Medications to treat agitation in dementia have no significant effect on cognition.

Key takeaways:

• Researchers reviewed 18 randomized clinical trials that recruited individuals with dementia and agitation/aggression.
• The effect of agitation treatment on cognitive performance was not statistically significant.

A systematic review and meta-analysis of trial literature found that medications investigated for treatment of agitation in dementia demonstrated no significant effect on cognition, according to a poster presentation at CTAD.

“Randomized controlled trials have investigated the potential of various medications to treat agitation in dementia,” Heather G. Belanger, PhD, vice president of research and assessment at Cognitive Research Corp. and collaborative professor of psychiatry and behavioral neurosciences at the University of South Florida, and colleagues wrote. “It is unclear whether cognition is significantly impacted.”

Belanger and colleagues conducted a review and meta-analysis to determine the extent to which various treatments for agitation may affect cognitive performance in clinical trials.

They culled data from electronic databases, including PubMed, EMBASE, International Pharmaceutical Abstracts, clinicaltrials.gov and the Cochrane Central Register of Controlled Trials, from inception to April 22, 2023, and also performed a manual search by screening reference lists of the included studies and recent reviews.

Of 138 full-text articles reviewed, researchers included 18 placebo-controlled trials of pharmaceuticals that recruited individuals with dementia and agitation or aggression, which also included standardized cognitive assessments.

The researchers evaluated study heterogeneity with the I² statistic and assigned attributes of low, moderate and high to values of 0 to 25%, 50% to 75% and more than 75%, respectively. They used fixed effect meta-analysis if there was no substantial heterogeneity and random effects models if heterogeneity was present.

Based on an I² of 89% (high heterogeneity), random effects models were used and researchers determined the overall effect of agitation treatment on cognitive performance was not statistically significant (standardized mean difference = -0.05; 95% CI, –0.26 to 0.16).

“Including measures of cognition in agitation trials for dementia appears to unnecessarily burden participants and increase study costs,” Belanger and colleagues wrote.