Journal ArticleDOI
A 5-month, randomized, placebo-controlled trial of galantamine in AD
TLDR
Slow dose escalation appears to enhance the tolerability of galantamine, minimizing the incidence and severity of adverse events and significantly benefits the cognitive, functional, and behavioral symptoms of AD.Abstract:
Objective: To investigate the efficacy and tolerability of galantamine, using a slow dose escalation schedule of up to 8 weeks, in 978 patients with mild to moderate AD. Methods: A 5-month multicenter, placebo-controlled, double-blind trial. Following a 4-week placebo run-in, patients were randomized to one of four treatment arms: placebo or galantamine escalated to final maintenance doses of 8, 16, or 24 mg/day. Outcome measures included the cognitive subscale of the AD Assessment Scale (ADAS-cog), the Clinician’s Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus), the AD Cooperative Study Activities of Daily Living inventory, and the Neuropsychiatric Inventory. Standard safety evaluations and adverse event monitoring were carried out. Results: After 5 months, the galantamine–placebo differences on ADAS-cog were 3.3 points for the 16 mg/day group and 3.6 points for the 24 mg/day group ( p Conclusions: Galantamine 16 and 24 mg/day significantly benefits the cognitive, functional, and behavioral symptoms of AD as compared with placebo. Slow dose escalation appears to enhance the tolerability of galantamine, minimizing the incidence and severity of adverse events.read more
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Journal ArticleDOI
Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study.
Constantine G. Lyketsos,Oscar L. Lopez,Beverly N. Jones,Annette L. Fitzpatrick,John C.S. Breitner,Steven T. DeKosky +5 more
TL;DR: These are the first population-based estimates for neuropsychiatric symptoms in MCI, indicating a high prevalence associated with this condition as well.
Journal ArticleDOI
Practice parameter: Diagnosis of dementia (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology
Rachelle S. Doody,James C. Stevens,Cornelia Beck,Richard Dubinsky,Jeffrey Kaye,Lisa P. Gwyther,Richard C. Mohs,Leon J. Thal,Peter J. Whitehouse,Steven T. DeKosky,Jeffrey L. Cummings +10 more
TL;DR: Dementia criteria for dementia have improved since the 1994 practice parameter, and further research is needed to improve clinical definitions of dementia and its subtypes, as well as to determine the utility of various instruments of neuroimaging, biomarkers, and genetic testing in increasing diagnostic accuracy.
Reference EntryDOI
Cholinesterase inhibitors for Alzheimer's disease
TL;DR: Treatment for periods of 6 months and one year, with donepezil, galantamine or rivastigmine at the recommended dose for people with mild, moderate or severe dementia due to Alzheimer's disease produced improvements in cognitive function, on average -2.7 points, in the midrange of the 70 point ADAS-Cog Scale.
Journal ArticleDOI
Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence.
TL;DR: Of the agents reviewed, the atypical antipsychotics risperidone and olanzapine currently have the best evidence for efficacy, however, the effects are modest and further complicated by an increased risk of stroke.
Journal ArticleDOI
Galantamine in AD A 6-month randomized, placebo-controlled trial with a 6-month extension
TL;DR: Galantamine is effective and safe in AD and significantly improved cognition and global function at 6 months, and cognitive and daily function were maintained for 12 months with the 24 mg/d dose.
References
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Journal ArticleDOI
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
Clinical diagnosis of Alzheimer's disease : report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease
Guy M. McKhann,David A. Drachman,Marshall F. Folstein,Robert Katzman,Donald L. Price,Emanuel M. Stadlan +5 more
TL;DR: The criteria proposed are intended to serve as a guide for the diagnosis of probable, possible, and definite Alzheimer's disease; these criteria will be revised as more definitive information becomes available.
Journal ArticleDOI
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
Jeffrey L. Cummings,Michael S. Mega,Kevin F. Gray,S. Rosenberg-Thompson,Daniela Carusi,Jeffrey Gornbein +5 more
TL;DR: The NPI has the advantages of evaluating a wider range of psychopathology than existing instruments, soliciting information that may distinguish among different etiologies of dementia, differentiating between severity and frequency of behavioral changes, and minimizing administration time.
Journal ArticleDOI
The Cholinergic Hypothesis of Geriatric Memory Dysfunction
Raymond T. Bartus,Raymond T. Bartus,Reginald L. Dean,Bernard Beer,Bernard Beer,Arnold S. Lippa,Arnold S. Lippa +6 more
TL;DR: Biochemical, electrophysiological, and pharmacological evidence supporting a role for cholinergic dysfunction in age-related memory disturbances is critically reviewed and an attempt has been made to identify pseudoissues, resolve certain controversies, and clarify misconceptions that have occurred in the literature.