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Evidence-based Complementary and... 2021Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had... (Review)
Review
BACKGROUND
Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others' results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi.
METHODS
A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software.
RESULTS
The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = -0.55, 95% CI [-0.80, -0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [-0.65, 1.71]; and digit span backward WMD = -0.1, 95% CI [-0.38, 0.19]. No adverse events were reported in the included articles.
CONCLUSION
There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.
PubMed: 34394392
DOI: 10.1155/2021/6679153 -
Frontiers in Psychiatry 2021People with schizophrenia are more likely to develop cannabis use disorder (CUD) and experience worse outcomes with use. Yet as cannabis is legalized for medical and...
People with schizophrenia are more likely to develop cannabis use disorder (CUD) and experience worse outcomes with use. Yet as cannabis is legalized for medical and recreational use, there is interest in its therapeutic potential. To conduct a systematic review summarizing the design and results of controlled trials using defined doses of THC and CBD in schizophrenia. A keyword search of eight online literature databases identified 11 eligible reports. One placebo controlled trial (13 stable patients without CUD) found that intravenous THC increased psychosis and worsened learning/recall. Two reports of a functional magnetic resonance (fMRI) study of smoked or oral THC in 12 abstinent patients with schizophrenia and CUD found no change in symptoms and cognition, and an amelioration of impaired resting state brain function in areas implicated in reward function and the default mode network. One 4 week trial in acutely psychotic inpatients without CUD (mean age 30 y) found 800 mg CBD to be similarly efficacious to amisupride in improving psychosis and cognition. Two 6 week studies of CBD augmentation of antipsychotics in stable outpatients reported mixed results: CBD 600 mg was not more effective than placebo; CBD 1,000 mg reduced symptoms in a sample that did not exclude cannabis use and CUD. A brain fMRI and proton magnetic resonance spectroscopy study of single dose CBD in a sample that did not exclude CUD and cannabis use found that CBD improved symptoms and brain function during a learning/recall task and was associated with increased hippocampal glutamate. There is substantial heterogeneity across studies in dose, method of drug delivery, length of treatment, patient age, whether patients with cannabis use/CUD were included or excluded, and whether patients were using antipsychotic medication. There is insufficient evidence for an effect of THC or CBD on symptoms, cognition, and neuroimaging measures of brain function in schizophrenia. At this time, research does not support recommending medical cannabis (THC or CBD) for treating patients with schizophrenia. Further research should examine THC and CBD in schizophrenia with and without comorbid CUD and consider the role of CBD in mitigating symptom exacerbation from THC.
PubMed: 34366924
DOI: 10.3389/fpsyt.2021.694394 -
Journal of General Internal Medicine Feb 2022Providing diagnostic and treatment information to patients is a core clinical skill, but evidence for the effectiveness of different information-giving strategies is...
BACKGROUND
Providing diagnostic and treatment information to patients is a core clinical skill, but evidence for the effectiveness of different information-giving strategies is inconsistent. This systematic review aimed to investigate the reported effects of empirically tested communication strategies for providing information on patient-related outcomes: information recall and (health-related) behaviors.
METHODS
The databases MEDLINE, Embase, PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and relevant bibliographies were systematically searched from the inception to April 24, 2020, without restrictions, for articles testing information-giving strategies for physicians (PROSPERO ID: CRD42019115791). Pairs of independent reviewers identified randomized controlled studies with a low risk of selection bias as from the Cochrane risk of bias 2 tool. Main outcomes were grouped into patient information recall and behavioral outcomes (e.g., alcohol consumption, weight loss, participation in screening). Due to high heterogeneity in the data on effects of interventions, these outcomes were descriptively reported, together with studies', interventions', and information-giving strategies' characteristics. PRISMA guidelines were followed.
RESULTS
Seventeen of 9423 articles were included. Eight studies, reporting 10 interventions, assessed patient information recall: mostly conducted in experimental settings and testing a single information-giving strategy. Four of the ten interventions reported significant increase in recall. Nine studies assessed behavioral outcomes, mostly in real-life clinical settings and testing multiple information-giving strategies simultaneously. The heterogeneity in this group of studies was high. Eight of the nine interventions reported a significant positive effect on objectively and subjectively measured patients' behavioral outcomes.
