Scope of our work
The Cochrane Dementia and Cognitive Improvement Group produces systematic reviews within the following scope:
- Prevention, treatment, and management of acute or chronic acquired cognitive impairments, their manifestations and complications, and the care of people affected
- Enhancement of cognitive function in healthy adults
- Diagnosis of dementia
Our remit includes both global cognitive impairment and focal cognitive impairments occurring in the context of brain disease. Many of our reviews are concerned with dementia. However, our remit also extends to mild cognitive impairment; non-specific, age-associated cognitive impairment; delirium (primarily in elderly people; delirium in critically ill patients in intensive care units is covered by the Anaesthesia, Critical and Emergency Care Group); and the chronic effects of brain injury (acute effects are covered by the Injuries Group). We are also concerned, sometimes in collaboration with other relevant Cochrane Groups, with cognitive impairment occurring as a complication of diseases such as diabetes, stroke, Parkinson's disease and HIV infection. We will also publish intervention reviews in which the target population is carers of people with dementia.
We are increasingly concentrating our resources on high priority reviews and will only rarely accept review proposals for unlicensed pharmacological interventions.
Our intervention reviews may cover single or more complex interventions of all kinds, including pharmacological, psychological or behavioural, environmental, organisational, and alternative or complementary therapies. All relevant outcomes are considered including changes in cognitive function, behaviour, neuropsychiatric symptoms, activities of daily living, global clinical impression, dependency, quality of life, use of resources, survival, institutionalisation and effects on care givers. Where suitable data are available, cost-effectiveness comparisons are included in reviews.
Our diagnostic test accuracy reviews cover both neuropsychological tests and biomarkers. In those diagnostic test accuracy reviews which are concerned with the early diagnosis of brain diseases associated with dementia (such as Alzheimer's disease), then conversion to dementia is used as the reference standard.
Our four most highly cited publications in 2019 were
- Donepezil for dementia due to Alzheimer's disease
- CSF tau and the CSF tau/ABeta ratio for the diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI)
- Music-based therapeutic interventions for people with dementia
- Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia
Our four reviews most frequently used reviews in guidelines are:
- Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia (2018)
- Interventions for preventing delirium in hospitalised non-ICU patients (2016)
- Statins for the prevention of dementia (2015)
- Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia (2014)