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Protection against Brain Atrophy by Anti-dementia Medication in Mild Cognitive Impairment and Alzheimer’s Disease: Meta-Analysis of Longitudinal Randomized Placebo-Controlled Trials
| Content Provider | Oxford Academic |
|---|---|
| Author | Kishi, Taro Matsunaga, Shinji Oya, Kazuto Ikuta, Toshikazu Iwata, Nakao |
| Copyright Year | 2015 |
| Abstract | Background:There has not been conclusive evidence for prevention of brain atrophy by anti-dementia drugs in mild cognitive impairment and Alzheimer's Disease.Methods:Relevant studies were identified through searches of PubMed, databases of the Cochrane Library, and PsycINFO citations up to 16 May, 2015. Only double-blind, randomized, placebo-controlled clinical trials of anti-dementia drugs in patients with mild cognitive impairment or Alzheimer's Disease were included. Primary outcomes were annualized percent change of total brain volume (%TBV/y), annualized percent change of hippocampal volume (%HV/y), and annualized percent change of ventricular volume (%VV/y) measured by magnetic resonance imaging. Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcomes.Results:Seven randomized, placebo-controlled clinical trials (n=1708) were found to meet the inclusion criteria, including 4 mild cognitive impairment studies (n=1327) and 3 Alzheimer's Disease studies (n=381) [3 donepezil studies (2 mild cognitive impairment studies and 1 Alzheimer's Disease study), 1 galantaime study for mild cognitive impairment, 2 mementine studies for Alzheimer's Disease, and 1 rivastigmine study for mild cognitive impairment]. Pooled anti-dementia drugs showed superior protective outcomes compared with placebo regarding %TBV/y (SMD=-0.21, 95%CI=-0.37 to -0.04, P=.01, N=4, n=624) and %VV/y (SMD=-0.79, 95%CI=-1.40 to -0.19, P=.01, N=3, n=851). However, %HV/y failed to show difference between both groups. Among anti-dementia drugs, donepezil showed significantly greater protective effects than placebo regarding %TBV/y (SMD=-0.43, 95%CI=-0.74 to -0.12, P=.007, N=1, n=164) and %VV/y (SMD=-0.51, 95%CI=-0.73 to -0.29, P<.00001, N=2, n=338). Rivastigmine was also superior to placebo regarding %VV/y (SMD=-1.33, 95%CI=-1.52 to -1.14, P<.00001).Conclusions:The results favored the hypothesis that anti-dementia drugs may prevent brain atrophy in patients with mild cognitive impairment and Alzheimer's Disease. |
| Related Links | https://academic.oup.com/ijnp/article-pdf/18/12/pyv070/16832834/pyv070.pdf |
| File Format | |
| ISSN | 14611457 |
| e-ISSN | 14695111 |
| DOI | 10.1093/ijnp/pyv070 |
| Journal | International Journal of Neuropsychopharmacology |
| Issue Number | 12 |
| Volume Number | 18 |
| Language | English |
| Publisher | Oxford Academic |
| Publisher Date | 2015-11-01 |
| Access Restriction | Open |
| Subject Keyword | Neuroscience Science and Mathematics Alzheimer's Disease Dementia Minimal Cognitive Impairment Brain Volume Donepezil Rivastigmine Hippocampus Ventricular Volume Magnetic Resonance Imaging Cochrane Collaboration Prevention Brain Atrophy Mild Cognitive Impairment/alzheimer's Disease Meta-analysis Anti-dementia Drugs |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology Pharmacology (medical) Psychiatry and Mental Health |