DISCUSSION
Using specific framing strategies for achieving specific communication goals when providing information to patients appears to have positive effects on information recall and patient health-related behaviors. The heterogeneity observed in this group of studies testifies the need for a more consistent methodological and conceptual agenda when testing medical information-giving strategies.
TRIAL REGISTRATION
PROSPERO registration number: CRD42019115791.
Topics: Alcohol Drinking; Communication; Health Behavior; Humans; Physicians
PubMed: 34355348
DOI: 10.1007/s11606-021-07044-5 -
The Cochrane Database of Systematic... Jul 2021The diagnosis of Alzheimer's disease dementia and other dementias relies on clinical assessment. There is a high prevalence of cognitive disorders, including undiagnosed...
BACKGROUND
The diagnosis of Alzheimer's disease dementia and other dementias relies on clinical assessment. There is a high prevalence of cognitive disorders, including undiagnosed dementia in secondary care settings. Short cognitive tests can be helpful in identifying those who require further specialist diagnostic assessment; however, there is a lack of consensus around the optimal tools to use in clinical practice. The Mini-Cog is a short cognitive test comprising three-item recall and a clock-drawing test that is used in secondary care settings.
OBJECTIVES
The primary objective was to determine the accuracy of the Mini-Cog for detecting dementia in a secondary care setting. The secondary objectives were to investigate the heterogeneity of test accuracy in the included studies and potential sources of heterogeneity. These potential sources of heterogeneity will include the baseline prevalence of dementia in study samples, thresholds used to determine positive test results, the type of dementia (Alzheimer's disease dementia or all causes of dementia), and aspects of study design related to study quality.
SEARCH METHODS
We searched the following sources in September 2012, with an update to 12 March 2019: Cochrane Dementia Group Register of Diagnostic Test Accuracy Studies, MEDLINE (OvidSP), Embase (OvidSP), BIOSIS Previews (Web of Knowledge), Science Citation Index (ISI Web of Knowledge), PsycINFO (OvidSP), and LILACS (BIREME). We made no exclusions with regard to language of Mini-Cog administration or language of publication, using translation services where necessary.
SELECTION CRITERIA
We included cross-sectional studies and excluded case-control designs, due to the risk of bias. We selected those studies that included the Mini-Cog as an index test to diagnose dementia where dementia diagnosis was confirmed with reference standard clinical assessment using standardised dementia diagnostic criteria. We only included studies in secondary care settings (including inpatient and outpatient hospital participants).
DATA COLLECTION AND ANALYSIS
We screened all titles and abstracts generated by the electronic database searches. Two review authors independently checked full papers for eligibility and extracted data. We determined quality assessment (risk of bias and applicability) using the QUADAS-2 tool. We extracted data into two-by-two tables to allow calculation of accuracy metrics for individual studies, reporting the sensitivity, specificity, and 95% confidence intervals of these measures, summarising them graphically using forest plots.
MAIN RESULTS
Three studies with a total of 2560 participants fulfilled the inclusion criteria, set in neuropsychology outpatient referrals, outpatients attending a general medicine clinic, and referrals to a memory clinic. Only n = 1415 (55.3%) of participants were included in the analysis to inform evaluation of Mini-Cog test accuracy, due to the selective use of available data by study authors. There were concerns related to high risk of bias with respect to patient selection, and unclear risk of bias and high concerns related to index test conduct and applicability. In all studies, the Mini-Cog was retrospectively derived from historic data sets. No studies included acute general hospital inpatients. The prevalence of dementia ranged from 32.2% to 87.3%. The sensitivities of the Mini-Cog in the individual studies were reported as 0.67 (95% confidence interval (CI) 0.63 to 0.71), 0.60 (95% CI 0.48 to 0.72), and 0.87 (95% CI 0.83 to 0.90). The specificity of the Mini-Cog for each individual study was 0.87 (95% CI 0.81 to 0.92), 0.65 (95% CI 0.57 to 0.73), and 1.00 (95% CI 0.94 to 1.00). We did not perform meta-analysis due to concerns related to risk of bias and heterogeneity.
