JNNP: Evidence-based prevention of Alzheimer's disease: 243 prospective observational studies and 153 systematic evaluation and meta-analysis of randomized controlled trials.

There is a clear downward trend in the prevalence and incidence of dementia.
past few decades, scientists have worked to update evidence on how to prevent Alzheimer's disease (AD).
because different research designs have different goals and credibility, it is difficult to explain the basis for preventing Alzheimer's disease (AD).
the authors completed a systematic evaluation and meta-analysis of current cases using forward-looking studies.
: Search for electronic databases and related websites from the beginning until March 1, 2019.
include observational prospective studies (OPS) and randomized controlled trials (RPTs).
inclusion criteria are as follows: (1) OPS studies are based on publications written in English by the National Institute of Neurology and Stroke and the Alzheimer's Association (NINCDS-ADRDA) Standard (2), which provide easy access to source information for all included articles.
detailed exclusion criteria are shown in Figure 1.
score of the Cochrane tool or NOS is considered an indicator of the overall bias risk for each study.
each item's score assessed the associated bias risk.
then, the credibility of each Meta analysis is divided into four levels based on a combination of scores in three areas: good (G-grade), acceptable (A-level), susceptible (S-grade), and poor (P-grade).
were not involved in setting research questions or outcome measurements, nor in developing research designs or implementation plans.
patients were asked to make recommendations on the interpretation or writing of the results.
has no plans to disseminate the results to study participants or the patient community involved.
For RCT, 29 Meta analyses covering 11 interventions were conducted, resulting in a list of 21 evidence-based recommendations with different levels of evidence (11 on A and 10 on B) and recommended strength (19 on I and two on iii).
19 factors, including 10 factors with A-level evidence (cognitive activity, hypercysteineemia, advanced BMI elevation, depression, stress, diabetes, head trauma, middle-age hypertension, low body levels and education) and Nine factors with B-level evidence (obesity, physical activity, smoking, sleep, CVD, infirmity, atrial fibrillation, and vitamin C) make twenty-one clinical evidence-based recommendations that provide clinicians and patients with evidence-based guidelines for preventing AD.
These recommendations have reliable but indeterminate evidence, including diabetes, hypercysteineemia, poor BMI management, reduced education, high blood pressure in middle-life, low levels of boweal pressure, head trauma, reduced cognitive activity, stress and depression.
that there is an urgent need for more high-quality OPS and RCT to strengthen the evidence base to find more promising ways to prevent AD.
Yu J, Xu W, Tan C, et al Evidence-base prevention of Alzheimer's disease: system review and meta-analysis of 243 observational prospective studies and 153 randomised trials Journal of Neurology, Neurosurgery and PsimsyPublished Online First: 20 July 2020. doi: 10.1136/jnnp-2019-321913 Source: MedSci Original !-- Content Presentation End -- !-- Judge Whether to Log In End.