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Neurologia 2024Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic... (Review)
Review
INTRODUCTION
Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia.
DEVELOPMENT
Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle-Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia.
CONCLUSION
Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.
Topics: Humans; Chronic Disease; Psoriasis; Risk Factors; Dementia
PubMed: 38161072
DOI: 10.1016/j.nrleng.2023.12.005 -
Journal of the American Medical... Nov 2022To examine the association between B vitamins status and the risk of dementia in older adults through a systematic review and meta-analysis of cohort studies. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To examine the association between B vitamins status and the risk of dementia in older adults through a systematic review and meta-analysis of cohort studies.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Older adults aged ≥60 years from community, nursing home, institution, or hospital.
METHODS
PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL, ClinicalTrials, WHO-ICTRP, NHS Trusts, and ACTR were searched from the date of their inception up to November 28, 2021. We included cohort studies that assessed the association between serum B vitamins or B vitamins intake and the risk of dementia among older adults aged ≥60 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale (NOS). The hazard ratios (HRs) and 95% CIs were calculated by the random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence.
RESULTS
Eleven cohort studies with sample sizes ranging from 233 to 3634 were included in the meta-analysis. Levels of serum folate showed statistically significant association with the risk of dementia (≥10 nmol/L: HR 1.57, 95% CI 1.01-2.46, low certainty; <10 nmol/L: HR 0.93, 95% CI 0.88-0.99, very low certainty). However, levels of vitamin B intake showed no statistically significant effects on risk of dementia; levels of serum vitamin B and vitamin B intake also showed no statistically significant effects on risk of dementia in older adults.
CONCLUSIONS AND IMPLICATIONS
The results from our meta-analysis suggest that vitamin B, B, and folate may not be modifiable risk factors for dementia among older adults. Current evidence on the relationship between vitamin B status and dementia is not sufficient for development of vitamin B recommendations. More high-quality cohort studies are needed to confirm the relationship between the two in the future.
Topics: Humans; Aged; Vitamin B Complex; Folic Acid; Vitamin B 12; Cohort Studies; Dementia
PubMed: 35779574
DOI: 10.1016/j.jamda.2022.05.022 -
Seminars in Thrombosis and Hemostasis Jul 2019Alzheimer's disease (AD) is considered the most frequent cause of dementia. It is known that vascular risk factors play an important role in the development and... (Meta-Analysis)
Meta-Analysis
Alzheimer's disease (AD) is considered the most frequent cause of dementia. It is known that vascular risk factors play an important role in the development and progression of this condition. Alterations in vascular walls represent documented findings in patients with AD and other dementias affecting elderly people. The authors performed a systematic review and meta-analysis, aiming to synthesize observational studies that evaluated how the hemostatic system may contribute to cognitive decline in the elderly, using papers published until April 2018 and as indexed in Medline (PubMed), Scopus, Web of Science, ScienceDirect, Lilacs, Cinahl, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Among 5,278 studies identified, 32 were included in the final synthesis, and these included 485 patients with mild cognitive impairment, 568 with vascular dementia (VD), 1,781 with AD, and 2,855 participants without dementia. AD patients had increased plasma von Willebrand factor (VWF) (standardized mean difference [SMD]: 2.53; 95% confidence interval [CI]: 0.10-4.95), D-dimer (SMD: 0.50; 95% CI: 0.35-0.66), plasminogen activator inhibitor-1 (SMD: 3.34; 95% CI: 1.01-5.67), thrombomodulin (SMD: 1.08; 95% CI: 0.53-1.62), and homocysteine levels (SMD: 0.65; 95% CI: 0.15-1.15). In contrast, the VD group showed increased fibrinogen levels (SMD: 0.77; 95% CI: 0.13-1.41), activated factor VII (SMD: 0.36; 95% CI: 0.05-0.67), factor VIII (SMD: 0.57; 95% CI: 0.22-0.91), VWF (SMD: 2.34; 95% CI: 0.38-4.29), D-dimer (SMD: 1.14; 95% CI: 0.51-1.78), and homocysteine (SMD: 2.17; 95% CI: 1.67-2.68). AD showed an elevation in some markers of endothelial dysfunction, whereas VD presented mostly an involvement of coagulation cascade components.
