment (MCI), Alzheimer's disease (AD), vascular dementia (VAD), Parkinson's disease related dementia (PDD), Lewy body dementia (DLB) and frontotemporal dementia (FTD). A comprehensive search was conducted to screen the eligible studies in online database PubMed, Web of Science and Embase from 1950 to January 2017 according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. The CLU concentration data in brain tissue, cerebrospinal fluid (CSF), serum and plasma was collected to determine the strength of this association. The results were presented with standard difference of the mean (SDM) with 95% confidence intervals (CIs). A total of 28 studies were identified to calculate the association between CLU concentration and dementia. The results showed that the CLU concentration in the plasma (SDM = 0.73, 95% CI 0.26-1.19, P = 0.002) and brain tissue (SDM = 0.71, 95% CI 0.10-1.32, P = 0.022) was increased in dementia compared to normal control. Subgroup analysis showed that the plasma CLU concentration was significantly increased only in the AD group (SDM = 1.85, 95% CI 0.84-2.85, P < 0.001), but not in MCI or other dementias. No association was found between serum and CSF clusterin concentration and dementia. This meta-analysis indicates that high CLU concentration in the plasma and brain is associated with dementia, especially in AD.
Topics: Alzheimer Disease; Brain; Clusterin; Cognitive Dysfunction; Dementia; Dementia, Vascular; Humans
PubMed: 30291488
DOI: 10.1007/s11011-018-0325-0 -
Psychiatry Research Nov 2022Accumulating evidence supports some health benefits of nutrients in fish, but evidence from comprehensive investigation of fish consumption and the risk of dementia is... (Meta-Analysis)
Meta-Analysis
Accumulating evidence supports some health benefits of nutrients in fish, but evidence from comprehensive investigation of fish consumption and the risk of dementia is limited. We performed a systematic review and meta-analysis of prospective cohort studies to investigate this association. Papers relevant to our study published by 2021 were searched using PubMed, Embase, Cochrane library, and Web of Science databases. Pooled relative risks (RRs) of the association between fish consumption and dementia risk were calculated using a random-effects model. Seven prospective cohort studies with a total of 30,638 subjects were included in the meta-analysis. Overall, people with high fish consumption had a significantly lower risk of dementia compared to those with low fish consumption. In addition, the dose-response meta-analysis also supported the inverse association. The inverse association tended to be stronger in studies conducted in Asia. The findings of the meta-analysis of prospective cohort studies provide quantitative evidence for an inverse association between fish consumption and the risk of dementia. Further research on consumption of specific types of fish with respect to the risk of dementia are needed to provide more informative recommendations to the public.
Topics: Animals; Prospective Studies; Risk Factors; Fishes; Dementia; Asia
PubMed: 36257206
DOI: 10.1016/j.psychres.2022.114889 -
British Journal of Clinical Pharmacology Feb 2022Growing evidence suggests an association between the use of sedative-hypnotic medications and risk of dementia. The aim of this study is to examine this association... (Meta-Analysis)
Meta-Analysis Review
AIMS
Growing evidence suggests an association between the use of sedative-hypnotic medications and risk of dementia. The aim of this study is to examine this association using a meta-analysis approach.
METHODS
MEDLINE (PubMed) and Scopus were systematically searched for studies published in English only. The quality of studies was evaluated using the Newcastle-Ottawa scale, and an overall odds ratio was pooled using a random-effects model.
RESULTS
A total of 35 articles were included in the analysis. Pooled odds ratios (ORs) for dementia from all records were (OR; 1.33, 95% CI 1.19-1.49) for benzodiazepine (BZD) combined use (Subgroup-1), (OR: 1.46, 95% CI 1.23-1.73) for short-acting BZD use (Subgroup-2), (OR: 1.72, 95% CI 1.48-1.99) for long-acting BZD use (Subgroup-3), (OR: 1.13, 95% CI 0.97-1.32) for BZDs without specification of duration of action (Subgroup-4), (OR: 1.64, 95% CI 1.13-2.38) for the combined BZDs and Z-drugs, (OR: 1.43, 95% CI 1.17-1.74) for Z-drugs only, (OR: 1.14, 95% CI 0.88-1.46) for antidepressant use, (OR: 0.97, 95% CI 0.68-1.39) for antipsychotic use and (OR: 0.98, 95% CI 0.85-1.13) for anticonvulsant use. When sensitivity analysis was performed, association between overall use of BZDs and short-acting BZDs with the increased risk of dementia disappeared after exclusion of studies that were not adjusted for age covariate (OR: 1.2, 95% CI 1.0-1.44) and (OR: 1.22, 95% CI 0.75-2.01), respectively. Adjustment for protopathic bias by introduction of a lag period showed no evidence of increased risk of dementia with the use of BZDs (Subgroup-1) (OR: 1.14, 95% CI 0.82-1.58), Z-drugs (OR: 1.29, 95% CI 0.78-2.13), and combined BZDs and Z-drugs (OR: 1.51, 95% CI 0.91-2.53). Combined use of BZDs and Z-drugs showed more positive association when only studies of non-user design were analysed (OR: 2.75, 95% CI 2.23-3.39).
