Goal: brain and mood
Evidence by Goal: Brain and Mood
Every graded record measured on memory, thinking, dementia, mood or loneliness, including the ones that failed. A letter here describes the human trial evidence for that use; it is not advice.
86 graded uses, grouped by what the trials measured, highest letter first within each group. Every letter is copied at build time from the record that owns it, and records graded D, tested without benefit or not yet tested, are listed with the rest.
Measured on deaths and disease events
Trials that counted deaths, heart attacks, strokes, fractures, falls, cancers or other clinical events.
- BHard clinical endpointProtocol · Individual-participant and trial-level meta-analyses A study that pools the numbers from several trials into one combined estimate. of randomized trials, and large randomized trials of intensive against standard targetsGrade for: Dementia or mild cognitive impairment
- DHard clinical endpoint · Tested, harm foundSupplement · Randomized controlled trials People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect. (harm found → D Route 2 Human randomized trials have been run and did not show benefit on the stated outcome. One of the two routes to the lowest letter on EBL's scale.)Endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score.: Tested at scale for cancer prevention in six large trials. Beta-carotene alone raised lung cancer in male smokers (ATBC); beta-carotene with retinyl palmitate raised lung cancer and death in smokers and asbestos workers (CARET, stopped early); in mostly non-smoking physicians and women it did nothing. A harm finding in smokers, a null in everyone else.
- DHard clinical endpoint · Tested, no benefitSupplement · Meta-analyses of randomized trials and a randomized trialGrade for: Dementia prevention in older adults
- DHard clinical endpoint · Not yet testedProtocol · Randomized placebo-controlled trials for shingles; natural experiments and observational Research that watches what people already do rather than assigning a treatment. It can show that two things travel together, not that one causes the other. studies, no randomized trial yet, for dementiaGrade for: Dementia in older adults
- DHard clinical endpoint · Not yet testedProtocol · Meta-analyses of randomized trials and randomized trials (meaning, purpose, distress, physical and cognitive tests); population studies of purpose with death, dementia and heart disease are listed as excluded evidence and carry no letterGrade for: Death, dementia and heart disease
- DHard clinical endpoint · Not yet testedProtocol · Randomized trials of disclosing APOE results and a meta-analysis of trials of DNA-based risk results (found no benefit on behavior or risk factors, D); risk estimates for e4 carriers come from genetic and population studies and are listed as excluded evidenceGrade for: Dementia, heart disease and death after learning the APOE result
- DHard clinical endpoint · Tested, no benefitPrescription · Randomized controlled trials and individual-participant meta-analyses of randomized trialsGrade for: Disability-free survival (living without dementia or persistent physical disability) in adults aged 70 and over without cardiovascular disease
Measured on function, or by a blinded clinician
Trials that measured performance with an instrument, or used a scale scored by a clinician who did not know the treatment.
- AMeasured functionProtocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies An observational study that follows a group of people over time and compares what happens to them. and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letterGrade for: Alertness and cognitive performance in the hours after an afternoon nap, healthy adults
- AMeasured functionProtocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letterGrade for: Cognitive performance during a night shift after an on-shift nap
- AMeasured functionProtocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letterGrade for: Memory retention after an afternoon nap
- ABlinded clinician ratingDevice or therapy · Randomized sham-controlled trials and meta-analyses, by useGrade for: Postoperative cognitive dysfunction in older adults having major surgery
- ADevice or therapy · Randomized controlled trials + meta-analysis of randomized trialsEndpoint: Response and remission in treatment-resistant major depression on blinded clinician-rated scales (HAM-D, MADRS)
- BMeasured functionSupplement · Meta-analyses of randomized trials and a randomized trialGrade for: Cognitive symptoms in mild to moderate dementia
- BSupplement · Meta-analysis of RCTs Randomized controlled trial: people are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect.Endpoint: Depression symptom scales (HAM-D and similar)
