Background
Methods
Eligibility criteria
Outcomes
Data sources, study selection, data abstraction, and risk of bias appraisal
Data synthesis and analysis
Results
Characteristic | Number of Studies (%) |
---|---|
Age, mean (years) | |
< 70 | 7 (3.3) |
70–79·9 | 116 (55.5) |
≥ 80 | 68 (32.5) |
Not Reported | 18 (8.6) |
% Women | |
0–49 | 31 (14.8) |
50–100 | 165 (78.9) |
Not Reported | 13 (6.2) |
Type of Dementia | |
Multiple (e.g. AD + VaD) | 50 (23.9) |
AD | 110 (52.6) |
VaD | 10 (4.8) |
Othera | 9 (4.3) |
Not Reported | 30 (14.4) |
Severity of Dementia | |
Mild | 2 (1) |
Mild/Moderate | 67 (32.1) |
Mild/Moderate/Severe | 36 (17.2) |
Moderate | 5 (2.4) |
Moderate/Severe | 24 (11.5) |
Severe | 6 (2.9) |
Not Reported | 69 (33) |
Study Design | |
RCT | 148 (70.8) |
Cohort Study | 52 (24.9) |
Case-Control Study | 5 (2.4) |
Pairwise Meta-Analysis of RCTs | 2 (1) |
Other Non-Randomized Study | 2 (1) |
Setting | |
Clinic/Community | 65 (31.1) |
Hospital | 7 (3.3) |
Nursing home/Assisted Living | 45 (21.5) |
Multiple Settings | 22 (10.5) |
Not Reported | 70 (33.5) |
Sample Size (No. of patients) | |
< 200 | 64 (30.6) |
201–500 | 63 (30.1) |
> 500 | 81 (38.8) |
Not Reported | 1 (0.5) |
Duration of Intervention, weeks | |
< 13 | 65 (31.1) |
13–30 | 78 (37.3) |
> 30 | 57 (27.2) |
Not Reported | 9 (4.3) |
Fracture
Intervention (vs. Placebo) | Bayesian NMA OR Estimate (95% CrI) | Frequentist NMA OR Estimate (95% CI) |
---|---|---|
Fracture (n = 29 RCTs, 13,410 patients, 133 events) | ||
Anticonvulsants | 0.11 (< 0.01 to 2.10) | 0.21 (0.01 to 4.34) |
Antidepressants | 0.16 (< 0.01 to 5.34) | 0.28 (0.01 to 7.4) |
Antipsychotics | 0.72 (0.33 to 1.66) | 0.64 (0.3 to 1.37) |
Cholinesterase Inhibitors | 1.34 (0.86 to 2.14) | 1.29 (0.81 to 2.04) |
Cholinesterase Inhibitors + Memantine | 6.63 (0.75 to 209.7) | 4.84 (0.51 to 46.35) |
Memantine | 0.58 (0.16 to 1.93) | 0.64 (0.16 to 2.64) |
Mortality (n = 104 RCTs, 38,683 patients, 1037 events) | ||
Anticonvulsants | 1.29 (0.55 to 2.95) | 1.13 (0.48 to 2.64) |
Antidepressants | 0.83 (0.33 to 2.25) | 0.88 (0.36 to 2.16) |
Antipsychotics | 1.17 (0.87 to 1.6) | 1.14 (0.84 to 1.55) |
Cholinesterase Inhibitors | 0.82 (0.68 to 1) | 0.8 (0.65 to 0.98) |
Cholinesterase Inhibitors + Memantine | 0.85 (0.45 to 1.67) | 0.86 (0.44 to 1.65) |
Memantine | 1.08 (0.78 to 1.45) | 1.05 (0.77 to 1.44) |
Cerebrovascular Event (n = 47 RCTs, 19,070 patients, 314 events) | ||
Anticonvulsants | 1.04 (0.1 to 11.39) | 1.03 (0.1 to 10.03) |
Antidepressants | 0.19 (< 0.01 to 5.85) | 0.32 (0.01 to 8.23) |
Antipsychotics | 2.23 (1.36 to 3.79) | 1.94 (1.15 to 3.27) |
Cholinesterase Inhibitors | 1.02 (0.72 to 1.48) | 1.01 (0.72 to 1.39) |
Cholinesterase Inhibitors + Memantine | 1.11 (0.29 to 3.8) | 0.99 (0.28 to 3.46) |
Dextromethorphan-Quinidine | 1.35 (0.03 to 55.23) | 1.37 (0.08 to 22.18) |
Memantine | 0.76 (0.45 to 1.29) | 0.74 (0.43 to 1.28) |
