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Cognitive interventions for mild cognitive impairment and dementia: An overview of systematic reviews
Affiliation:1. School of Public Health, Lanzhou University, Lanzhou, 730000, China;2. Evidence Based Medicine Center, Lanzhou University, Lanzhou, 730000, China;3. Evidence Based Social Science Research Center, Lanzhou, 730000, China;1. Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA;2. Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA;3. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA;4. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA;5. Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA;6. Division of Geriatrics, Department of Internal Medicine, Home Instead Center for Successful Aging, University of Nebraska Medical Center, Omaha, NE, USA;1. Yuquan Hospital, TsingHua University, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100040, China;2. Tianjin University of Traditional Chinese Medicine, No. 88 Yuquan Road, Anshan West Road, Nankai District, Tianjin 300193, China;3. Department of Thoracic Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China;4. Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yang Fang Dian, Haidian District, Beijing 100038, China;1. Experimental Pathology Institute, Faculty of Medicine, University of Coimbra, Portugal;2. Biophysics Institute, Faculty of Medicine, University of Coimbra, Portugal;3. Institute of Integrated Clinical Practice, Dentistry Department, Faculty of Medicine, University of Coimbra, Portugal;4. Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal;5. CNC.IBILI Consortium, University of Coimbra, Portugal;6. Radiation Oncology Department, Coimbra University Hospital Centre, Portugal;7. Coimbra Chemistry Centre, Faculty of Sciences and Technology, University of Coimbra, Portugal;1. The First Clinical School of Guangzhou University of Chinese Medicine, Guangzhou 510405, China;2. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
Abstract:PurposeConducting an overview of systematic reviews (SRs)/Meta analyses (MAs) to assess the effectiveness of cognitive interventions on participants with mild cognitive impairment (MCI) or dementia and evaluate the methodological quality of SRs/MAs.MethodsPubMed, EMBASE, Cochrane library, Web of science, China National Knowledge Infrastructure (CNKI) and Chinese Biomedical Databases (CBM) were systematically searched from inception to January 1, 2019 to identify SRs/MAs. Three reviewers independently screened the articles, extracted data and assessed the quality of the included studies according to the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Grading of Recommendations Assessment Development and Evaluation (GRADE) was used to evaluate the quality of evidence.ResultsA total of 22 reviews were included. New meta-analyses (36 RCTs) showed that cognitive interventions were more effective than routine therapies for the alleviation of MCI and dementia symptoms (SMD: 0.62; 95%CI: 0.47, 0.78; I2 = 53.9%). The results of AMSTAR-2 showed that the methodological quality of most included studies was critically low, and two reviews were low quality. The lowest score was item 10, none of reviews reported on the sources of funding for the included studies. Followed by the “provide a list of excluded studies and justify the exclusions” item with only one (4.5%) reviews conforming to this item. Results of GRADE manifested that moderate quality evidence was provided in 11 reviews (39.3%), 12 (42.9%) were low quality and 5 (17.8%) were very low.ConclusionThe present SRs/MAs indicated that persons with MCI or dementia could benefit from cognitive interventions. Future trial designs should focus on measuring changes in individual specific cognitive functions. More high-quality evidence is needed to further determine the effectiveness of cognitive interventions.
Keywords:Cognitive interventions  Mild cognitive impairment  Dementia  Overview
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