Journal article
Over-the-Counter Supplement Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia A Systematic Review
Annals of internal medicine, Vol.168(1), pp.52-62
01/02/2018
DOI: 10.7326/M17-1530
PMID: 29255909
Abstract
Background: Optimal interventions to prevent or delay cognitive decline, mild cognitive impairment (MCI), or dementia are uncertain.
Purpose: To summarize the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, MCI, or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis.
Data Sources: Multiple electronic databases from 2009 to July 2017 and bibliographies of systematic reviews.
Study Selection: English-language trials of at least 6 months' duration that enrolled adults without dementia and compared cognitive outcomes with an OTC supplement versus placebo or active controls.
Data Extraction: Extraction performed by a single reviewer and confirmed by a second reviewer; dual-reviewer assessment of risk of bias; consensus determination of strength of evidence.
Data Synthesis: Thirty-eight trials with low to medium risk of bias compared omega-3 fatty acids, soy, ginkgo biloba, B vitamins, vitamin D plus calcium, vitamin C or beta-carotene, multi-ingredient supplements, or other OTC interventions with placebo or other supplements. Few studies examined effects on clinical Alzheimer-type dementia or MCI, and those that did suggested no benefit. Daily folic acid plus vitamin B-12 was associated with improvements in performance on some objectively measured memory tests that were statistically significant but of questionable clinical significance. Moderate-strength evidence showed that vitamin E had no benefit on cognition. Evidence about effects of omega-3 fatty acids, soy, ginkgo biloba, folic acid alone or with other B vitamins, beta-carotene, vitamin C, vitamin D plus calcium, and multivitamins or multi-ingredient supplements was either insufficient or low-strength, suggesting that these supplements did not reduce risk for cognitive decline. Adverse events were rarely reported.
Limitation: Studies had high attrition and short follow-up and used a highly variable set of cognitive outcome measures.
Conclusion: Evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
Details
- Title: Subtitle
- Over-the-Counter Supplement Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia A Systematic Review
- Creators
- Mary Butler - Minneapolis VA Health Care SystemVictoria A. Nelson - Minneapolis VA Health Care SystemHeather Davila - Minneapolis VA Health Care SystemEdward Ratner - Minneapolis VA Health Care SystemHoward A. Fink - Minneapolis VA Health Care SystemLaura S. Hemmy - Minneapolis VA Health Care SystemJ. Riley McCarten - Minneapolis VA Health Care SystemTerry R. Barclay - Minneapolis VA Health Care SystemMichelle Brasure - Minneapolis VA Health Care SystemRobert L. Kane - Minneapolis VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Annals of internal medicine, Vol.168(1), pp.52-62
- Publisher
- Amer Coll Physicians
- DOI
- 10.7326/M17-1530
- PMID
- 29255909
- ISSN
- 0003-4819
- eISSN
- 1539-3704
- Number of pages
- 12
- Grant note
- 290-2015-00008-I / Agency for Healthcare Research and Quality; United States Department of Health & Human Services; Agency for Healthcare Research & Quality
- Language
- English
- Date published
- 01/02/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984359691802771
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