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Latest & greatest articles for dementia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on dementia or other clinical topics then use Trip today.
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Effect of hydroxychloroquine on progression of dementia in early Alzheimer's disease: an 18-month randomised, double-blind, placebo-controlled study. Results of epidemiological studies, neuropathological observations, and in-vitro experiments all suggest that inflammatory mechanisms contribute to the destructive lesions in Alzheimer's disease. We aimed to establish the effect of the anti-inflammatory drug hydroxychloroquine on the progression of dementia.We did a double-blind, parallel-group (...) , multicentre trial in which we randomly assigned 168 patients with early Alzheimer's disease to hydroxychloroquine (200 or 400 mg dependent on bodyweight), or placebo for 18 months. Outcome measures were related to activities of daily living, cognitive function, and behavioural abnormalities. Analysis was by intention to treat.At 18 months, mean scores for the interview for deterioration in daily life in dementia in patients on hydroxychloroquine (22.6 [SD 11.4]) did not differ from those for patients
2001LancetControlled trial quality: predicted high
A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Psychosocial interventions for caregivers of people with dementia: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis Acton G J, Kang J Authors' objectives To evaluate, using meta-analytic techniques, intervention strategies designed to help caregivers cope with the burden of caregiving. Searching MEDLINE, CINAHL, PsycINFO, ERIC, Social (...) Sciences Index and Social Science Abstracts were searched from inception to 1999, using the following keywords: 'caregiver', 'caregiving', 'dementia' and 'Alzheimer's disease'. In addition, the reference lists of retrieved studies were checked and researchers in the field were contacted. Study selection Study designs of evaluations included in the review Experimental, quasi-experimental, and single-group pre-test post-test study designs were included in the review. Specific interventions included
Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique Cohen-Mansfield J Authors' objectives To assess the impact of non-pharmacologic interventions for inappropriate behaviours in dementia. Searching PsycLIT, MEDLINE and a nursing subset (...) -stimulation environments. Medical or nursing care interventions, including light or sleep therapy, pain management, hearing aids and removal of restraints. Combination therapies, including individualised and group treatments. Participants included in the review The participants were at least 60 years old and suffered from dementia or cognitive impairment. The majority of the studies (76%) were conducted in residential facilities, primarily nursing homes, with the rest in hospitals, the community or other
Practice parameter: early detection of dementia. Mild cognitive impairment (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology Practice parameter: early detection of dementia. Mild cognitive impairment (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology Practice parameter: early detection of dementia. Mild cognitive impairment (an evidence-based review): report of the Quality (...) Standards Subcommittee of the American Academy of Neurology Petersen R C, Stevens J C, Ganguli M, Tangalos E G, Cummings J L, DeKosky S T Authors' objectives To determine whether screening different groups of elderly individuals in a general or speciality practice would be beneficial in detecting dementia. Searching MEDLINE, EMBASE, Current Contents, Psychological Abstracts, PsycINFO, the Cochrane Library and CINAHL were searched. The key search terms were listed in the review. Reviews published from
Aspirin for vascular dementia. For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition (...) and also any publications found were searched for additional references.All randomised controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias.Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim was to evaluate data
Validation therapy for dementia. Validation therapy is a "therapy for communicating with old-old people who are diagnosed as having Alzheimer's disease and related dementia". The approach was developed by Naomi Feil between 1963 and 1980. She classifies individuals with cognitive impairment as having one of four stages on a continuum of dementia: these stages are Malorientation, Time Confusion, Repetitive Motion and Vegetation. The benefits of Validation therapy for patients are reported (...) across a number of well designed studies. The potential number of people that might benefit from the implementation of Validation therapy is considerable given the increasing incidence of dementia.To evaluate the effectiveness of using validation therapy with people diagnosed as having senile dementia of the Alzheimer's type, other forms of dementia, or cognitive impairment.The Cochrane Controlled Trials Register was searched by the Cochrane Dementia and Cognitive Impairment Group Coordinator
