Details

Autor(en) / Beteiligte

• Yu, Jin-Tai
• Xu, Wei
• Tan, Chen-Chen
• Andrieu, Sandrine
• Suckling, John
• Evangelou, Evangelos
• Pan, An
• Zhang, Can
• Jia, Jianping
• Feng, Lei
• Kua, Ee-Heok
• Wang, Yan-Jiang
• Wang, Hui-Fu
• Tan, Meng-Shan
• Li, Jie-Qiong
• Hou, Xiao-He
• Wan, Yu
• Tan, Lin
• Mok, Vincent
• Tan, Lan
• Dong, Qiang
• Touchon, Jacques
• Gauthier, Serge
• Aisen, Paul S
• Vellas, Bruno

Titel

Evidence-based prevention of Alzheimer's disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials

Ist Teil von

• Journal of neurology, neurosurgery and psychiatry, 2020-11, Vol.91 (11), p.1201

Ort / Verlag

England

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Evidence on preventing Alzheimer's disease (AD) is challenging to interpret due to varying study designs with heterogeneous endpoints and credibility. We completed a systematic review and meta-analysis of current evidence with prospective designs to propose evidence-based suggestions on AD prevention. Electronic databases and relevant websites were searched from inception to 1 March 2019. Both observational prospective studies (OPSs) and randomised controlled trials (RCTs) were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment according to its risk of bias, inconsistency and imprecision. Levels of evidence and classes of suggestions were summarised. A total of 44 676 reports were identified, and 243 OPSs and 153 RCTs were eligible for analysis after exclusion based on pre-decided criteria, from which 104 modifiable factors and 11 interventions were included in the meta-analyses. Twenty-one suggestions are proposed based on the consolidated evidence, with Class I suggestions targeting 19 factors: 10 with Level A strong evidence (education, cognitive activity, high body mass index in latelife, hyperhomocysteinaemia, depression, stress, diabetes, head trauma, hypertension in midlife and orthostatic hypotension) and 9 with Level B weaker evidence (obesity in midlife, weight loss in late life, physical exercise, smoking, sleep, cerebrovascular disease, frailty, atrial fibrillation and vitamin C). In contrast, two interventions are not recommended: oestrogen replacement therapy (Level A2) and acetylcholinesterase inhibitors (Level B). Evidence-based suggestions are proposed, offering clinicians and stakeholders current guidance for the prevention of AD.