TY - JOUR
T1 - Systematic review of the effectiveness of pharmacologic interventions to improve quality of life and well-being in people with dementia
AU - Cooper, Claudia
AU - Mukadam, Naaheed
AU - Katona, Cornelius
AU - Lyketsos, Constantine G.
AU - Blazer, Dan
AU - Ames, David
AU - Rabins, Peter
AU - Brodaty, Henry
AU - De Mendonça Lima, Carlos
AU - Livingston, Gill
N1 - Funding Information:
HB: Grant support/sponsored speaker or advisory board member: NHMRC , Australian Commonwealth Department of Health and Ageing , Pfizer, Eisai, Janssen, Novartis, Lundbeck, Lilly, Medivation, Sanofi, Prana. CGL: Grant support (research or CME): NIMH , NIA , Associated Jewish Federation of Baltimore , Weinberg Foundation , Forest, Glaxo-Smith-Kline, Eisai, Pfizer, Astra-Zeneca, Lilly, Ortho-McNeil, Bristol-Myers, Novartis, National Football League , Elan; Consultant/Advisor: Astra-Zeneca, Glaxo-Smith Kline, Eisai, Novartis, Forest, Supernus, Adlyfe, Takeda, Wyeth, Lundbeck, Merz, Lilly, Pfizer, Genentech, NFL Players Association, NFL Benefits Office. Honorarium or travel support: Pfizer, Forest, Glaxo-Smith Kline, Health Monitor. CK: Paid lectures and consultancy fees from several pharmaceutical companies including Lilly Lundbeck and Pfizer Eisai; grant funding from Lundbeck. DA: Paid lectures, consultancy fees, advisory board membership and/or support for conference attendance from Eisai, Eli Lilly, Janssen-Cilag, Lundbeck, Novartis and Pfizer, and Prana. PR: legal testimony for Janssen Pharmaceutica , Grant support NIMH, NIA.
PY - 2013/2
Y1 - 2013/2
N2 - Objective: To review systematically, for the first time, the effectiveness of all pharmacologic interventions to improve quality of life and well-being in people with dementia. Design: Systematic review and meta-analysis. Methods: We systematically reviewed the 15 randomized controlled trials and one review that fitted predetermined criteria. We included studies that reported the outcomes quality of life, well-being, happiness, or pleasure. Measurements: We rated the validity of studies using a checklist. We calculated mean differences between intervention and control groups at follow-up. Results: None of the evaluated trials reported a significant benefit to quality of life or well-being for people with dementia when comparing those taking a drug or its comparator at follow-up (pooled weighted mean difference: 0.18 [95% confidence interval: -0.82 to 0.46]). Conclusion: We found no consistent evidence that any drug improves quality of life in people with dementia. We recommend that all dementia trials should include quality of life as an outcome, as this is important to patients, and cannot be presumed from improvements in cognition or other symptomatic outcomes, especially if the latter are small.
AB - Objective: To review systematically, for the first time, the effectiveness of all pharmacologic interventions to improve quality of life and well-being in people with dementia. Design: Systematic review and meta-analysis. Methods: We systematically reviewed the 15 randomized controlled trials and one review that fitted predetermined criteria. We included studies that reported the outcomes quality of life, well-being, happiness, or pleasure. Measurements: We rated the validity of studies using a checklist. We calculated mean differences between intervention and control groups at follow-up. Results: None of the evaluated trials reported a significant benefit to quality of life or well-being for people with dementia when comparing those taking a drug or its comparator at follow-up (pooled weighted mean difference: 0.18 [95% confidence interval: -0.82 to 0.46]). Conclusion: We found no consistent evidence that any drug improves quality of life in people with dementia. We recommend that all dementia trials should include quality of life as an outcome, as this is important to patients, and cannot be presumed from improvements in cognition or other symptomatic outcomes, especially if the latter are small.
KW - Dementia
KW - Quality of life
KW - Systematic review
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U2 - 10.1016/j.jagp.2012.10.018
DO - 10.1016/j.jagp.2012.10.018
M3 - Article
C2 - 23343491
AN - SCOPUS:85027931444
SN - 1064-7481
VL - 21
SP - 173
EP - 183
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 2
ER -