Dataset Information

Efficacy of cognitive enhancers for Alzheimer's disease: protocol for a systematic review and network meta-analysis.

ABSTRACT:

Background

Approximately 35 million people world-wide have Alzheimer's disease and this is projected to nearly double by 2030. Cognitive enhancers, including cholinesterase inhibitors (for example, donepezil, galantamine and rivastigmine) and memantine (N-methyl-D-aspartic acid (NMDA) receptor antagonist) have been approved for the treatment of Alzheimer's disease in many countries. Our objective is to evaluate the comparative effectiveness, safety, and cost of cognitive enhancers for Alzheimer's disease through a systematic review.

Methods/design

Studies examining the efficacy, safety, and cost of cognitive enhancers compared to placebo, supportive care, and other cognitive enhancers for Alzheimer's patients will be included. The primary outcome is cognition and secondary outcomes include function, behavior, quality of life, safety, and cost. Experimental studies (randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials), quasi-experimental studies (controlled before-after, interrupted time series), and observational studies (cohort, case-control studies) will be eligible for inclusion. Inclusion will not be limited by publication status, time period or language of dissemination.We will search electronic databases (for example, MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Ageline) from inception onwards. The electronic database search will be supplemented by searching for grey literature (for example, conference proceedings, searches in Google and relevant organization websites). Two reviewers will independently screen the studies for inclusion using the eligibility criteria established a priori and independently extract data. Risk of bias will be assessed using the Cochrane Risk of Bias tool for experimental and quasi-experimental studies and the Newcastle Ottawa Scale for observational studies. If deemed appropriate, meta-analysis and network (that is, indirect comparisons) meta-analysis will be conducted.

Discussion

Our systematic review will inform the decision of healthcare providers, policy-makers, Alzheimer's patients and family members about the use of cognitive enhancers, by improving their understanding of the costs, benefits and harms that are associated with these agents. PROSPERO REGISTRY NUMBER: CRD42012001948.

SUBMITTER: Tricco AC

PROVIDER: S-EPMC3407718 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Publications

Efficacy of cognitive enhancers for Alzheimer's disease: protocol for a systematic review and network meta-analysis.

Tricco Andrea C AC Vandervaart Sondra S Soobiah Charlene C Lillie Erin E Perrier Laure L Chen Maggie H MH Hemmelgarn Brenda B Majumdar Sumit R SR Straus Sharon E SE

Systematic reviews 20120628

<h4>Background</h4>Approximately 35 million people world-wide have Alzheimer's disease and this is projected to nearly double by 2030. Cognitive enhancers, including cholinesterase inhibitors (for example, donepezil, galantamine and rivastigmine) and memantine (N-methyl-D-aspartic acid (NMDA) receptor antagonist) have been approved for the treatment of Alzheimer's disease in many countries. Our objective is to evaluate the comparative effectiveness, safety, and cost of cognitive enhancers for Al ...[more]

PMID: 22742585

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Project description:IntroductionThe incidence of Alzheimer's disease (AD) is increasing rapidly, causing a growing burden to health and economic worldwide. Several clinical trials in the past decade failed to find solutions, and there remains a lack of an effective treatment. The evidence suggests that early intervention for neurodegeneration would likely be effective in preventing cognitive decline. Cognitive decline in AD occurs continuously over a long period; however, there remains a lack of simple, rapid and accurate approach for diagnosis of amnestic mild cognitive impairment or subjective cognitive decline due to underlying Alzheimer's pathology. Resting-state functional MRI (rs-fMRI) determines the functional activities of the human brain non-invasively. The amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo) are rs-fMRI indicators with high repeatability. They have been studied as early diagnostic imaging markers for other diseases and may be promising markers also for AD.Methods and analysisThe following electronic literature databases will be searched from inception to December 2021: Medline-Ovid, Medline-PubMed, EMBase-Ovid, Cochrane Central and ClinicalTrials.gov. Two independent reviewers will select studies with eligible criteria, extract data and assess the quality of the original studies with our quality assessment tool individually. Missing data will be requested by sending emails to the corresponding authors. Brain regions will be presented for ALFF/fALFF and ReHo by performing activation likelihood estimation with the Seed-based d Mapping-Permutation of subject images V.6.21 software. Meta-regression will be performed to determine the potential brain regions that may strongly correlate with cognitive decline progression. Subgroup analysis, funnel plot, Egger's test and sensitivity analysis will be conducted to detect and explain potential heterogeneity.Ethics and disseminationThis study does not require formal ethical approval. The findings will be submitted to a peer-review journal.Prospero registration numberCRD42021229009.

Project description:IntroductionBehavioural and cognitive behavioural programmes are commonly used to assist with weight management, but there is considerable scope to improve their effectiveness, particularly in the longer term. Third-wave cognitive behaviour therapies (CBTs) have this potential and are increasingly used. This systematic review will assess the effect of third-wave CBTs for weight management on weight, psychological and physical health outcomes in adults with overweight or obesity.Methods and analysisThe systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance. We will include studies of any third-wave CBTs focusing on weight loss or weight maintenance for adults with a body mass index (BMI) ≥25kg/m2. Eligible study designs will be randomised control trials, non-randomised trials, prospective cohort and case series. Outcomes of interest will be body weight/BMI, psychological and physical health, and adherence. We will search the following databases from inception to 16 January 2018: MEDLINE, CINAHL, Embase, Cochrane database (CENTRAL), PsycINFO, AMED, ASSIA and Web of Science. The search strategy will be based on the concepts: (1) third-wave CBTs and (2) overweight, obesity or weight management. No restrictions will be applied. We will search reference lists of relevant reviews and included articles. Two independent reviewers will screen articles for eligibility using a two-stage process. Two independent reviewers will extract data, assess risk of bias using Risk of Bias 2.0, Risk of Bias in Non-randomised studies of Interventions or Risk of Bias in Non-randomised Studies of Exposures checklist and assess quality using the Grading of Recommendations Assessment, Development and Evaluation tool. A random-effects network meta-analysis of outcomes, and sub-group analyses and meta-regression will be conducted, where data permit. If not appropriate, a narrative synthesis will be undertaken.Ethics and disseminationEthical approval is not required as no primary data will be collected. The completed systematic review will be disseminated in a peer-reviewed journal, presented at conferences and used to inform the development of a weight management programme.Prospero registration numberCRD42018088255.

Dataset Information

Efficacy of cognitive enhancers for Alzheimer's disease: protocol for a systematic review and network meta-analysis.

Background

Methods/design

Discussion

Publications

Efficacy of cognitive enhancers for Alzheimer's disease: protocol for a systematic review and network meta-analysis.

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