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International Journal of Geriatric... Dec 2022Research priority setting aims to collate stakeholder opinion to determine the most pressing research questions. Priority setting exercises influence decisions around... (Review)
Review
OBJECTIVES
Research priority setting aims to collate stakeholder opinion to determine the most pressing research questions. Priority setting exercises influence decisions around research funding, development and policy. We compared published dementia research priority setting exercises from international healthcare systems.
METHODS
Four multidisciplinary, international, electronic databases were searched for relevant studies (2010 until 2021). Priorities were extracted, coded and assigned to categories using thematic analysis. The Nine Common Themes of Good Practice (9CTGP) and the Reporting guideline for priority setting of health research (REPRISE) checklists were used to assess methodological and reporting quality respectively.
RESULTS
From 265 titles, 10 priority setting exercises (1179 participants, 147 priorities) were included. Studies spanned four continents and the majority included people living with dementia and their care-givers in the priority setting process (68%). Only one paper met all the best practice indicators. Issues around inclusiveness, implementation and evaluation of the priorities were apparent in nine papers. We categorised priorities under eight themes: caregivers (25%, n = 37), support (24%, n = 35), awareness and education (16%, n = 24), drugs and interventions (14%, n = 21), diagnosis (8%, n = 12), pathology (6%, n = 9), research design (5%, n = 7), and prevention (1%, n = 2). Priorities varied by geographical region, with awareness and education of higher priority in low-middle income countries, compared to caregivers and support in high income countries.
CONCLUSIONS
Key priorities were identified with some commonality around themes considered of greatest importance. There is scope to improve the process and reporting of priority setting. Priorities differed according to contextual factors and so, priorities specific to one healthcare setting may not be applicable to others.
Topics: Humans; Dementia; Research
PubMed: 36326065
DOI: 10.1002/gps.5836 -
Brain and Behavior Feb 2024Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta-analysis aimed to... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta-analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia.
METHODS
We searched five databases until November 2023 for case-control, cross-sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta-analysis. Meta-regression, subgroup, and sensitivity analysis were also conducted.
RESULTS
We evaluated a total of five studies (one cross-sectional, one case-control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia.
CONCLUSION
Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association.
Topics: Humans; Dementia; Herpes Zoster Vaccine; Herpes Zoster; Vaccination
PubMed: 38687552
DOI: 10.1002/brb3.3415 -
Journal of Medical Systems Feb 2023Nowadays, Artificial Intelligence (AI) and machine learning (ML) have successfully provided automated solutions to numerous real-world problems. Healthcare is one of the...
Nowadays, Artificial Intelligence (AI) and machine learning (ML) have successfully provided automated solutions to numerous real-world problems. Healthcare is one of the most important research areas for ML researchers, with the aim of developing automated disease prediction systems. One of the disease detection problems that AI and ML researchers have focused on is dementia detection using ML methods. Numerous automated diagnostic systems based on ML techniques for early prediction of dementia have been proposed in the literature. Few systematic literature reviews (SLR) have been conducted for dementia prediction based on ML techniques in the past. However, these SLR focused on a single type of data modality for the detection of dementia. Hence, the purpose of this study is to conduct a comprehensive evaluation of ML-based automated diagnostic systems considering different types of data modalities such as images, clinical-features, and voice data. We collected the research articles from 2011 to 2022 using the keywords dementia, machine learning, feature selection, data modalities, and automated diagnostic systems. The selected articles were critically analyzed and discussed. It was observed that image data driven ML models yields promising results in terms of dementia prediction compared to other data modalities, i.e., clinical feature-based data and voice data. Furthermore, this SLR highlighted the limitations of the previously proposed automated methods for dementia and presented future directions to overcome these limitations.
Topics: Humans; Artificial Intelligence; Machine Learning; Voice; Dementia
PubMed: 36720727
DOI: 10.1007/s10916-023-01906-7 -
Alzheimer Disease and Associated... 2011The purpose of this study was to review the relationship between education and dementia. (Review)
Review
OBJECTIVE
The purpose of this study was to review the relationship between education and dementia.
METHODS
A systematic literature review was conducted of all published studies examining the relationship between education and dementia listed in the PubMed and PsycINFO databases from January 1985 to July 2010. The inclusion criteria were a measure of education and a dementia diagnosis by a standardized diagnostic procedure. Alzheimer disease and Total Dementia were the outcomes.
RESULTS
A total of 88 study populations from 71 studies met inclusion criteria. Overall, 51 studies (58%) reported significant effects of lower education on risk for dementia, whereas 37 studies (42%) reported no significant relationship. A relationship between education and risk for dementia was more consistent in developed regions compared with developing regions. Age, sex, race/ethnicity, and geographical region moderated the relationship.