- BDevice or therapy · Randomized controlled trials + meta-analysis of randomized trialsEndpoint: Depression scores, response and remission in winter seasonal depression and non-seasonal major depression on clinician-rated scales (SIGH-SAD, HAM-D, MADRS)
- CMeasured functionSupplement · Meta-analyses + RCTGrade for: Memory and cognition in older adults
- CBlinded clinician ratingSupplement · Randomized trials and meta-analyses, mixed resultsGrade for: Symptoms in schizophrenia, as an adjunct A treatment tested on top of standard prescribed therapy rather than in place of it. to antipsychotic treatment
- CMeasured functionSupplement · Small randomized trials on measured cognitive testsEndpoint: Cognitive test scores in older adults with mild cognitive impairment
- CMeasured functionSupplement · Randomized controlled trialsEndpoint: Cognitive test performance in middle-aged and older adults
- CMeasured functionSupplement · RCT + systematic review A review that searches for every study on a question using a method set in advance, then assesses them together. + safety-association studyEndpoint: Cognitive scores in diagnosed mild cognitive impairment, Alzheimer's disease or diabetes with cognitive decline
- CBlinded clinician ratingSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: Behavior scores in autism spectrum disorder
- CBlinded clinician ratingSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: Negative symptoms of schizophrenia, added to antipsychotic treatment
- CMeasured functionSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: Cognition and memory in older adults
- CBlinded clinician ratingSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: Depression after cardiac procedures
- CMeasured functionSupplement · One randomized pilot + observational studiesEndpoint: Verbal learning in mild cognitive impairment
- CMeasured functionSupplement · RCTs + population studiesEndpoint: Cognitive decline in mild cognitive impairment and Alzheimer's disease
- CMeasured functionSupplement · Cochrane meta-analysis + RCTsEndpoint: Memory and behavior in chronic cerebral disorders of the elderly
- CMeasured functionSupplement · Meta-analyses + RCTEndpoint: Cognition in mild cognitive impairment and mild Alzheimer's disease, and diabetic neuropathy pain
- CMeasured functionSupplement · Randomized controlled trialsGrade for: Memory and cognition in older adults, bovine-cortex phosphatidylserine (no longer sold)
- CMeasured functionSupplement · Meta-analyses of randomized trials and a randomized trialGrade for: Mild cognitive impairment
- CBlinded clinician ratingSupplement · Small randomized trials and two pooled analyses, low quality; one large null trial on fatigueGrade for: Depressive symptoms
- CMeasured functionSupplement · Small randomized and controlled trials under acute stressEndpoint: Working memory and reaction measures during acute cold or combat stress
- CMeasured function
- CMeasured functionSupplement · Two small single-dose randomized trials from one laboratoryGrade for: Memory retrieval and contextual memory after a single oral dose of about 260 mg
- CMeasured functionSupplement · One placebo-controlled trial; other studies small, dose-order or uncontrolledGrade for: Cognition in older adultsEndpoint: Cognitive performance
- CBlinded clinician ratingSupplement · Randomized trials and meta-analyses, mixed for monotherapy, negative for add-on useGrade for: Major depressive disorder, SAM-e as monotherapy
- CMeasured functionProtocol · Meta-analyses of randomized trials + randomized trialsEndpoint: Objectively measured memory and cognitive test performance
- CMeasured functionProtocol · Meta-analysis of randomized trialsEndpoint: Objective cognitive test performance
- CMeasured functionProtocol · Randomized controlled trialEndpoint: A cognitive score (HDS-R) in mild cognitive impairment
- CMeasured functionProtocol · Randomized trials: one large multicenter trial with a prespecified subgroup analysis, one small trial in Alzheimer's diseaseGrade for: Cognitive decline over 3 years in older adults with hearing loss at higher risk of decline
- CMeasured functionProtocol · Randomized laboratory and workplace trials and meta-analyses of them (short-term alertness and performance); cohort studies and genetic analyses on heart disease, mortality and dementia are listed as excluded evidence and carry no letterGrade for: Reducing habitual napping in older adults: verbal memory over one year
- CMeasured functionProtocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letterGrade for: Dementia in care facilities: nighttime sleep with morning bright light
- CMeasured functionProtocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letterGrade for: Whole-day bright ceiling light in group care homes: cognitive decline and daily function
