A systematic review of the safety and efficacy on cognitive function of herbal and nutritional medicines in older adults with and without subjective cognitive impairment

Systematic Reviews

Research

Adele E. Cave¹  Dennis H. Chang¹  Gerald W. Münch²  Genevieve Z. Steiner-Lim³ 

[1] NICM Health Research Institute, Western Sydney University, Locked Bag 1797, 2751, Penrith, NSW, Australia;NICM Health Research Institute, Western Sydney University, Locked Bag 1797, 2751, Penrith, NSW, Australia;School of Medicine, Western Sydney University, 2751, Penrith, NSW, Australia;NICM Health Research Institute, Western Sydney University, Locked Bag 1797, 2751, Penrith, NSW, Australia;Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, 2751, Penrith, NSW, Australia;

关键词: Cognition;    Complementary medicine;    Herbal medicine;    Nutrition;    Subjective cognitive impairment (SCI);    Mild cognitive impairment (MCI);    Dementia;    Alzheimer’s disease;    Systematic review;   

DOI  :  10.1186/s13643-023-02301-6

 received in 2022-03-15, accepted in 2023-07-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSubjective cognitive impairment (SCI) substantially increases dementia risk and is often conceptualised as the preclinical asymptomatic phase of the cognitive decline continuum. Due to the lack of pharmacological interventions available to treat SCI and reduce dementia risk, and the popularity of herbal and nutritional medicines, the primary aim of this review was to investigate the efficacy on cognitive function and safety of herbal and nutritional medicines (relative to a control) for older adults with and without SCI. The secondary aims were to describe the study characteristics and assess the methodological quality of included studies.MethodFive databases (Cochrane, MEDLINE, CINAHL, PsycInfo, and EMBASE) were searched from database inception with weekly alerts established until review finalisation on 18 September 2022. Articles were eligible if they included the following: study population of older adults with and without SCI, herbal and nutritional medicines as an intervention, evaluated cognitive outcomes and were randomised control trials.ResultsData were extracted from 21/7666 eligible full-text articles, and the risk of methodological bias was assessed (with SCI = 9/21; without SCI = 12/21). Most studies (20/21) employed parallel, randomised, placebo-controlled designs and were 12 weeks in length. Herbal supplements were widely used (17/21), namely a form of Ginkgo biloba (8/21) or Bacopa monnieri (6/21). Measures of cognition varied across studies, with 14/21 reporting improvements in at least one domain of cognitive functioning over time, in the intervention group (compared to control). A total of 14/21 studies were deemed as having an overall high methodological risk of bias, 6/21 had some concerns, and only one study (using an SCI population) was assessed as having a low risk of methodological bias.ConclusionsOverall, this review found that there is a low quality of evidence regarding the efficacy of cognitive function and safety of herbal and nutritional medicines for older adults with and without SCI, due to a high risk of bias across studies. Additionally, further work needs to be done in classifying and understanding SCI and selecting appropriate trial primary outcomes before future studies can more accurately determine the efficacy of interventions for this population.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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