Piracetam for dementia or cognitive impairment. To determine the clinical efficacy of piracetam for the features of dementia or cognitive impairment, classified according to the major subtypes of dementia: vascular, Alzheimer's disease or mixed vascular and Alzheimer's disease or unclassified dementia or cognitive impairment not fulfilling the criteria for dementia.The Cochrane Dementia and Cognitive Impairment Group Register of Clinical Trials was searched using the terms "piracetam (...) will be reviewed as possible.All unconfounded trials specified as randomised in which treatment with piracetam was administered for more than a day and compared with placebo in patients with dementia of the Alzheimer's type, vascular dementia or mixed vascular and Alzheimer's disease or uncalssified dementia or cognitive impairment not fulfilling the criteria for dementia.Data were extracted independently by two reviewers. Each study was independently verified as fulfilling the inclusion criteria. Studies were
Reminiscence therapy for dementia. Reminiscence Therapy (RT) has been defined as vocal or silent recall of events in a person's life, either alone, or with another person or group of people. It typically involves group meetings, at least once a week. in which participants are encouraged to talk about past events, often assisted by aids such as photos, music, objects and videos of the past. There is, often, little consistent application of psychological therapies in dementia services. A number (...) , Journal of Gerontology, Current Opinion in Psychiatry, Current Research in Britain: Social Sciences, British Psychological Society conference proceedings and Reminiscence database.Randomised controlled trials and quasi-randomised trials of RT for dementia in elderly people.Two reviewers independently extracted data and assessed trial quality.Two trials are included in the review, but only one trial with 15 participants had extractable data. The results were statistically non-significant for both
Reality orientation for dementia. Reality Orientation (RO) was first described as a technique to improve the quality of life of confused elderly people, although its origins lie in an attempt to rehabilitate severely disturbed war veterans, not in geriatric work. It operates through the presentation of orientation information (eg time, place and person-related) which is thought to provide the person with a greater understanding of their surroundings, possibly resulting in an improved sense (...) of control and self-esteem. There has been criticism of RO in clinical practice, with some fear that it has been applied in a mechanical fashion and has been insensitive to the needs of the individual. There is also a suggestion that constant relearning of material can actually contribute to mood and self-esteem problems. There is often little consistent application of psychological therapies in dementia services, so a systematic review of the available evidence is important in order to identify
Music therapy for dementia symptoms. While music/music therapy does not represent a treatment of dementia, its use is based on a possible beneficial effect on symptoms including social, emotional and cognitive skills and for decreasing behavioral problems of individuals with dementias. Thus, there are clear implications for patients' and caregivers' quality of life. However, quantification and documentation of the evidence of this effect is necessary. Professional music therapists (...) client can be served. On the other hand, promulgating the efficacy of music therapy in general, or of specific music therapy techniques, in the absence of any substantiation other than intuition or tradition borders on professional recklessness.To gather and evaluate the evidence for the effectiveness of music therapy for dementia symptoms.All available sources of references were searched for randomised controlled trials of music therapy used as an intervention in dementia. The search terms included
Nimodipine for primary degenerative, mixed and vascular dementia. Dementia is an age-related condition in which Alzheimer's disease (AD) and cerebrovascular disease account for the bulk of cases. The role played by calcium in regulating brain functions is well known - the calcium ion links membrane excitation to subsequent intracellular enzymatic response. Change in calcium homeostasis is one important effect of aging with repercussions on higher cortical functions. Nimodipine is an isopropyl (...) calcium channel blocker which can easily cross the blood brain barrier. Its primary action is to reduce the number of open channels, thus restricting influx of calcium ions into the cell. The usefulness of nimodipine in patients with Alzheimer's disease and vascular dementia and unspecified dementia is still controversial with mixed results. In spite of the uncertainties about its efficacy in dementia, nimodipine is currently a frequently prescribed drug for cognitive impairment and dementia
Support for carers of people with Alzheimer's type dementia. Research has highlighted the problems for carers of people with dementia. These include the effective loss of companionship and support of a life partner, social isolation and complex financial, legal and social decision making. The burden of caring is financially, emotionally and physically significant. Studies of the effects of ways of supporting carers and reducing the burden of caring often examine a range of outcomes. Probably (...) an assessment of the effectiveness of health and/or social interventions designed to help support the carers of people with Alzheimer's-type dementias.The Cochrane Controlled Trials Register was searched using the terms 'carer*' and 'caregiv*'. See the Cochrane Dementia & Cognitive Impairment group's details for the full search strategy.All randomised trials in which primary carers of people with Alzheimer's disease are allocated to either intervention or non-intervention/control groups and where
