Treatment effects of pharmacotherapy and non-pharmacotherapy of Alzheimer dementia: A systematic review overview and updated network meta-analysis.

Abstract Introduction: Many existing systematic reviews and meta-analyses summarize the evidence of pharmacotherapies (PTs) and non-pharmacotherapies (NPTs) for wide range of available interventions for the management of Alzheimer dementia (AD). However, a succinct summary and efficacy comparison across the different types of treatments and interventions is lacking. We aim to identify the treatment or treatments with the highest efficacy of current pharmacological and non-pharmacological treatments for AD.Methods and analysis: Systematic reviews of randomized controlled trials (RCTs) will be selected according to the following criteria: conducted in elderly patients aged 60 years or older with AD, applied pairwise meta-analysis (PMA) or network meta-analysis (NMA) for pooled relative treatment effects for at least one pair of PTs and NPTs, and at least one of following outcomes was provided for patients/caregivers: cognitive function status, behavior, quality of life. The summary characteristics for each RCT will include the general design, participants, intervention, outcome measurements, duration of therapy and adverse events. The risk of bias will be assessed using Risk of Bias in Systematic Reviews (ROBIS) checklist and the risk of bias of individual RCTs will be assessed using the Revised Cochrane risk-of-bias tool.Ethics and Dissemination: Ethical approval will not be required because this study is based solely on published literature that meets accepted ethical standards, and there will be no concerns about privacy. Dissemination of the evidence obtained will include publication in a peer-reviewed international journal to improve clinical practices on the basis of robust scientific evidence.PROSPERO registration number: CRD42021228245