AUTHORS' CONCLUSIONS
This review identified only a limited number of diagnostic test accuracy studies using Mini-Cog in secondary care settings. Those identified were at high risk of bias related to patient selection and high concerns related to index test conduct and applicability. The evidence was indirect, as all studies evaluated Mini-Cog differently from the review question, where it was anticipated that studies would conduct Mini-Cog and independently but contemporaneously perform a reference standard assessment to diagnose dementia. The pattern of test accuracy varied across the three studies. Future research should evaluate Mini-Cog as a test in itself, rather than derived from other neuropsychological assessments. There is also a need for evaluation of the feasibility of the Mini-Cog for the detection of dementia to help adequately determine its role in the clinical pathway.
Topics: Aged; Aged, 80 and over; Alzheimer Disease; Bias; Cognition Disorders; Cross-Sectional Studies; Dementia; Diagnosis, Differential; Disease Progression; Humans; Mental Status and Dementia Tests; Patient Selection; Prevalence; Secondary Care; Sensitivity and Specificity
PubMed: 34260060
DOI: 10.1002/14651858.CD011414.pub3 -
Frontiers in Psychiatry 2021Research examining trauma, memory, and mental health among refugee and asylum-seeking people has increased in recent years. We systematically reviewed empirical work...
Research examining trauma, memory, and mental health among refugee and asylum-seeking people has increased in recent years. We systematically reviewed empirical work focusing on the link between autobiographical memory and mental health among these populations. The review protocol was registered with PROSPERO (CRD42018095888). Six major databases were searched in August-2020 with no time limit for publication. Following PRISMA Statement guidelines, 22 articles reporting ten quantitative, nine qualitative, and three mixed-method studies were selected from 254 articles identified in the initial search. A basic convergent and qualitative meta-integration technique was employed for data extraction. Four recurrent themes were extracted: (1) memory activation method, (2) memory features, (3) memory content, and (4) refugee mental health. Theme 1 illustrates that narrative interviews, important event recall, and cue word methods were used in most studies. Theme 2 highlights that memories of refugee people were often less specific, inconsistent, and negative-focused. Retrieval failure was also common among these people. Theme 3 reveals that refugee and asylum-seeking people frequently discussed their abandoned identities, lost resources, injustices, ongoing sufferings, and pointless futures. Finally, theme 4 identifies the prevalence of various mental health conditions like Post-traumatic Stress Disorder, depression, helplessness, and anger among these people. The results are discussed in the context of the current autobiographical memory and mental health theories, considering refugee-specific experiences in the asylum process and refugee status.
PubMed: 34149479
DOI: 10.3389/fpsyt.2021.658700 -
Cureus May 2021We sought to summarize, in a systematic review, the effectiveness of songs to support learning, performance, and recall of quality characteristics of cardiopulmonary... (Review)
Review
We sought to summarize, in a systematic review, the effectiveness of songs to support learning, performance, and recall of quality characteristics of cardiopulmonary resuscitation (CPR) compression rate, and depth. We systematically reviewed the literature from eight academic indexes from the fields of medicine, nursing, allied health, and education, from 2014 to 2020 to identify studies that evaluated an intervention of song use during CPR training against control and reported outcomes of compression rate and depth. There were 185 studies initially identified for review, eight met criteria for inclusion and analysis. For the critical outcome of compression depth, a pooled song group (n=446) when compared to a non-song group (n=443) demonstrated higher odds of being in the recommended range (OR 3.47). All studies, however, performed an average compression depth shallower than recommended guidelines in each arm. The available literature, we found, utilized heterogenous methodology and was at high risk of bias. When pooled, there were trends towards improved CPR metric performance in groups who were exposed to songs during treatment, though this only reached significance when groups were tested at >30 days from initial exposure. Findings of lower compression rates in the song groups suggest that song selection should favor beats per minute closer to the midpoint of the 100-120 ideal range to allow for variation when used as mental metronomes.
