Table 5.
Results of evidence quality with GRADE.
| Included studies | Outcomes | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Relative effect (95% CI) | p-value | Quality |
|---|---|---|---|---|---|---|---|---|---|
| Cheng and Wu (2016) | PNTS (Watermeyer and Calia, 2019) | −1 | 0 | 0 | −1 | −1 | MD 16.30 (14.03,18.57) | <0.0001 | Very low |
| NPI (Kaur et al., 2019) | −1 | 0 | 0 | −1 | −1 | MD -6.42 (−8.87, −3.97) | <0.0001 | Very low | |
| ADAS-cog (van der Kant et al., 2020) | −1 | 0 | 0 | −1 | −1 | MD −3.63 (−4.82, −2.45) | <0.0001 | Very low | |
| Dong et al. (2018) | ADAS-cog (Watermeyer and Calia, 2019) | −1 | 0 | 0 | −1 | −1 | MD −3.65 (−5.82, −1.48) | 0.001 | Very low |
| MMSE (Watermeyer and Calia, 2019) | −1 | 0 | 0 | 0 | −1 | MD 0.49 (−1.45, 2.42) | 0.61 | Low | |
| GDS scale (Kaur et al., 2019) | −1 | 0 | 0 | 0 | −1 | MD −1.36 (−3.93, 1.21) | 0.30 | Low | |
| CGIC scale (Kaur et al., 2019) | −1 | 0 | 0 | −1 | −1 | MD −0.79 (−1.24, −0.34) | 0.0006 | Very low | |
| IADL scale (Kaur et al., 2019) | −1 | −1 | 0 | −1 | −1 | MD 0.59 (−1.21, 2.38) | 0.52 | Very low | |
| Liang et al. (2017) | MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | 0 | −1 | MD 1.05 (0.21,1.88) | 0.001 | Low |
| ADAS-cog (Watermeyer and Calia, 2019) | −1 | 0 | 0 | 0 | −1 | MD -0.71 (−1.04, −0.39) | <0.0001 | Low | |
| Liao et al. (2015) | MMSE (Silva et al., 2019) | −1 | 0 | 0 | 0 | −1 | MD 1.00 (0.41, 1.58) | 0.0008 | Low |
| High frequency MMSE (Leng and Edison, 2021) | −1 | 0 | 0 | 0 | −1 | MD 1.06 (0.47, 1.66) | 0.0004 | Low | |
| Low frequency MMSE (Watermeyer and Calia, 2019) | −1 | 0 | 0 | 0 | −1 | MD 0.97 (−0.62, 2.50) | 0.24 | Low | |
| Lin et al. (2019) | MMSE (Barker et al., 1985) | −1 | 0 | 0 | 0 | 0 | MD 0.60 (0.35, 0.85) | <0.001 | Moderate |
| Sing site MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | −1 | 0 | MD 0.13 (−0.35, 0.62) | 0.60 | Low | |
| Multiple sites MMSE (Birks and Harvey, 2018) | −1 | 0 | 0 | 0 | 0 | MD 0.86 (0.18, 1.54) | 0.01 | Moderate | |
| Short term treatment MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | −1 | −1 | MD 0.29 (−1.04, 1.62) | 0.67 | Very low | |
| Long term treatment MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | 0 | −1 | MD 2.77 (1.90, 2.92) | <0.0001 | Very low | |
| Wang et al. (2020) | MMSE (Pardo-Moreno et al., 2022) | −1 | 0 | 0 | 0 | −1 | MD 0.42 (0.18, 0.67) | 0.0006 | Moderate |
| Sing site MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | 0 | 0 | MD 0.24 (−0.45, 0.92) | 0.50 | Moderate | |
| Multiple sites MMSE (van der Kant et al., 2020) | −1 | 0 | 0 | 0 | 0 | MD 0.47 (0.14, 0.79) | 0.005 | Moderate | |
| Short term treatment MMSE (Braak et al., 2006) | −1 | 0 | 0 | 0 | −1 | MD 0.18 (−0.20, 0.56) | 0.36 | Low | |
| Long term treatment MMSE (Birks and Harvey, 2018) | −1 | 0 | 0 | 0 | −1 | MD 0.59 (0.28, 0.90) | 0.0002 | Low | |
| Xiu et al. (2024) | MMSE (Pardo-Moreno et al., 2022) | −1 | 0 | 0 | 0 | 0 | MD 3.64 (1.86, 5.42) | <0.0001 | Moderate |
| Short term treatment MMSE (Kaur et al., 2019) | −1 | 0 | 0 | 0 | −1 | MD 2.90 (−1.06, 6.86) | 0.15 | Low | |
| Long term treatment MMSE (Watermeyer and Calia, 2019) | −1 | 0 | 0 | 0 | −1 | MD 5.43 (2.84, 8.01) | <0.0001 | Low | |
| MoCA (Silva et al., 2019) | −1 | 0 | 0 | 0 | −1 | MD 3.69 (1.84, 5.54) | <0.0001 | Low | |
| ADAS-cog (Silva et al., 2019) | −1 | 0 | 0 | 0 | −1 | MD -3.53 (−4.91, −2.15) | <0.0001 | Low | |
| P300 latency (Kaur et al., 2019) | −1 | −1 | 0 | 0 | −1 | MD −38.32 (−72.40, −4.24) | 0.03 | Very low | |
| P300 amplitude (Kaur et al., 2019) | −1 | −1 | 0 | 0 | −1 | MD 1.09 (0.45, 1.72) | <0.0001 | Very low | |
| Zhang et al. (2022) | MMSE (Braak et al., 2006) | −1 | 0 | 0 | 0 | −1 | MD 1.82 (1.41, 2.22) | <0.0001 | Low |
| ADAS-cog (Leng and Edison, 2021) | −1 | 0 | 0 | 0 | −1 | MD 2.72 (1.77, 3.67) | <0.0001 | Low |
PNTS, picture naming test score; NPI, neuropsychiatric inventory; ADAS-cog, Alzheimer disease assessment cognitive scale; MMSE, mini-mental state examination; IADL, instrumental daily living activity; GDS, geriatric depression scale; CGIC, clinician’s global impression of change.