PMID- 36578447
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 1663-4365 (Print)
IS  - 1663-4365 (Electronic)
IS  - 1663-4365 (Linking)
VI  - 14
DP  - 2022
TI  - Comparative efficacy and acceptability of treatments for depressive symptoms in 
      cognitive impairment: A systematic review and Bayesian network meta-analysis.
PG  - 1037414
LID - 10.3389/fnagi.2022.1037414 [doi]
LID - 1037414
AB  - BACKGROUND: Depressive symptoms play an essential role in cognition decline, 
      while the benefit and acceptability of treatments for depressive symptoms in 
      cognitive impairment are still unknown. OBJECTIVE: To comprehensively evaluate 
      the comparative efficacy and acceptability of treatments for depressive symptoms 
      in cognitive impairment based on the quantitative Bayesian network meta-analysis 
      method (NMA). METHOD: We searched MEDLINE, Embase, the Cochrane Library, CINAHL, 
      and PsycINFO from inception until August 2022 to identify randomized clinical 
      trials (RCTs) evaluating treatments for depressive symptoms in cognitive 
      impairment. Efficacy was evaluated by the Cornell Scale for Depression in 
      Dementia (CSDD), the Hamilton Depression Rating Scale (HDRS), and the Geriatric 
      Depression Scale (GDS) for depression; the Neuropsychiatric Inventory (NPI) and 
      the Cohen-Mansfeld Agitation Inventory (CMAI) for behavior; and the Mini-Mental 
      State Examination (MMSE) for cognition. Safety was evaluated by total adverse 
      events (AEs), serious AEs, diarrhea, headache, and nausea. RESULTS: In this 
      study, 13,043 participants from 107 RCTs were included, involving 28 treatments 
      and the discontinuation of antidepressants. On CSDD, aerobic exercise (MD -4.51, 
      95%CrI -8.60 to -0.37), aripiprazole (MD -1.85, 95%CrI -3.66 to -0.02), 
      behavioral training (MD -1.14, 95%CrI -2.04 to -0.34), electrical current 
      stimulation (MD -3.30, 95%CrI -5.94 to -0.73), massage (MD -12.67, 95%CrI -14.71 
      to -10.59), music therapy (MD -2.63, 95%CrI -4.72 to -0.58), and reminiscence 
      therapy (MD -2.34, 95%CrI -3.51 to -1.25) significantly outperformed the placebo. 
      On MMSE, cognitive stimulation therapy (MD 1.42, 95%CrI 0.49 to 2.39), electrical 
      current stimulation (MD 4.08, 95%CrI 1.07 to 7.11), and reminiscence therapy (MD 
      1.31, 95%CrI 0.04 to 2.91) significantly outperformed the placebo. Additionally, 
      no treatments showed a significantly higher risk than the placebo. CONCLUSION: 
      Our NMAs indicated that non-pharmacological interventions were more efficacious 
      and safe than pharmacological treatments for reducing depressive symptoms as well 
      as improving cognitive impairment. Electrical current stimulation, aerobic 
      exercise, and reminiscence therapy could be first recommended considering their 
      beneficial performance on both depression and cognition. Hence, 
      non-pharmacological treatments deserve more attention and extensive application 
      and should at least be considered as an alternative or assistance in clinical 
      settings. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021239621, 
      identifier: CRD42021239621.
CI  - Copyright (c) 2022 Jin, Xv, Zhang, Qiao and Liu.
FAU - Jin, Boru
AU  - Jin B
AD  - Department of Neurology, First Affiliated Hospital of China Medical University, 
      Shenyang, Liaoning, China.
AD  - Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China.
FAU - Xv, Yunting
AU  - Xv Y
AD  - Department of Rehabilitation, Fourth Affiliated Hospital of China Medical 
      University, Shenyang, Liaoning, China.
FAU - Zhang, Bixuan
AU  - Zhang B
AD  - Department of Neurology, First Affiliated Hospital of China Medical University, 
      Shenyang, Liaoning, China.
FAU - Qiao, Lei
AU  - Qiao L
AD  - Department of General Surgery, Sheng Jing Hospital of China Medical University, 
      Shenyang, Liaoning, China.
FAU - Liu, Huayan
AU  - Liu H
AD  - Department of Neurology, First Affiliated Hospital of China Medical University, 
      Shenyang, Liaoning, China.
LA  - eng
PT  - Systematic Review
DEP - 20221212
PL  - Switzerland
TA  - Front Aging Neurosci
JT  - Frontiers in aging neuroscience
JID - 101525824
PMC - PMC9790988
OTO - NOTNLM
OT  - cognitive impairment
OT  - depressive symptoms
OT  - network meta-analysis
OT  - non-pharmacological (NON-Mesh)
OT  - pharmacological
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/12/30 06:00
MHDA- 2022/12/30 06:01
PMCR- 2022/01/01
CRDT- 2022/12/29 02:21
PHST- 2022/09/05 00:00 [received]
PHST- 2022/11/18 00:00 [accepted]
PHST- 2022/12/29 02:21 [entrez]
PHST- 2022/12/30 06:00 [pubmed]
PHST- 2022/12/30 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fnagi.2022.1037414 [doi]
PST - epublish
SO  - Front Aging Neurosci. 2022 Dec 12;14:1037414. doi: 10.3389/fnagi.2022.1037414. 
      eCollection 2022.