PubMed: 34141503
DOI: 10.7759/cureus.15053 -
The International Journal of Behavioral... Jan 2021Reproducibility of FFQs measures the consistency of the same subject at different time points. We performed a meta-analysis to explore the reproducibility of FFQs and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Reproducibility of FFQs measures the consistency of the same subject at different time points. We performed a meta-analysis to explore the reproducibility of FFQs and factors related to reproducibility of FFQs.
METHODS AND FINDINGS
A systematic literature review was performed before July 2020 using PubMed and Web of Science databases. Pooled intraclass and Spearman correlation coefficients (95% confidence interval) were calculated to assess the reproducibility of FFQs. Subgroup analyses based on characteristics of study populations, FFQs, or study design were performed to investigate factors related to the reproducibility of FFQs. A total of 123 studies comprising 20,542 participants were eligible for the meta-analysis. The pooled crude intraclass correlation coefficients ranged from 0.499 to 0.803 and 0.499 to 0.723 for macronutrients and micronutrients, respectively. Energy-adjusted intraclass correlation coefficients ranged from 0.420 to 0.803 and 0.507 to 0.712 for macronutrients and micronutrients, respectively. The pooled crude and energy-adjusted Spearman correlation coefficients ranged from 0.548 to 0.851 and 0.441 to 0.793, respectively, for macronutrients; and from 0.573 to 0.828 and 0.510 to 0.744, respectively, for micronutrients. FFQs with more food items, 12 months as dietary recall interval (compared to less than 12 months), and a shorter time period between repeated FFQs resulted in superior FFQ reproducibility.
CONCLUSIONS
In conclusion, FFQs with correlation coefficients greater than 0.5 for most nutrients may be considered a reliable tool to measure dietary intake. To develop FFQs with higher reproducibility, the number of food items and dietary recall interval should be taken into consideration.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Diet; Diet Records; Diet Surveys; Eating; Energy Intake; Epidemiologic Studies; Female; Humans; Male; Mental Recall; Middle Aged; Nutritional Status; Reproducibility of Results; Research Design
PubMed: 33430897
DOI: 10.1186/s12966-020-01078-4 -
Trends in Psychiatry and Psychotherapy 2020The experience of stressful events can alter brain structures involved in memory encoding, storage and retrieval. Here we review experimental research assessing the...
INTRODUCTION
The experience of stressful events can alter brain structures involved in memory encoding, storage and retrieval. Here we review experimental research assessing the impact of the stress-related hormone cortisol on long-term memory retrieval.
METHOD
A comprehensive literature search was conducted on PubMed, Web of Science and PsycNet databases with the following terms: "stress," "long-term memory," and "retrieval." Studies were included in the review if they tested samples of healthy human participants, with at least one control group, and with the onset of the stress intervention occurring after the encoding phase and shortly (up to one hour) before the final memory test.
RESULTS
Thirteen studies were included in the qualitative synthesis (N = 962) and were classified according to the time elapsed between stress induction and memory retrieval (stress-retrieval delay), the stress-inducing protocol (stressor), the time of day in which stress induction took place, sex, and age of participants. Most studies induced stress with the Trier Social Stress Test (TSST) between 15 and 25 minutes before the final memory (mostly recall) test and showed significant increases in cortisol levels and memory impairment.
DISCUSSION
The reviewed studies indicate that stress does impair retrieval, particularly when induced with the TSST, in the afternoon, up to 45 minutes before the onset of the final memory test, in healthy young men. These results may inform future research on the impact of stress-induced cortisol surges on memory retrieval.