Topics: Alzheimer Disease; Dementia; Hemostatics; Humans
PubMed: 31096308
DOI: 10.1055/s-0039-1688444 -
Journal of Advanced Nursing Apr 2006This paper reports a systematic review of the literature on interventions to promote oral nutritional intake of older people with dementia and feeding difficulty between... (Review)
Review
AIM
This paper reports a systematic review of the literature on interventions to promote oral nutritional intake of older people with dementia and feeding difficulty between 1993 and 2003.
BACKGROUND
Older people with dementia commonly experience difficulty with feeding, especially in the later stages of the condition. This topic and related nursing care was reviewed in 1993 and the conclusion was that there was little research into interventions that nurses could use to alleviate feeding difficulty.
METHOD
A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE and Cochrane databases and the search terms 'feeding', 'eating' and 'dementia' combined as follows: '(feeding or eating) and (dementia)'. A second search was carried out combining the search terms 'mealtimes' and 'dementia' as follows: 'mealtimes and dementia'. The literature search was carried out on 1 December 2003 and papers were included in the review if retrieved by 31 December 2003. English language papers only were retrieved.
RESULTS
Sixty-seven papers were retrieved, of which 13 addressed interventions aimed at helping older people with dementia to feed. All studies reported positive outcomes but only one randomized controlled trial was reported. Music was the most common intervention but there were no standardized interventions or outcomes across the studies and none reported the use of power analysis to decide on sample size. There were problems in some studies with confounding variables.
CONCLUSIONS
Further research is needed into interventions aimed at how nurses can help older people with dementia to feed. There are some promising lines of enquiry, with music being one of these, but future studies need to use adequate samples and to use power calculations and account adequately for confounding variables. There is also a need to standardize interventions and outcomes across such studies to facilitate meta-analysis.
Topics: Aged; Data Interpretation, Statistical; Dementia; Feeding Methods; Female; Humans; Music Therapy; Research Design; Treatment Outcome
PubMed: 16553694
DOI: 10.1111/j.1365-2648.2006.03793.x -
Archives of Gerontology and Geriatrics 2016Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that... (Review)
Review
PURPOSE
Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that facilitate or hamper dementia patients' PA participation will increase the success rate of implementing PA in dementia patients' daily care. We systematically screened the barriers, motivators, and facilitators of PA participation in dementia patients, complementing previous analyses of quantitative correlates of PA in community-dwelling dementia patients.
METHODS
Systematic searches yielded 78 potential studies of which seven met the eligibility criteria including 39 dementia patients and 36 caregivers (33 spouses and three daughters).
RESULTS
We identified 35 barriers, 26 motivators, and 21 facilitators related to PA. We reduced these factors to six themes within the social-ecological model. Prominent barriers to PA were physical and mental limitations and difficulties with guidance and organization of PA by caregivers. Motivators included the motivation to maintain physical and mental health and participate in preferred PA options. Facilitators included strategies to avoid health problems, providing support and guidance for PA, and access to convenient and personalized PA options.
CONCLUSIONS
The emerging picture suggests that dementia patients' PA participation will increase if service providers become familiar with the health benefits of PA, the characteristics of PA programs, methods of delivery, and the concepts of how such programs can be personalized to and synchronized with patients' individual needs.
Topics: Aged; Aged, 80 and over; Caregivers; Dementia; Exercise; Humans; Independent Living; Mental Health; Motivation; Nursing Homes
PubMed: 27295140
DOI: 10.1016/j.archger.2016.05.008 -
The Lancet. Healthy Longevity Aug 2021People with dementia die prematurely. Identifying differences in mortality rates between different types of dementia might aid in the development of preventive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
People with dementia die prematurely. Identifying differences in mortality rates between different types of dementia might aid in the development of preventive interventions for the most vulnerable populations. The aim of this study was to compare the difference in mortality rates between individuals without dementia and individuals with various types of dementia.
