Summary
The Norwegian Directorate of Health commissioned the Norwegian Institute of Public Health (NIPH) to produce a series of evidence reviews – dating back to 2014 (and earlier) – with a view to the development of national evidence-based guidelines. These reviews draw largely on previous Cochrane reviews, and are accordingly cautious in their approach; being characteristically reluctant to take much of the published literature “on trust”.
On Potential Interventions for Dementia / Cognitive Decline Prevention
Various conclusions regarding dementia prevention include (quotation):
- Antihypertensive Drugs: a slight decrease in incidence of dementia in people with hypertension (low certainty of evidence).
- Statin Therapy: little or no difference on incidence of dementia in people with, or at risk of, cardiovascular disease (moderate certainty).
- Omega-3 Fatty Acids (FAs): little or no effect on cognitive test scores (moderate to high certainty).
- Computerised Cognitive Training: a slight improvement in cognitive test scores directly after the training (moderate certainty).
- Aerobic Exercise: little or no effect on cognitive test scores (low certainty).
Various conclusions regarding prevention of cognitive decline for people with mild cognitive impairment include (quotation):
- Cholinesterase Inhibitors: a slight decrease in dementia incidence, but to significantly more adverse events (moderate certainty).
- Vitamin E: little or no difference in incidence of Alzheimer’s dementia (moderate certainty).
- Omega-3 Fatty Acids (FAs): little or no difference in cognitive test scores (moderate to high certainty).
Reference
Flodgren, GM. [and] Berg, RC. (2016). Primary and Secondary Prevention Interventions for Cognitive Decline and Dementia. Oslo: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH), December 15th 2016.
See also, on the possible association of ChEIs or memantine with significantly higher rates of cognitive decline:
Reference
Kennedy, RE. Cutter, GR. [and] Fowler, ME. [et al] (2018). Association of concomitant use of cholinesterase inhibitors or Memantine with cognitive decline in Alzheimer clinical trials: a meta-analysis. JAMA Network Open, 1(7), pp.e184080-e184080.
On Psychological Interventions for People With Dementia
A 2014 summary of evidence on the efficacy of psychological interventions for people with dementia; with respect to outcomes including cognition, agitation, depression, anxiety, quality of life, activities of daily living and 24-hours care.
Reference
Dahm, KT. Dalsbø, TK. Håvelsrud, K. [et al] (2014). Effect of psychological interventions for people with dementia. Oslo: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); December 2014.
On Physical Activity and Various Other Care Interventions for People with Dementia
A 2014 summary of evidence on the efficacy of physical activity and other care interventions for people with dementia with respect to the same broad set of outcomes.
Reference
Dahm, KT. Dalsbø, TK. Håvelsrud, K. [et al] (2014). Effect of physical activity and other care interventions for people with dementia. Oslo: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); December 2014.
On Day Care Centers for People With Dementia
A 2011 summary of evidence on the efficacy of daycare for reducing admissions to nursing homes / care homes or hospital, and on other outcomes relevant to carers / families etc.
Reference
Reinar, LM. Fure, B. Kirkehei, I. [et al] (2011). Effect of day care centers for people with dementia. Oslo: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); December 2011.
Note: The full technical reports for each of these studies are available, although they are written in Norwegian.
