The efficacy of pharmacological interventions to improve cognitive and behavior symptoms in people with dementia: A systematic review and meta‐analysis

Abstract

Background and Aims: Dementia is becoming a major global public health menace in the aging population affecting 47 million people globally. Dementia has no cure and effective interventions. Treatment of dementia is a big problem. The most common symptomatic medications for cognition, behavior, and global functioning among patients with dementia currently are cholinesterase inhibitors and memantine. However, Information on the effectiveness of cholinesterase inhibitors for dementia is conflicting and controversial. Thus, this makes it difficult for decision-makers, healthcare providers, patients, and caregivers to decide on the most effective intervention. The current metaanalysis sought to investigate the efficacy of pharmacologic interventions to improve cognitive and behavioral symptoms in people with living dementia.Methods: This current systematic review and meta-analysis used the preferred reporting items for systematic reviews and meta-analyses to ensure accuracy and comprehensiveness. The Cochrane MEDLINE, Database of Systematic Reviews, and other databases were thoroughly searched for relevant studies. We selected Studies such as randomized controlled trials published in English with a sample size of at least 20 subjects. We selected and applied the random-effects meta-analysis as the most preferred model because of the heterogeneity across studies. The computation of the weighted effect size was based on the result from the test of heterogeneity.Results: Twenty-two studies were finally used in the meta-analysis. The study subjects who received donepezil 5 mg/day, donepezil 10 mg/day, and galantamine 24 mg/day had improved cognition symptoms (ADAS-cog) score of −1.46 (95%

Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis

“…Cognitive enhancers (donepezil, rivastigmine, galantamine, and memantine) also slow the rate of cognitive decline. 52,53 Although these older drugs, as monotherapy, do not provide a benefit that exceeds the MCID, at least their safety and cost are much better than those of the newer agents. To our knowledge, no head-to-head comparisons exist, and a search of ClinicalTrials.gov performed February 2, 2023 failed to identify any planned clinical trials comparing cholinesterase inhibitors and anti-amyloid antibodies in adults with dementia.…”