Hyperbaric oxygen did not importantly improve cognitive function in patients with vascular dementia (Cochrane Review)

Clinical bottom line:
1. No evidence of improvement in cognitive state with the addition of HBOT to donepezil for the treatment of vascular dementia.

1. Xiao Y, Wang J, Jiang S, Luo H. Hyperbaric oxygen therapy for vascular dementia. Cochrane Dementia and Cognitive Improvement Group, editor. Cochrane Database of Systematic Reviews. 2012 Jul 11;31(7):478–23.

Lead author's name and fax: Xiao, Y et al (Contact: Jin Wang wangjin72@126.com)
Three-part Clinical Question: For patients with vascular dementia, does the addition of hyperbaric oxygen to treatment with the anti-cholinesterase donepezil, result in improved cognition?
Search Terms: vascular dementia, cognition
The Review:

Data Sources: Comprehensive search strategy in appropriate databases.

Study Selection: RCTs comparing HBOT to no intervention or to sham HBOT or comparing HBOT plus another treatment to the same other treatment in patients with vascular dementia

Data Extraction: Cochrane methodology

The Evidence:
1070 papers screened 1 study included in the review. 64 patients comparing HBOT as an adjuvant to donepezil to donepezil alone.

Weighted Mean Difference
Mini Mental State Examination
12 wks
0.91 to 6.09
Hasegawas Dementia Rating Scale
12 wks
1.16 to 5.04


1) One study only available as RCT and it has significant flaws in design (no sham, no blinding, some important outcomes not done (eg global function, behavioural disturbances and ADLs were not included in the outcome measures).

2) No safety assessment was done at all in the one study listed.

Appraised by: Dr Glen Hawkins Hyperbaric Health, Suite 3 Ground Floor, 46-50 Kent Road Mascot, NSW 2020, Australia Fax +61282125987 ; 8 January 2018

Email: glen@hawkeyemedical.com.au

Kill or Update By: June 2020