Evidence for Alzheimer’s Disease (AD) is collected using observational prospective studies (OPS). Large community samples and potential causal links are identified. Randomized controlled trials (RCTs) are standard to test the effects of interventions. Their credibility gets lowered due to heterogeneous endpoints and varying designs. This systematic review aims to design current evidence-based suggestions to prevent AD.
The new study was designed using both the OPS and RCT. Relevant websites and electronic databases were searched to identify 44676 reports. Multivariable-adjusted effects got estimated. Random-effects model pooled them. The credibility assessment factored in inconsistency, imprecision, and bias risk. The summaries included levels of evidence and classes of suggestions.
The researchers analyzed the eligible 243 OPS and 153 RCT. The meta-analysis involved 104 modifiable factors and 11 interventions. The consolidated evidence was used to propose 21 suggestions in two classes. The Class I suggestions had 19 target factors with 10 Level A strong evidence factors. They include education, depression, stress, cognitive activity, diabetes, head trauma, hyperhomocysteinemia, high body mass index in late life, and orthostatic hypotension. The 9 Level B weaker evidences included obesity in midlife, physical exercise, smoking, weight loss in late life, sleep, frailty, cerebrovascular disease, atrial fibrillation, and vitamin C. The two interventions, not recommended, were acetylcholinesterase inhibitors (Level B) and estrogen replacement therapy (Level A2).
Clinicians can use these suggestions as a guide for AD prevention.
Ref: https://jnnp.bmj.com/content/91/11/1201