- CMeasured functionProtocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letterGrade for: Older adults without dementia: sleep with brighter morning or daytime indoor light
- CMeasured functionDevice or therapy · Systematic review of randomized trialsEndpoint: Cognition (limited human evidence)
- CMeasured functionDevice or therapy · Randomized sham-controlled trials and meta-analyses, by useGrade for: Cognitive test performance in healthy adults and mixed clinical samples
- CMeasured functionDevice or therapy · Randomized sham-controlled trials and meta-analyses, by useGrade for: Cognition in mild cognitive impairment
- CBlinded clinician ratingDevice or therapy · Randomized sham-controlled trials and meta-analyses, inconsistentGrade for: Depressive symptoms in major depression, clinic-administered
- CBlinded clinician ratingDevice or therapy · Randomized sham-controlled trials and meta-analyses, inconsistentGrade for: Depressive symptoms in major depression, home-based
- DMeasured function · Tested, no benefitSupplement · Randomized trials, mostly null on clinical outcomes; one unreplicated positiveGrade for: Cognition in mild cognitive impairment
- DHard clinical endpoint · Tested, no benefitSupplement · Animal + observational for aging (D Route 1 No human randomized trial has been run, so the record rests on animal or mechanistic evidence only. One of the two routes to the lowest letter on EBL's scale.); randomized trial null for memory (D Route 2); pharmacokinetic trialsGrade for: Memory in older adults with subjective cognitive decline
- DMeasured function · Tested, no benefitSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: Cognition in schizophrenia
- DMeasured function · Tested, no benefitSupplement · Randomized controlled trialsGrade for: Memory and cognition in older adults, soy-derived phosphatidylserine (the form sold)
- DMeasured function · Not yet testedSupplement · Two small single-dose randomized trials from one laboratoryGrade for: Daily low-dose methylene blue for memory or cognition
- DBlinded clinician rating · Tested, no benefitSupplement · Randomized trials and meta-analyses, mixed for monotherapy, negative for add-on useGrade for: Major depressive disorder, SAM-e added to an antidepressant
- DMeasured function · Tested, no benefitProtocol · Randomized controlled trials + meta-analysis of randomized trialsEndpoint: Cognitive function in older adults
- DMeasured function · Tested, no benefitProtocol · Randomized controlled trialEndpoint: Memory in older adults with memory complaints
- DMeasured function · Tested, no benefitProtocol · Observational harm-association study; no deprescribing Reducing or stopping a medication under a prescriber's supervision. RCT demonstrates benefitEndpoint: Cognition, falls, quality of life and mortality
- DMeasured function · Tested, no benefitProtocol · Randomized trials: one large multicenter trial with a prespecified subgroup analysis, one small trial in Alzheimer's diseaseGrade for: Cognitive decline over 3 years in adults aged 70 to 84 with untreated hearing loss, overall
- DMeasured function · Tested, no benefitProtocol · Randomized trials: one large multicenter trial with a prespecified subgroup analysis, one small trial in Alzheimer's diseaseGrade for: Cognition in people with Alzheimer's disease and hearing loss
- DMeasured function · Tested, no benefitProtocol · Randomized trials and Cochrane reviews of falls interventions (falls counted as events) and of cataract surgery against waiting; population studies on dementia, crashes and mortality are listed as excluded evidence and carry no letterGrade for: Cognitive test scores, cataract surgery in cognitively normal older adults
- DMeasured function · Tested, harm foundProtocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letterGrade for: Older adults with memory impairment living at home: 30 minutes of bright light within 30 minutes of rising
- DMeasured function · Not yet testedProtocol · Randomized laboratory and clinical trials and meta-analyses of them; population studies of personal light exposure, mood, sleep and mortality are listed as excluded evidence and carry no letterGrade for: Healthy adults: outdoor light within a fixed window after waking, for sleep, mood or energy
- DMeasured function · Tested, no benefitPrescription · Randomized controlled trials and individual-participant meta-analyses of randomized trialsGrade for: Preventing dementia and cognitive decline in older people
Measured on a blood marker or other stand-in
Trials that measured a number standing in for the outcome, such as blood pressure, LDL Low-density lipoprotein cholesterol, the cholesterol fraction most closely tied to plaque in the arteries. cholesterol or HbA1c A blood test that reflects average blood sugar over the previous two to three months.. These letters stop at B.