CONCLUSIONS
Lower education was associated with a greater risk for dementia in many but not all studies. The level of education associated with risk for dementia varied by study population and more years of education did not uniformly attenuate the risk for dementia. It seemed that a more consistent relationship with dementia occurred when years of education reflected cognitive capacity, suggesting that the effect of education on risk for dementia may be best evaluated within the context of a lifespan developmental model.
Topics: Alzheimer Disease; Dementia; Educational Measurement; Educational Status; Humans; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 21750453
DOI: 10.1097/WAD.0b013e318211c83c -
Alzheimer's Research & Therapy Sep 2023Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society... (Review)
Review
BACKGROUND
Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society is largely unknown. This study aimed to summarize evidence on the cost-effectiveness of PA interventions to prevent and manage cognitive decline and dementia.
METHODS
Electronic databases, including PubMed/MEDLINE, Embase, and ScienceDirect, were searched from January 2000 to July 2023. The search strategy was driven by a combination of subject-heading terms related to physical activity, cognitive function, dementia, and cost-effectiveness. Selected studies were included in narrative synthesis, and extracted data were presented in narrative and tabular forms. The risk of bias in each study was assessed using the Consolidated Health Economic Evaluation Reporting Standards and Consensus on Health Economic Criteria list.
RESULTS
Five of the 11 identified studies focused on individuals with existing dementia. Six of the 11 identified studies focused on individuals with no existing dementia, including 3 on those with mild cognitive impairment (MCI), and 3 on those with no existing MCI or dementia. PA interventions focused on individuals with no existing dementia were found to be cost-effective compared to the control group. Findings were mixed for PA interventions implemented in individuals with existing dementia.
CONCLUSIONS
PA interventions implemented before or during the early stage of cognitive impairment may be cost-effective in reducing the burden of dementia. More research is needed to investigate the cost-effectiveness of PA interventions in managing dementia. Most existing studies used short-term outcomes in evaluating the cost-effectiveness of PA interventions in the prevention and management of dementia; future research should consider adding long-term outcomes to strengthen the study design.
Topics: Humans; Cost-Benefit Analysis; Cognitive Dysfunction; Cognition; Exercise; Dementia
PubMed: 37749587
DOI: 10.1186/s13195-023-01286-7 -
Psychiatry Research Nov 2023Dementia is a progressive neurodegenerative disease that burdens the person living with the disease, their families, and medical and social services. Timely diagnosis of... (Review)
Review
Dementia is a progressive neurodegenerative disease that burdens the person living with the disease, their families, and medical and social services. Timely diagnosis of dementia could be followed by introducing interventions that may slow down its progression or reduce its burdens. However, the diagnostic process of dementia is often complex and resource intensive. Access to diagnostic services is also an issue in low and middle-income countries. The abundance and easy accessibility of speech and language data have created new possibilities for utilizing Deep Learning (DL) technologies to be part of the dementia diagnostic process. This systematic review included studies published between 2012-2022 that utilized such technologies to aid in diagnosing dementia. We identified 72 studies using the PRISMA 2020 protocol, extracted and analyzed data from these studies and reported the related DL technologies. We found these technologies effectively differentiated between healthy individuals and those with a dementia diagnosis, highlighting their potential in the diagnosis of dementia. This systematic review provides insights into the contributions of DL-based speech and language techniques to support the dementia diagnostic process. It also offers an understanding of the advancements made in this field thus far and highlights some challenges that still need to be addressed.
Topics: Humans; Speech; Deep Learning; Neurodegenerative Diseases; Language; Dementia
PubMed: 37864994
DOI: 10.1016/j.psychres.2023.115538 -
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 -
Translational Psychiatry Apr 2020An increasing number of original studies suggest that sedentary behavior is associated with the risk of dementia, but the results remain inconsistent and inconclusive.... (Meta-Analysis)
Meta-Analysis Review
An increasing number of original studies suggest that sedentary behavior is associated with the risk of dementia, but the results remain inconsistent and inconclusive. In this meta-analysis, we analyzed available observational epidemiological evidence to identify the association between sedentary behavior and the risk of dementia. We searched PubMed and Embase from their inception to March 2019 to identify observational studies examining the association between sedentary behavior and risk of dementia. Two authors independently extracted data and assessed study quality using predefined criteria. The Q statistics and I² methods were used to test for heterogeneity. The publication bias of the included studies was also estimated using Begg's and Egger's tests. We identified 18 relevant cohort studies involving 250,063 participants and 2269 patients with dementia. Pooled result showed that sedentary behavior was significantly associated with increased risk of dementia (RR = 1.30; 95% CI: 1.12-1.51). In addition, subgroup analyses by state, and controlling for the concomitant effects of age, sex, education were conducted for the increase of dementia risk, relating to sedentary, respectively. In general, these subgroup analyses showed no statistically significant differences. The results of our meta-analysis suggested that sedentary behavior was independently associated with a significantly increased risk of dementia, which might have important implications in conducting etiological studies for dementia and developing strategies for dementia prevention.