Fall (n = 58 RCTs, 21,776 patients, 1751 events) | ||
Anticonvulsants | 1.31 (0.89 to 1.95) | 1.33 (0.94 to 1.87) |
Antidepressants | 1.06 (0.54 to 2.09) | 1.13 (0.55 to 2.32) |
Antipsychotics | 0.99 (0.79 to 1.23) | 0.98 (0.79 to 1.2) |
Cholinesterase Inhibitors | 0.93 (0.77 to 1.14) | 0.94 (0.78 to 1.13) |
Cholinesterase Inhibitors + Memantine | 0.97 (0.63 to 1.48) | 1.06 (0.68 to 1.66) |
Dextromethorphan-Quinidine | 4.24 (1.47 to 14.79) | 3.97 (1.36 to 11.55) |
Memantine | 0.95 (0.77 to 1.17) | 0.96 (0.79 to 1.18) |
Intervention (vs. Placebo/Control) | Combined RCT + NRS RR (95% CrI) | RCT RR (95% CrI) | NRS RR (95% CrI) |
---|---|---|---|
Fracture | |||
Anticonvulsants | 0.63 (0.05 to 6.54) | 0.63 (0.08 to 4.33) | – |
Antidepressants | 0.82 (0.16 to 3.24) | 0.74 (0.12 to 3.11) | 0.94 (0.25 to 2.39) |
Antipsychotics | 0.89 (0.29 to 2.68) | 0.77 (0.36 to 1.58) | 1.05 (0.41 to 2.25) |
Cholinesterase Inhibitor + Memantine | 6.18 (0.5 to 325.1) | 6.1 (0.7 to 294.8) | – |
Cholinesterase Inhibitors | 1.02 (0.36 to 2.76) | 1.23 (0.81 to 1.91) | 0.84 (0.48 to 1.52) |
Memantine | 0.59 (0.1 to 3.38) | 0.59 (0.17 to 1.93) | – |
Mortality | |||
Anticonvulsants | 1.28 (0.82 to 1.99) | 1.27 (0.81 to 2.0) | 1.29 (0.85 to 1.9) |
Antidepressants | 0.86 (0.5 to 1.48) | 0.86 (0.49 to 1.5) | 0.87 (0.52 to 1.43) |
Antipsychotics | 1.33 (1.01 to 1.73) | 1.28 (1 to 1.59) | 1.38 (1.13 to 1.69) |
Anxiolytic/hypnotics | 0.84 (0.41 to 1.72) | – | 0.84 (0.44 to 1.61) |
Cholinesterase Inhibitor + Memantine | 1.04 (0.68 to 1.58) | 1.02 (0.66 to 1.52) | 1.06 (0.72 to 1.57) |
Cholinesterase Inhibitors | 0.84 (0.65 to 1.1) | 0.84 (0.71 to 0.99) | 0.84 (0.68 to 1.04) |
Memantine | 1.15 (0.84 to 1.59) | 1.12 (0.87 to 1.43) | 1.17 (0.87 to 1.64) |
Cerebrovascular Event | |||
Anticonvulsants | 1.03 (0.1 to 11.56) | 1.02 (0.15 to 8.05) | – |
Antidepressants | 0.27 (< 0.01 to 8.34) | 0.28 (< 0.01 to 6.8) | – |
Antipsychotics | 1.76 (0.57 to 4.79) | 2.02 (1.25 to 3.39) | 1.51 (0.63 to 3.28) |
Cholinesterase Inhibitor + Memantine | 1.04 (0.16 to 5.73) | 1.05 (0.27 to 3.29) | – |
Cholinesterase Inhibitors | 0.93 (0.3 to 2.5) | 0.99 (0.72 to 1.42) | 0.86 (0.33 to 1.89) |
Dextromethorphan-Quinidine | 1.11 (0.03 to 40.95) | 1.11 (0.04 to 30.25) | – |
Memantine | 0.76 (0.18 to 3.11) | 0.76 (0.45 to 1.28) | – |
Fall | |||
Anticonvulsants | 1.09 (0.26 to 4.6) | 1.09 (0.64 to 1.89) | – |
Antidepressants | 1.32 (0.49 to 3.98) | 1.16 (0.67 to 1.97) | 1.59 (0.79 to 2.84) |
Antipsychotics | 1.21 (0.5 to 3.74) | 1.05 (0.91 to 1.23) | 1.54 (0.82 to 2.88) |
Cholinesterase Inhibitor + Memantine | 0.97 (0.24 to 3.94) | 0.96 (0.66 to 1.43) | – |
Cholinesterase Inhibitors | 0.94 (0.24 to 3.73) | 0.94 (0.79 to 1.14) | – |
Dextromethorphan-Quinidine | 3.66 (0.72 to 18.91) | 3.65 (1.4 to 10.42) | – |
Memantine | 0.95 (0.24 to 3.82) | 0.95 (0.79 to 1.15) | – |