- BSurrogate biomarkerSupplement · Randomized controlled trialsEndpoint: Cortisol and stress or anxiety scores in stressed adults
- CSupplement · RCTs (small) + systematic reviewEndpoint: Sleep quality, mood and heart-rate variability (self-report and surrogate)
- CSurrogate biomarkerProtocol · Randomized controlled trialEndpoint: Telomere length, senescent T cells and cognitive measures in healthy older adults
- CSurrogate biomarkerDevice or therapy · Randomized controlled trialGrade for: 2.0 ATA or higher, 100% oxygen by mask or hoodEndpoint: cognition, vascular
- CSurrogate biomarkerDevice or therapy · Systematic review / meta-analysis of randomized trialsEndpoint: Structural brain change; cognition unestablished
- CSurrogate biomarkerDevice or therapy · Randomized controlled trials, one small trial per indication; the one hard-endpoint trial nullGrade for: Brain swelling after glioma surgery
- DSurrogate biomarker · Not yet testedProtocol · No trial of magnesium glycinate on this endpoint (D Route 1); class evidence from other magnesium salts shown as contextEndpoint: Blood pressure
Measured on what people reported
Trials that asked people how they felt or slept. These letters stop at B.
- BProtocol · Randomized double-blind Neither the participants nor the people assessing them know who received the real treatment until the trial ends. placebo-controlled trial (self-reported outcomes)Endpoint: Sleep in adults with insomnia and anxiety, measured by a wrist sleep monitor (actigraphy) in one trial and self-reported in the pooled trials
- BProtocol · Meta-analysis of randomized trialsEndpoint: Self-reported anxiety, depression and pain
- BProtocol · Meta-analyses of randomized trials and randomized trials (meaning, purpose, distress, physical and cognitive tests); population studies of purpose with death, dementia and heart disease are listed as excluded evidence and carry no letterGrade for: Self-reported meaning, purpose and distress, meaning-centered therapy (mostly people with cancer)
- BDevice or therapy · Meta-analyses of randomized trials and a sham-controlled randomized trialGrade for: Self-reported anxiety, HRV biofeedback (resonance breathing) training
- CSelf-reportSupplement · Meta-analyses + RCTGrade for: Major depressive disorder, as an adjunct to SSRI treatment
- CSelf-report
- CSelf-reportSupplement · Randomized controlled trials, small and short, mixed; meta-analyses in autism and schizophreniaGrade for: ADHD symptoms in children, added to methylphenidate
- CProtocol · One randomized trial of the glycinate form plus systematic reviews of other saltsEndpoint: Self-reported insomnia severity in adults with poor sleep
- CSelf-reportProtocol · Meta-analyses of randomized trials of loneliness programs and one randomized trial with mortality; cohort studies described, not gradedGrade for: Self-rated loneliness in older adults
- CProtocol · Meta-analyses of randomized trials and randomized trials (meaning, purpose, distress, physical and cognitive tests); population studies of purpose with death, dementia and heart disease are listed as excluded evidence and carry no letterGrade for: Self-reported meaning and purpose, programs for older adults without serious illness
- CSelf-reportDevice or therapy · Randomized controlled trialsGrade for: Physical complaints and appetite in mild depression (inpatients)Endpoint: Somatic complaint, hunger and relaxation scores; daily calorie intake
- CDevice or therapy · Systematic review / meta-analysis of randomized trialsEndpoint: Self-reported anxiety, sleep and pain; cognitive test scores
- DSelf-report · Tested, no benefitSupplement · RCTs + meta-analyses (use-specific)Grade for: Prevention of depression in adults aged 50 and over
- DSelf-report · Tested, no benefitDevice or therapy · Systematic review / meta-analysis of randomized trialsGrade for: Mood
- DTested, no benefitDevice or therapy · Sham-controlled RCTs + meta-analyses of randomized trialsEndpoint: ADHD symptoms in children and adolescents (self-report, blinding-sensitive)
Related pages