Meta AnalysisID 370

假马齿苋治疗阿尔茨海默病所致痴呆——系统评价与Meta分析

CRD42020169421

Among people with dementia or mild cognitive impairment due to Alzheimer’s disease, what is the efficacy of Bacopa Monnieri (Brahmi) as defined by change in standard neuropsychological scales from baseline, compared to p

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Meta Analysis Id
370
Evidence Id
8928
Core Evidence Id
8928
Source Meta Analysis Id
349
Herb2 Meta Analysis Id
HBMA000349
Crd Id
CRD42020169421
Title
Brahmi (Bacopa Monnieri) for Dementia due to Alzheimer’s Disease- Systematic Review and Meta-analysis
Review Question
Among people with dementia or mild cognitive impairment due to Alzheimer’s disease, what is the efficacy of Bacopa Monnieri (Brahmi) as defined by change in standard neuropsychological scales from baseline, compared to placebo or standard doses of Cholinesterase inhibitor?
Study Type Included
We will include randomised controlled trials (RCTs and quasi-RCTs) that have compared Brahmi with placebo or a choline esterase inhibitor (Donepezil or Rivastigmine) in persons with AD and MCI-AD. Quasi-randomised trials assign participants to treatments using methods that are partly systematic (for example, alternate allocation or allocation according to the day of the week), and so potentially predictable. Cohort studies, case control studies, case series, case reports, systematic reviews, policy papers/briefs, letter to the editors, correspondence, non-human studies will not be included in this review. We will include studies irrespective of any duration of intervention. We will consider cross-over trials for inclusion. We will include eligible studies regardless of publication status or language.
Condition Being Studied
Dementia is a clinical syndrome of acquired decline in cognitive abilities in one or more domains which causes impairment in activities of daily living and not due to delirium. Alzheimer Disease is the most common cause of dementia in elderly. Memory is the most commonly affected domain initially and later progresses to other domains causing global cognitive impairment. Pathology involves progressive loss of neurons and the deposition of amyloid plaques and neurofibrillary tangles. Mild cognitive impairment (MCI) is a clinical syndrome of acquired cognitive decline from their previous level of functioning and yet not interfering with daily activities. B. monnieri or Brahmi is a herb belonging to plant family Scrophulariaceae. Its medicinal properties have been reported in Indian traditional medicine (Ayurveda) literature for treatment of anxiety, intellect and memory disorders.4 Major active constituents in Brahmi with possible action on memory and cognition are bacoside-A and bacoside-B apart from other phytochemicals like alkaloids, saponins, flavonoids etc. Brahmi is available in tablet and capsule forms. Various doses are commonly used (250mg/day, 300 mg/day, 450 mg/day, 600 mg/day) each containing variable standardised extracts of Bacopa monnieri.
Participant
We will include individuals diagnosed with dementia due to Alzheimer’s Disease and Mild Cognitive Impairment-AD (MCI-AD) according to any internationally accepted criteria such as ICD-10, the Diagnostic and Statistical Manual of Mental Disorders (DSM IV or DSM V), NINCDS-ADRDA or Duboi’s criteria.
Animal
Human Disease Modelled
Intervention
• Brahmi (Bacopa Monnieri) of any formulation and dose given for any duration will be the intervention.
Comparator Control
• Placebo or any Choline esterase inhibitor at standard doses given for AD and MCI-AD will be the comparator
Main Outcome
The primary outcomes that will be assessed are: • Cognitive function (as measured by psychometric tests) • Activities of daily living • Behavioural disturbance • Clinical global impression • Quality of life • Dependency (such as institutionalisation) • Death • Acceptability of treatment as measured by withdrawal from trial • Safety as measured by the incidence of adverse effects • (including side effects) leading to withdrawal • Safety as measured by the overall incidence of adverse effects Cognitive function assessed by any standardized test will be included. Quality of life and Activity of daily living measured by any validated scale will be included. We will note physiological outcomes, such as plasma levels, changes on functional imaging or electroencephalogram (EEG) changes but will not assess them, as they are not primarily measuring efficacy. Measures of effect We will include all studies irrespective of dose and duration of intervention
Outcome Measure
Additional Outcome
None Measures of effect NA
Study Method
Meta-analysis, Systematic review
Keyword
Alzheimer Disease; Bacopa; Humans; Plant Extracts
Contact
Venugopalan Vishnu [email protected]
Organisational Affiliation
AII India Institute of Medical Sciences, New Delhi Pondicherry Institute of Medical Sciences, Puducherry Cochrane South Asia Prof BV Moses centre for evidence informed Healthcare and Health Policy
Funding Source
Indian Council of Medical Research (ICMR)
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
India
Review Stage
Review Ongoing
First Submission Date
2020-02-14
Registration Date
2020-04-28
Anticipated Start Date
2020-04-15
Anticipated Completion Date
2021-03-15
Title Cn
假马齿苋治疗阿尔茨海默病所致痴呆——系统评价与Meta分析
Title En
Brahmi (Bacopa Monnieri) for Dementia due to Alzheimer’s Disease- Systematic Review and Meta-analysis
Bilingual Status
complete