METHODS
For this systematic review and meta-analysis, we did a systematic search of MEDLINE, PubMed, Embase, and Cochrane Library from inception to July 11, 2020, for cross-sectional or cohort studies that assessed mortality and survival-related outcomes among people with different types of dementia compared with people without dementia. Single-arm studies without comparison groups and autopsy studies or family studies that used a selected sample were excluded. The Newcastle-Ottawa Scale was used by two authors (D-JL and C-SC) independently to measure the methodological quality of included studies, and two authors (F-CY and P-TT) independently extracted data. We assessed differences in all-cause mortality rate and survival time from dementia diagnosis between individuals without dementia, individuals with Alzheimer's disease, and individuals with non-Alzheimer's disease dementias. The secondary outcomes were age at death and survival time from disease onset. Random-effects meta-analyses were done. Effect sizes included hazard ratios (HRs) and mean differences (MDs) with 95% CIs. Potential moderators, including age-associated moderators, were identified through meta-regression and subgroup analyses. This study is registered with PROSPERO, CRD42020198786.
FINDINGS
Our database search identified 11 973 records, and we included 78 eligible studies in our analyses, encompassing 63 125 individuals with dementia and 152 353 controls. Individuals with any type of dementia had a higher mortality rate than individuals without dementia (HR 5·90, 95% CI 3·53 to 9·86), and the HR for all-cause mortality was highest for Lewy body dementia (17·88, 5·87 to 54·46). After diagnosis, the mean survival time for people with Alzheimer's disease was 5·8 years (SD 2·0). Compared with people with Alzheimer's disease, a diagnosis of any non-Alzheimer's disease dementia was associated with a higher risk of all-cause mortality (HR 1·33, 1·21 to 1·46), a shorter survival time from diagnosis (MD -1·12 years, 95% CI -1·52 to -0·72), and a younger age at death (-1·76 years, -2·66 to -0·85). Survival time from disease onset was also shorter in people with non-Alzheimer's dementia, across types, compared with people with Alzheimer's disease, but the subgroup analysis revealed that this difference was only significant for vascular dementia (MD -1·27 years, -1·90 to -0·65) and dementia with Lewy bodies (MD -1·06 years, -1·68 to -0·44). The interactions between age and several survival-related outcomes were significant. 39 (50%) of the 78 included studies were rated as good quality, and large heterogeneity (I>75%) was observed for most of the study outcomes.
INTERPRETATION
Alzheimer's disease is the most common type of dementia and one of the major causes of mortality worldwide. However, the findings from the current study suggest that non-Alzheimer's disease dementias were associated with higher morality rates and shorter life expectancy than Alzheimer's disease. Developing tailored treatment and rehabilitation programmes for different types of dementia is important for mental health providers, patients, and their families.
FUNDING
None.
Topics: Alzheimer Disease; Cross-Sectional Studies; Dementia; Dementia, Vascular; Humans; Lewy Body Disease
PubMed: 36097997
DOI: 10.1016/S2666-7568(21)00140-9 -
Journal of the American Geriatrics... Feb 2023Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of the association between different aspects of social integration and the risk of dementia is unclear.
METHODS
Five databases were systematically searched. Newcastle-Ottawa scale for assessing the quality of the reporting was used for quality appraisal. Longitudinal cohort studies examining the association between social integration and the risk of dementia were analyzed using random effects model. A series of sensitivity analyses was conducted to enhance the robustness of the findings.
RESULTS
Forty publications generated from 32 studies/databases were included. The meta-analysis showed that strong social engagement (overall RR = 0.81, 95% CI = 0.74-0.89, p < 0.001) and frequent social contact (overall RR = 0.86, 95% CI = 0.76-0.97, p = 0.018) were positively associated with decreased risk of dementia. The influence of social support (overall RR = 0.92, 95% CI = 0.80-1.06, p = 0.238) and close social contact (overall RR = 0.74, 95% CI = 0.48-1.13, p = 0.167) was not significant. Loneliness was significantly associated with an increased risk of dementia (overall RR = 1.42, 95% CI = 1.26-1.60, p < 0.001), whereas the influence of social isolation (overall RR = 1.58, 95% CI = 0.80-3.12, p = 0.192) was not significant. A larger social network size (RR = 0.75, 95% CI = 0.59-0.97, p = 0.028) was a promising influencing factor even though the number of studies was insufficient for a meta-analysis. However, the heterogeneity among studies was generally high even though sensitivity analysis was conducted.