Thioridazine for dementia. Neuroleptic drugs are controversial treatments in dementia, with evidence accumulating that they may hasten clinical decline. Despite these concerns, they are commonly prescribed for elderly and demented patients. Thioridazine, a phenothiazine neuroleptic, is one of the most commonly prescribed. It has often been a preferred agent because it is thought to produce relatively less frequent motor side effects. The drug has significant sedative effects, and it is thought (...) that these are the main mechanism of action in calming and controlling the patient. However, pharmacologically, it also has marked anticholinergic properties that could potentially have a detrimental effect on cognitive function.To determine the evidence on which the use of thioridazine in dementia is based in terms of: 1) efficacy in controlling symptoms 2) cognitive outcome for the patient 3) safetyThe Cochrane Controlled Trials Register and other electronic databases were searched using the terms 'thioridazine
Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia. To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture.Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland.243 independently living patients aged 65 years or older admitted to hospital with hip fracture.After surgery patients in the intervention (...) group (n=120) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals.Length of hospital stay, mortality, and place of residence three months and one year after surgery for hip fracture.The median length of hospital stay of hip fracture patients with moderate dementia (mini mental state examination score 12-17) was 47 days in the intervention group (n=24) and 147 days in the control group (n=12, P=0.04). The corresponding figures for patients
Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Dementia with Lewy bodies is a common form of dementia in the elderly, characterised clinically by fluctuating cognitive impairment, attention deficits, visual hallucinations, parkinsonism, and other neuropsychiatric features. Neuroleptic medication can provoke severe sensitivity reactions in patients with dementia of this type. Many deficits in cholinergic (...) neurotransmission are seen in the brain of patients with Lewy-body dementia; therefore, drugs enhancing central cholinergic function represent a rationally-based therapeutic approach to this disorder. Rivastigmine, a cholinesterase inhibitor, was tested in a group of clinically characterised patients with Lewy-body dementia.A placebo-controlled, double-blind, multicentre study was done in 120 patients with Lewy-body dementia from the UK, Spain, and Italy. Individuals were given up to 12 mg rivastigmine daily
Propentofylline treatment for Alzheimer disease and vascular dementia: an economic evaluation based on functional abilities Propentofylline treatment for Alzheimer disease and vascular dementia: an economic evaluation based on functional abilities Propentofylline treatment for Alzheimer disease and vascular dementia: an economic evaluation based on functional abilities Bachynsky J, McCracken P, Lier D, Alloul K, Jacobs P Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Propentofylline drug treatment (300mg three times daily one hour before meals) for the treatment of patients with mild to moderate Alzheimer disease and/or vascular dementia. Type of intervention Treatment. Economic study type Cost-effectiveness analysis
The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature Finnema E, Droes R M, Ribbe M, Van Tilburg W Authors' objectives To assess the effectiveness of emotion-orientated approaches in the care (...) of people with dementia. Searching MEDLINE, PsycLIT, EMBASE, Sociofile, and Current Contents were searched from 1990 to 1999 using the terms 'dementia' and 'Alzheimer's disease' linked separately to the following terms: 'emotion-orientated', 'validation (therapy)', 'sensory integration/sensory stimulation/snoezelen/multi-sensory environment/multi-sensory enhancement', 'stimulated presence therapy' and ' reminiscence (therapy)/life review'. References from identified studies were examined, and additional
Novel antipsychotics in the treatment of psychosis and aggression associated with dementia: a meta-analysis of randomized controlled clinical trials Novel antipsychotics in the treatment of psychosis and aggression associated with dementia: a meta-analysis of randomized controlled clinical trials Novel antipsychotics in the treatment of psychosis and aggression associated with dementia: a meta-analysis of randomized controlled clinical trials Davidson M, Weiser M, Soares K Authors' objectives (...) To assess the quality and results of trials of atypical antipsychotics in elderly patients with behavioural and psychological symptoms of dementia. Searching The Cochrane Controlled Trials Register (Issue 2, 1999) and MEDLINE (to June 1999) were searched using the following keywords in combination with 'dementia': 'risperidone', 'olanzapine', ziprasidone', 'quetiapine', 'sertindole' and 'clozapine'. Reference lists of RCTs were also checked and pharmaceutical companies that produced these drugs were