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A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients
BACKGROUND: Cognitive decline is common in older people. Numerous studies point to the detrimental impact of polypharmacy and inappropriate medication on older people’s cognitive function. Here we aim to systematically review evidence on the impact of medication optimisation and drug interventions o...
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
Springer International Publishing
2022
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| Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626423/ https://www.ncbi.nlm.nih.gov/pubmed/36284081 http://dx.doi.org/10.1007/s40266-022-00980-9 |
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| author | Pazan, Farhad Petrovic, Mirko Cherubini, Antonio Cruz-Jentoft, Alfonso J. Denkinger, Michael van der Cammen, Tischa J. M. Stevenson, Jennifer M. Ibrahim, Kinda Rajkumar, Chakravarthi Bakken, Marit Stordal Crome, Peter Guðmundsson, Adalsteinn Knol, Wilma Snijders, Birgitta M. G. O’Mahony, Denis Serra-Rexach, José Antonio Soulis, George van Marum, Rob J. Ziere, Gijsbertus Mair, Alpana Burkhardt, Heinrich Neumann-Podczaska, Agnieszka Wieczorowska-Tobis, Katarzyna Fernandes, Marilia Andreia Gruner, Heidi van der Velde, Nathalie Wehling, Martin |
| author_facet | Pazan, Farhad Petrovic, Mirko Cherubini, Antonio Cruz-Jentoft, Alfonso J. Denkinger, Michael van der Cammen, Tischa J. M. Stevenson, Jennifer M. Ibrahim, Kinda Rajkumar, Chakravarthi Bakken, Marit Stordal Crome, Peter Guðmundsson, Adalsteinn Knol, Wilma Snijders, Birgitta M. G. O’Mahony, Denis Serra-Rexach, José Antonio Soulis, George van Marum, Rob J. Ziere, Gijsbertus Mair, Alpana Burkhardt, Heinrich Neumann-Podczaska, Agnieszka Wieczorowska-Tobis, Katarzyna Fernandes, Marilia Andreia Gruner, Heidi van der Velde, Nathalie Wehling, Martin |
| author_sort | Pazan, Farhad |
| collection | PubMed |
| description | BACKGROUND: Cognitive decline is common in older people. Numerous studies point to the detrimental impact of polypharmacy and inappropriate medication on older people’s cognitive function. Here we aim to systematically review evidence on the impact of medication optimisation and drug interventions on cognitive function in older adults. METHODS: A systematic review was performed using MEDLINE and Web of Science on May 2021. Only randomised controlled trials (RCTs) addressing the impact of medication optimisation or pharmacological interventions on quantitative measures of cognitive function in older adults (aged > 65 years) were included. Single-drug interventions (e.g., on drugs for dementia) were excluded. The quality of the studies was assessed by using the Jadad score. RESULTS: Thirteen studies met the inclusion criteria. In five studies a positive impact of the intervention on metric measures of cognitive function was observed. Only one study showed a significant improvement of cognitive function by medication optimisation. The remaining four positive studies tested methylphenidate, selective oestrogen receptor modulators, folic acid and antipsychotics. The mean Jadad score was low (2.7). CONCLUSION: This systematic review identified a small number of heterogenous RCTs investigating the impact of medication optimisation or pharmacological interventions on cognitive function. Five trials showed a positive impact on at least one aspect of cognitive function, with comprehensive medication optimisation not being more successful than focused drug interventions. More prospective trials are needed to specifically assess ways of limiting the negative impact of certain medication in particular and polypharmacy in general on cognitive function in older patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40266-022-00980-9. |
| format | Online Article Text |
| id | pubmed-9626423 |
| institution | National Center for Biotechnology Information |
| language | English |
| publishDate | 2022 |
| publisher | Springer International Publishing |
| record_format | MEDLINE/PubMed |
| spelling | pubmed-96264232022-11-03 A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients Pazan, Farhad Petrovic, Mirko Cherubini, Antonio Cruz-Jentoft, Alfonso J. Denkinger, Michael van der Cammen, Tischa J. M. Stevenson, Jennifer M. Ibrahim, Kinda Rajkumar, Chakravarthi Bakken, Marit Stordal Crome, Peter Guðmundsson, Adalsteinn Knol, Wilma Snijders, Birgitta M. G. O’Mahony, Denis Serra-Rexach, José Antonio Soulis, George van Marum, Rob J. Ziere, Gijsbertus Mair, Alpana Burkhardt, Heinrich Neumann-Podczaska, Agnieszka Wieczorowska-Tobis, Katarzyna Fernandes, Marilia Andreia Gruner, Heidi van der Velde, Nathalie Wehling, Martin Drugs Aging Systematic Review BACKGROUND: Cognitive decline is common in older people. Numerous studies point to the detrimental impact of polypharmacy and inappropriate medication on older people’s cognitive function. Here we aim to systematically review evidence on the impact of medication optimisation and drug interventions on cognitive function in older adults. METHODS: A systematic review was performed using MEDLINE and Web of Science on May 2021. Only randomised controlled trials (RCTs) addressing the impact of medication optimisation or pharmacological interventions on quantitative measures of cognitive function in older adults (aged > 65 years) were included. Single-drug interventions (e.g., on drugs for dementia) were excluded. The quality of the studies was assessed by using the Jadad score. RESULTS: Thirteen studies met the inclusion criteria. In five studies a positive impact of the intervention on metric measures of cognitive function was observed. Only one study showed a significant improvement of cognitive function by medication optimisation. The remaining four positive studies tested methylphenidate, selective oestrogen receptor modulators, folic acid and antipsychotics. The mean Jadad score was low (2.7). CONCLUSION: This systematic review identified a small number of heterogenous RCTs investigating the impact of medication optimisation or pharmacological interventions on cognitive function. Five trials showed a positive impact on at least one aspect of cognitive function, with comprehensive medication optimisation not being more successful than focused drug interventions. More prospective trials are needed to specifically assess ways of limiting the negative impact of certain medication in particular and polypharmacy in general on cognitive function in older patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40266-022-00980-9. Springer International Publishing 2022-10-26 2022 /pmc/articles/PMC9626423/ /pubmed/36284081 http://dx.doi.org/10.1007/s40266-022-00980-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
| spellingShingle | Systematic Review Pazan, Farhad Petrovic, Mirko Cherubini, Antonio Cruz-Jentoft, Alfonso J. Denkinger, Michael van der Cammen, Tischa J. M. Stevenson, Jennifer M. Ibrahim, Kinda Rajkumar, Chakravarthi Bakken, Marit Stordal Crome, Peter Guðmundsson, Adalsteinn Knol, Wilma Snijders, Birgitta M. G. O’Mahony, Denis Serra-Rexach, José Antonio Soulis, George van Marum, Rob J. Ziere, Gijsbertus Mair, Alpana Burkhardt, Heinrich Neumann-Podczaska, Agnieszka Wieczorowska-Tobis, Katarzyna Fernandes, Marilia Andreia Gruner, Heidi van der Velde, Nathalie Wehling, Martin A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title | A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title_full | A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title_fullStr | A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title_full_unstemmed | A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title_short | A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients |
| title_sort | systematic review of the current evidence from randomised controlled trials on the impact of medication optimisation or pharmacological interventions on quantitative measures of cognitive function in geriatric patients |
| topic | Systematic Review |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626423/ https://www.ncbi.nlm.nih.gov/pubmed/36284081 http://dx.doi.org/10.1007/s40266-022-00980-9 |
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