CONCLUSIONS
Our findings reveal that high social engagement and frequent social contact are significantly associated with a lower risk of dementia, whereas loneliness is associated with a higher risk. The promising impact of large social network size is also identified. Substantial heterogeneity appeared in most of the analysis, making the inference tentative. Nevertheless, the sensitivity analysis provided valuable implications that enhancing social engagement and reducing loneliness may prevent or delay the onset of dementia among middle-aged and older adults.
Topics: Humans; Middle Aged; Aged; Longitudinal Studies; Social Isolation; Loneliness; Social Integration; Dementia
PubMed: 36307921
DOI: 10.1111/jgs.18094 -
BMC Geriatrics Dec 2008Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of... (Review)
Review
BACKGROUND
Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimer's disease, vascular dementia and cognitive decline.
METHODS
In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over.
RESULTS
The review reported here found a significantly increased risk of Alzheimer's disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking.
CONCLUSION
Current smoking increases risk of Alzheimer's disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation.
Topics: Aged; Aging; Cognition Disorders; Dementia; Humans; Risk Factors; Smoking
PubMed: 19105840
DOI: 10.1186/1471-2318-8-36 -
Nursing Open Mar 2022This meta-analysis evaluated the effectiveness of intergenerational program participation for long-term care institution residents with dementia. (Meta-Analysis)
Meta-Analysis Review
AIM
This meta-analysis evaluated the effectiveness of intergenerational program participation for long-term care institution residents with dementia.
DESIGN
A systematic review and meta-analysis.
METHODS
Ten electronic databases were systematically searched until August 2020: CINAHL, the Cochrane Library, EBSCO, EMBASE, Ovid Medline, ProQuest, Psychology and Behavioral Sciences Collection, PubMed, Scopus, and Web of Science. The Joanna Briggs Institute tool (JBI tool) was used for the quality appraisal of the included publications, and Review Manager 5.3 was used for the meta-analysis.
RESULTS
Thirteen articles were identified (1993-2015). Intergenerational program participation could improve the pleasure level and significantly reduce disengagement behaviours of residents with dementia. The intergenerational program intervention caused no apparent improvement in their quality of life, depression levels, and engagement levels.
Topics: Dementia; Humans; Quality of Life
PubMed: 34021969
DOI: 10.1002/nop2.919 -
Alzheimer's & Dementia : the Journal of... Oct 2023The number of cases of dementia attributable to physical inactivity remains unclear due to heterogeneity in physical inactivity definitions and statistical approaches... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The number of cases of dementia attributable to physical inactivity remains unclear due to heterogeneity in physical inactivity definitions and statistical approaches used.
METHODS
Studies that used population-based samples to estimate the population attributable fraction (PAF) of physical inactivity for dementia were included in this review. Weighted PAFs were adjusted for communality among the risk factors (i.e., inactive persons may also share other risk factors) analyzed. Values were reported as percentage (%) of cases of dementia attributable to physical inactivity.
RESULTS
We included 22 studies. The overall impact of physical inactivity, defined by any criteria, on dementia ranged from 6.6% (95% CI: 3.6%, 9.6%; weighted) to 16.6% (95% CI: 14.4%, 18.9%; unweighted). Studies using the WHO criterion for physical inactivity estimated a higher unweighted impact (β = 7.3%; 95% CI: 2.0%, 12.6%) than studies using other criteria.
DISCUSSION
Conservatively, one in 15 cases of dementia may be attributable to physical inactivity, defined by any criteria.
Topics: Humans; Sedentary Behavior; Risk Factors; Life Style; Data Collection; Dementia
PubMed: 37575082
DOI: 10.1002/alz.13417