CONCLUSIONS
All the investigated sedative-hypnotics showed no association with increased risk of dementia except for BZDs. However, the observed association with BZDs did not persist after exclusion of studies with potential reverse causation and confounding by indication. Therefore, this association needs to be assessed carefully in future research.
Topics: Antidepressive Agents; Benzodiazepines; Dementia; Humans; Hypnotics and Sedatives; Odds Ratio
PubMed: 34679196
DOI: 10.1111/bcp.15113 -
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 -
Acta Bio-medica : Atenei Parmensis Dec 2022The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact...
BACKGROUND AND AIM
The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease.
METHODS
We conducted a literature search in PubMed and EMBASE databases up to May 6, 2022, to retrieve epidemiological studies evaluating the effect of environmental and lifestyle factors on EOD risk.
RESULTS
We eventually included 22 studies, ten with cohort and twelve with case-control design. Traumatic injury, especially on the head/brain, some cardiovascular diseases such as atrial fibrillation and stroke, metabolic diseases including diabetes and hypercholesterolemia, and alcohol consumption have been identified as potential risk factors for EOD. Conversely, playing leisure activities including sports (without trauma), higher educational attainment and higher adherence to Mediterranean DASH-Intervention for Neurodegenerative Delay (MIND) diet appeared to be protective for EOD.
CONCLUSIONS
The literature on environmental risk factors for EOD has been considerably growing in recent years. Overall, it supports an association between some environmental and lifestyle factors with disease risk. However, additional high-quality research is required to confirm these relations and its causal nature (www.actabiomedica.it).
Topics: Humans; Risk Factors; Life Style; Dementia
PubMed: 36533768
DOI: 10.23750/abm.v93i6.13279 -
Value in Health : the Journal of the... Apr 2018Several utility-based instruments have been applied in cost-utility analysis to assess health state values for people with dementia. Nevertheless, concerns and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Several utility-based instruments have been applied in cost-utility analysis to assess health state values for people with dementia. Nevertheless, concerns and uncertainty regarding their performance for people with dementia have been raised.
OBJECTIVES
To assess the performance of available utility-based instruments for people with dementia by comparing their psychometric properties and to explore factors that cause variations in the reported health state values generated from those instruments by conducting meta-regression analyses.
METHODS
A literature search was conducted and psychometric properties were synthesized to demonstrate the overall performance of each instrument. When available, health state values and variables such as the type of instrument and cognitive impairment levels were extracted from each article. A meta-regression analysis was undertaken and available covariates were included in the models.
RESULTS
A total of 64 studies providing preference-based values were identified and included. The EuroQol five-dimension questionnaire demonstrated the best combination of feasibility, reliability, and validity. Meta-regression analyses suggested that significant differences exist between instruments, type of respondents, and mode of administration and the variations in estimated utility values had influences on incremental quality-adjusted life-year calculation.
CONCLUSIONS
This review finds that the EuroQol five-dimension questionnaire is the most valid utility-based instrument for people with dementia, but should be replaced by others under certain circumstances. Although no utility estimates were reported in the article, the meta-regression analyses that examined variations in utility estimates produced by different instruments impact on cost-utility analysis, potentially altering the decision-making process in some circumstances.
Topics: Cost-Benefit Analysis; Decision Support Techniques; Dementia; Health Care Costs; Health Status; Health Status Indicators; Humans; Mental Health; Models, Economic; Predictive Value of Tests; Process Assessment, Health Care; Quality of Life; Surveys and Questionnaires; Treatment Outcome
PubMed: 29680105
DOI: 10.1016/j.jval.2017.09.005 -
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 -
A systematic review of the public's knowledge and understanding of Alzheimer's disease and dementia.Alzheimer Disease and Associated... 2015This paper reports findings from a systematic review of the literature on the general public's knowledge and understanding of dementia/Alzheimer's disease. The key... (Review)
Review
This paper reports findings from a systematic review of the literature on the general public's knowledge and understanding of dementia/Alzheimer's disease. The key purpose of the review was to evaluate existing literature with specific attention paid to conceptual and methodological issues and to key findings. Over a 20-year period, 40 published articles satisfied the inclusion criteria. Only 4 of these were qualitative and 5 were cross-national. The review revealed a lack of consistency across studies regarding how knowledge was operationalized, approaches to sampling, response rates, and data collection instruments used including validated scales. A consistent finding across the vast majority of studies was the only fair to moderate knowledge and understanding the general public had. The most common misconception was that dementia was a normal part of aging and there was a lack of clarity about at which point normal age-related memory loss problems become severe enough to indicate dementia. Knowledge of dementia was found to be particularly poor among racial and ethnic minority groups where several myths about causes of dementia were found. Findings point to the need for more educational and advocacy programmes on dementia to be developed particularly in low-income to middle-income countries.
Topics: Alzheimer Disease; Data Collection; Dementia; Developing Countries; Humans; Knowledge; Public Health Informatics
PubMed: 26207322
DOI: 10.1097/WAD.0000000000000102