Williams P S, Rands G, Orrel M, Spector A
Forensic Psychiatry, Enfield Community Care NHS Trust, Flat 5, 35 Haringey Park, Crouch End, London, UK, N8 9JD.
Cochrane Database Syst Rev. 2000;2000(4):CD001296. doi: 10.1002/14651858.CD001296.
For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition, does the risk of cerebral or gastric haemorrhage outweigh any benefit?
To assess the evidence of effectiveness of the use of aspirin for vascular dementia.
Computerized databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references. The most recent search for trials was carried out in February 2000.
All randomized controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias.
Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim is to evaluate data recorded via tools assessing cognitive and behavioural changes along with mortality, morbidity and institutionalization data.
No trials are eligible for inclusion in this review.
REVIEWER'S CONCLUSIONS: There is no evidence that aspirin is effective in treating patients with a diagnosis of vascular dementia. Further research is needed to assess the effect of aspirin on cognition, and on other outcomes such as behaviour, and quality of life. At present there is no evidence relating to other queries about the use of aspirin for dementia (these are described in the Background section of this review). The most recent search for references to relevant research was carried out in February 2000, but no new evidence was found.
对于诊断为血管性痴呆的患者，有证据表明阿司匹林被广泛使用——在英国老年病医生和精神科医生完成的一项研究中，80%有认知障碍（伴有血管危险因素）的患者被开了阿司匹林。然而，一些问题仍未得到解答：是否有令人信服的证据表明阿司匹林对血管性痴呆患者有益？阿司匹林是否会影响认知或改善预后？此外，脑或胃出血的风险是否超过了任何益处？
评估使用阿司匹林治疗血管性痴呆有效性的证据。
由两名审阅者独立检索计算机化数据库。此外，还检索了相关网站并手工检索了一些期刊。向该领域的专家咨询未发表的材料，并对找到的任何出版物进行额外参考文献检索。最近一次对试验的检索于2000年2月进行。
纳入所有研究阿司匹林对血管性痴呆影响的随机对照试验。研究的纳入/排除包括对研究设计质量和偏倚风险的系统评估。
两名审阅者独立提取数据，使用预先测试的数据提取表，如有需要，联系作者获取论文中未提供的数据。目的是评估通过评估认知和行为变化以及死亡率、发病率和机构化数据的工具记录的数据。
没有试验符合纳入本综述的条件。
没有证据表明阿司匹林对诊断为血管性痴呆的患者有效。需要进一步研究以评估阿司匹林对认知以及对行为和生活质量等其他结局的影响。目前没有关于阿司匹林用于痴呆症的其他问题的证据（这些问题在本综述的背景部分进行了描述）。最近一次对相关研究参考文献的检索于2000年2月进行，但未发现新的证据。