Topics: Humans; Memory, Long-Term; Mental Recall; Stress, Psychological
PubMed: 33084805
DOI: 10.1590/2237-6089-2019-0077 -
Molecular Psychiatry Sep 2021The burden of large and rare copy number genetic variants (CNVs) as well as certain specific CNVs increase the risk of developing schizophrenia. Several cognitive... (Meta-Analysis)
Meta-Analysis
The burden of large and rare copy number genetic variants (CNVs) as well as certain specific CNVs increase the risk of developing schizophrenia. Several cognitive measures are purported schizophrenia endophenotypes and may represent an intermediate point between genetics and the illness. This paper investigates the influence of CNVs on cognition. We conducted a systematic review and meta-analysis of the literature exploring the effect of CNV burden on general intelligence. We included ten primary studies with a total of 18,847 participants and found no evidence of association. In a new psychosis family study, we investigated the effects of CNVs on specific cognitive abilities. We examined the burden of large and rare CNVs (>200 kb, <1% MAF) as well as known schizophrenia-associated CNVs in patients with psychotic disorders, their unaffected relatives and controls (N = 3428) from the Psychosis Endophenotypes International Consortium (PEIC). The carriers of specific schizophrenia-associated CNVs showed poorer performance than non-carriers in immediate (P = 0.0036) and delayed (P = 0.0115) verbal recall. We found suggestive evidence that carriers of schizophrenia-associated CNVs had poorer block design performance (P = 0.0307). We do not find any association between CNV burden and cognition. Our findings show that the known high-risk CNVs are not only associated with schizophrenia and other neurodevelopmental disorders, but are also a contributing factor to impairment in cognitive domains such as memory and perceptual reasoning, and act as intermediate biomarkers of disease risk.
Topics: Cognition; DNA Copy Number Variations; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Psychotic Disorders; Schizophrenia
PubMed: 32719466
DOI: 10.1038/s41380-020-0820-7 -
Annals of Internal Medicine May 2020The accuracy and harms of brief cognitive tests for identifying clinical Alzheimer-type dementia (CATD) are uncertain.
Brief Cognitive Tests for Distinguishing Clinical Alzheimer-Type Dementia From Mild Cognitive Impairment or Normal Cognition in Older Adults With Suspected Cognitive Impairment.
BACKGROUND
The accuracy and harms of brief cognitive tests for identifying clinical Alzheimer-type dementia (CATD) are uncertain.
PURPOSE
To summarize evidence on accuracy and harms of brief cognitive tests for CATD in older adults with suspected cognitive impairment.
DATA SOURCES
Electronic bibliographic databases (from inception to November 2019) and systematic review bibliographies.
STUDY SELECTION
English-language, controlled observational studies in older adults that evaluated the accuracy of brief cognitive tests (standalone tests; memory, executive function, and language tests; and brief multidomain batteries) for distinguishing CATD from mild cognitive impairment (MCI) or normal cognition as defined by established diagnostic criteria. Studies with low or medium risk of bias (ROB) were analyzed.
DATA EXTRACTION
Two reviewers rated ROB. One reviewer extracted data; the other verified extraction accuracy.
DATA SYNTHESIS
Fifty-seven studies met analysis criteria. Many brief, single cognitive tests were highly sensitive and specific for distinguishing CATD from normal cognition. These included standalone tests (clock-drawing test, median sensitivity 0.79 and specificity 0.88 [8 studies]; Mini-Mental State Examination, 0.88 and 0.94 [7 studies]; Montreal Cognitive Assessment, 0.94 and 0.94 [2 studies]; and Brief Alzheimer Screen, 0.92 and 0.97 [1 study]), memory tests (list delayed recall, 0.89 and 0.94 [5 studies]), and language tests (category fluency, 0.92 and 0.89 [9 studies]). Accuracy was lower in distinguishing mild CATD from normal cognition and distinguishing CATD from MCI. No studies reported on testing harms.
LIMITATIONS
Studies were small. Few test metrics were evaluated by multiple studies. Few studies directly compared different tests, scores, cut points, or test combinations.
CONCLUSION
Many brief, single cognitive tests accurately distinguish CATD from normal cognition in older adults but are less accurate in distinguishing mild CATD from normal cognition or CATD from MCI. No studies reported on testing harms.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality. (PROSPERO: CRD42018117897).
Topics: Aged; Alzheimer Disease; Cognition; Cognitive Dysfunction; Humans; Psychometrics
PubMed: 32340040
DOI: 10.7326/M19-3889