Topics: Cohort Studies; Dementia; Humans; Observational Studies as Topic; Sedentary Behavior
PubMed: 32317627
DOI: 10.1038/s41398-020-0799-5 -
Advances in Nutrition (Bethesda, Md.) Jan 2024Dairy intake may influence cognition through several molecular pathways. However, epidemiologic studies yield inconsistent results, and no dose-response meta-analysis... (Meta-Analysis)
Meta-Analysis Review
Dairy intake may influence cognition through several molecular pathways. However, epidemiologic studies yield inconsistent results, and no dose-response meta-analysis has been conducted yet. Therefore, we performed a systematic review with a dose-response meta-analysis about the association between dairy intake and cognitive decline or incidence of dementia. We investigated prospective studies with a follow-up ≥6 mo on cognitive decline or dementia incidence in adults without known chronic conditions through a systematic search of Embase, Medline, Cochrane Library, Web of Science, and Google Scholar from inception to 11 July 2023. We evaluated the dose-response association using a random-effects model. We identified 15 eligible cohort studies with >300,000 participants and a median follow-up of 11.4 y. We observed a negative nonlinear association between cognitive decline/dementia incidence and dairy intake as assessed through the quantity of consumption, with the nadir at ∼150 g/d (risk ratio: 0.88; 95% confidence interval: 0.78, 0.99). Conversely, we found an almost linear negative association when we considered the frequency of consumption (risk ratio for linear trend: 0.84; 95% confidence interval: 0.77, 0.92 for 1 time/d increase of dairy products). Stratified analysis by dairy products showed different shapes of the association with linear inverse relationship for milk intake, whereas possibly nonlinear for cheese. The inverse association was limited to Asian populations characterized by generally lower intake of dairy products, compared with the null association reported by European studies. In conclusion, our study suggests a nonlinear inverse association between dairy intake and cognitive decline or dementia, also depending on dairy types and population characteristics, although the heterogeneity was still high in overall and several subgroup analyses. Additional studies should be performed on this topic, including a wider range of intake and types of dairy products, to confirm a potential preventing role of dairy intake on cognitive decline and identify ideal intake doses. This review was registered at PROSPERO as CRD42020192395.
Topics: Animals; Humans; Cognitive Dysfunction; Dairy Products; Dementia; Diet; Milk; Prospective Studies; Risk Factors
PubMed: 38043604
DOI: 10.1016/j.advnut.2023.100160 -
Ageing Research Reviews Jan 2023This study aimed to systematically review and meta-analyse the prevalence of sleep disturbances in people with dementia and examine demographic predictors and whether... (Meta-Analysis)
Meta-Analysis Review
This study aimed to systematically review and meta-analyse the prevalence of sleep disturbances in people with dementia and examine demographic predictors and whether overall prevalence has changed over time. We searched Embase, MEDLINE and PsycINFO for studies reporting the prevalence of sleep disturbances in people with dementia living at home. We meta-analysed the data and calculated the pooled prevalence of sleep disturbances in people with dementia overall and in dementia subtypes. We used meta-regressions to investigate the effects of study characteristics, publication dates and participant demographics. Eleven studies fulfilled the inclusion criteria. The pooled prevalence of any symptoms of sleep disturbance was 26 % (95 % confidence intervals, CI: 23-30 %; n = 2719) and of clinically significant sleep disturbance 19 % (13-25 %; n = 2753). The pooled prevalence of sleep disturbance symptoms was significantly lower among people with Alzheimer's disease (24 %; 16-33 %, n = 310) than Lewy body dementia (49 %; 37-61 %, n = 65). Meta-regression analysis did not find that publication year, participant's age, sex and study quality predicted prevalence. Sleep disturbances are common among people with dementia living in the community, especially in Lewy body dementia. There was no change in prevalence according to publication dates, suggesting treatment has not improved over time.
Topics: Humans; Alzheimer Disease; Lewy Body Disease; Prevalence; Sleep Wake Disorders; Dementia; Male; Female; Independent Living
PubMed: 36356799
DOI: 10.1016/j.arr.2022.101782