Systematic review investigating the reporting of comorbidities and medication in randomized controlled trials of people with dementia.
OBJECTIVES
dementia is a debilitating condition characterised by global loss of cognitive and intellectual functioning, which reduces social and occupational performance. This population frequently presents with medical co-morbidities such as hypertension, cardiovascular disease and diabetes. The CONSORT statement outlines recommended guidance on reporting of participant characteristics in clinical trials. It is, however, unclear how much these are adhered to in trials assessing people with dementia. This paper assesses the reporting of medical co-morbidities and prescribed medications for people with dementia within randomised controlled trial (RCT) reports.


DESIGN
a systematic review of the published literature from the databases AMED, CINAHL, MEDLINE, EMBASE and the Cochrane Clinical Trial Registry from 1 January 1997 to 9 January 2014 was undertaken in order to identify RCTs detailing baseline medical co-morbidities and prescribed medications . Eligible studies were appraised using the Critical Appraisal Skills Programme (CASP) RCT appraisal tool, and descriptive statistical analyses were calculated to determine point prevalence.


RESULTS
nine trials, including 1474 people with dementia, were identified presenting medical co-morbidity data. These indicated neurological disorders (prevalence 91%), vascular disorders (prevalence 91%), cardiac disorders (prevalence 74%) and ischaemic cerebrovascular disease (prevalence 53%) were most frequently seen.


CONCLUSIONS
published RCTs poorly report medical co-morbidities and medications for people with dementia. Future trials should include the report of these items to allow interpretation of whether the results are generalisable to frailer older populations.


PROSPERO REGISTRATION
CRD42013006735.
['Smith|Toby|T|', 'Maidment|Ian|I|', 'Hebding|Jennifer|J|', 'Madzima|Tairo|T|', 'Cheater|Francine|F|', 'Cross|Jane|J|', 'Poland|Fiona|F|', 'White|Jacqueline|J|', 'Young|John|J|', 'Fox|Chris|C|']
D000367:Age Factors D015897:Comorbidity D003625:Data Collection D003704:Dementia D006801:Humans D019338:Polypharmacy D015995:Prevalence D016032:Randomized Controlled Trials as Topic D012107:Research Design
systematic review dementia co-morbidity cognitive impairment older people