Evidence map›Paper›PMID 36284081›Full record

SynthesisDrugs & aging2022

A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients.

Farhad Pazan, Mirko Petrovic, Antonio Cherubini, Alfonso J Cruz-Jentoft, Michael Denkinger, Tischa J M van der Cammen, Jennifer M Stevenson, Kinda Ibrahim, Chakravarthi Rajkumar, Marit Stordal Bakken and 17 more

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Drugs & aging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 20 institutions in 12 countries.

Farhad PazanClinical Pharmacology Mannheim, Faculty of Medicine Mannheim, Ruprecht-Karls-University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Mirko PetrovicSection of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
Antonio CherubiniGeriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy.
Alfonso J Cruz-JentoftServicio de Geriatría. Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
Michael DenkingerInstitute for Geriatric Research, University of Ulm and Geriatric Center Ulm, Agaplesion Bethesda Hospital, Ulm, Germany.
Tischa J M van der CammenFaculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
Jennifer M StevensonInstitute of Pharmaceutical Science, King's College London, London, UK.
Kinda IbrahimAcademic Geriatric Medicine, Faculty of Medicine, Southampton University, Southampton, UK.
Chakravarthi RajkumarGeriatric & Stroke Medicine, Brighton and Sussex Medical School, Brighton, UK.
Marit Stordal BakkenDepartment of Clinical Science, University of Bergen, Bergen, Norway.
Peter CromeKeele University, Newcastle under Lyme, UK.
Adalsteinn GuðmundssonUniversity of Iceland, Geriatrics K4, Landspítali University, Reykjavík, Iceland.
Wilma KnolGeriatrics, Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Birgitta M G SnijdersDepartment of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Denis O'MahonyDepartment of Medicine, University College Cork, Cork University Hospital, Cork, Ireland.
José Antonio Serra-RexachGeriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
George SoulisOutpatient Geriatric Assessment Unit, Henry Dunant Hospital Center, Athens, Greece.
Rob J van MarumDepartment of General Medicine and Geriatric Medicine, Free University, Amsterdam, The Netherlands.
Gijsbertus ZiereSection of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Alpana MairEffective Prescribing and Therapeutics, Scottish Government, Edinburgh, EH1 3DG, UK.
Heinrich BurkhardtIV. Medical Department, Geriatrics, University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
Agnieszka Neumann-PodczaskaDepartment of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Katarzyna Wieczorowska-TobisDepartment of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Marilia Andreia FernandesDepartment of Internal Medicine/ Geriatric Clinic, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Heidi GrunerDepartment of Internal Medicine/ Geriatric Clinic, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Nathalie van der VeldeDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Martin WehlingClinical Pharmacology Mannheim, Faculty of Medicine Mannheim, Ruprecht-Karls-University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. martin.wehling@medma.uni-heidelberg.de.
Heidelberg University · DEHospital Curry Cabral · PTUniversity of Amsterdam · NLBrighton and Sussex Medical School · GBDelft University of Technology · NLErasmus MC · NLGhent University Hospital · BEGuy's and St Thomas' NHS Foundation Trust · GBHenry Dunant Hospital · GRHospital General Universitario Gregorio Marañón · ESHospital Universitario Ramón y Cajal · ESIstituti di Ricovero e Cura a Carattere Scientifico · ITKeele University · GBNational University Hospital of Iceland · ISPoznan University of Medical Sciences · PLScottish Government · GBUniversität Ulm · DEUniversity College Cork · IEUniversity Hospital of Lord’s Transfiguration · PLUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCognitive decline is common in older people. Numerous studies point to the detrimental impact of polypharmacy and inappropriate medication on older people's cognitive function. Here we aim to systematically review evidence on the impact of medication optimisation and drug interventions on cognitive function in older adults.

methodsA systematic review was performed using MEDLINE and Web of Science on May 2021. Only randomised controlled trials (RCTs) addressing the impact of medication optimisation or pharmacological interventions on quantitative measures of cognitive function in older adults (aged > 65 years) were included. Single-drug interventions (e.g., on drugs for dementia) were excluded. The quality of the studies was assessed by using the Jadad score.

resultsThirteen studies met the inclusion criteria. In five studies a positive impact of the intervention on metric measures of cognitive function was observed. Only one study showed a significant improvement of cognitive function by medication optimisation. The remaining four positive studies tested methylphenidate, selective oestrogen receptor modulators, folic acid and antipsychotics. The mean Jadad score was low (2.7).

conclusionThis systematic review identified a small number of heterogenous RCTs investigating the impact of medication optimisation or pharmacological interventions on cognitive function. Five trials showed a positive impact on at least one aspect of cognitive function, with comprehensive medication optimisation not being more successful than focused drug interventions. More prospective trials are needed to specifically assess ways of limiting the negative impact of certain medication in particular and polypharmacy in general on cognitive function in older patients.

Indexed as

Antipsychotic AgentsCognitive DysfunctionAgedCognitionHumansPolypharmacyRandomized Controlled Trials as TopicAntipsychotic Agents

Identifiers

PMID36284081
PMCPMC9626423
OpenAlexW4307342465

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.