Physicians' Efficacy Requirements for Prescribing Medications to Persons with Alzheimer's Disease

2007 ◽  
Vol 26 (2) ◽  
pp. 139-148 ◽  
Author(s):  
Mark Oremus ◽  
Christina Wolfson ◽  
Howard Bergman ◽  
Alain C Vandal
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Progression ◽  
Odds Ratio ◽  
Daily Living ◽  
Cholinesterase Inhibitors ◽  
Postal Survey ◽  
Drug Treatments ◽  
Efficacy Measures ◽  
Cent Level

ABSTRACTPhysicians (N = 803) were contacted via postal survey and given two sets of efficacy measures for drug treatments in Alzheimer's disease: (a) the time that patients spend in a mild or moderate state of disease; (b) levels of modification to disease progression in the areas of cognition, behaviour, and mood, and ability to perform basic activities of daily living. Physicians reported that they would prescribe a hypothetical, new Alzheimer's disease medication if it would allow patients to remain in their current disease state for 15 (mild) or 11 (moderate) additional months. Most physicians required a permanent halt to, or some reversal of, disease progression as a prerequisite for prescribing; a few required substantial reversal. More stringent efficacy requirements were negatively associated with physicians' current prescribing of cholinesterase inhibitors to persons with Alzheimer's disease, although the effects were either small (odds ratio = 0.99) or not statistically significant at the 5 per cent level. The results suggest that physicians with stringent efficacy requirements for clinically relevant efficacy measures are less likely to prescribe cholinesterase inhibitors.

The Positive Effects of Pet Ownership on Alzheimer’s Disease

2021 ◽  
pp. 1-7
Author(s):  
Minna Rusanen ◽  
Tuomas Selander ◽  
Virve Kärkkäinen ◽  
Anne Koivisto
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Progression ◽  
Daily Living ◽  
Neuropsychiatric Symptoms ◽  
Health Conditions ◽  
Pet Ownership ◽  
Positive Effects ◽  
Pet Owners

Background: Human-animal interactions are known to have many beneficial psychosocial and psychophysiological effects on persons with and without medical health conditions. There are no previous prospective studies with long follow-up times on the effects of domestic pets on the persons with Alzheimer’s disease (AD) living at home. Objective: To investigate the effects of pets on the activities of daily living (ADL), disease progression, and neuropsychiatric symptoms (NPS) during a five-year follow-up on the persons with AD. Methods: Altogether 223 home-dwelling persons (mean age 75.2 years) with very mild (CDR 0.5) or mild (CDR 1) AD at baseline were included for this study. ADCS-ADL, NPI, MMSE, and CDR-SOB were measured at baseline, annually for three years and after five years. Results: Totally 40 (17.9%) participants had a pet. At the baseline, pet owners and non-pet owners had no significant differences in age, gender, or the ADCS-ADL, NPS, and CDR-SOB scores, while MMSE was lower in pet owners than non-pet owners (20.2 versus 21.7; p = 0.009). Over the follow-up, pet owners had significantly better mean ADCS-ADL (57.5 versus 54.0; p = 0.031), NPI (9.3 versus 13.0; p = 0.038), and CDR-SOB scores (5.7 versus 6.6; p = 0.004) compared to non-pet owners. The differences in the MMSE scores between the groups detected at baseline attenuated over time. Conclusion: Significant positive effects of the pets on ADL functions, NPS, and disease progression were detected over the whole follow-up suggesting that having a pet may support daily activity and slow the disease progression in AD.

Institutional Respite Care: Benefits and Risks for Dementia Patients and Caregivers

1993 ◽  
Vol 5 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Geri Adler ◽  
Linda Ott ◽  
Mary Jelinski ◽  
James Mortimer ◽  
Renee Christensen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Behavior Problems ◽  
Activities Of Daily Living ◽  
Disease Progression ◽  
Daily Living ◽  
Respite Care ◽  
Dementia Patients ◽  
Before And After ◽  
Return Home

Thirty-seven dementia patients and their caregivers were studied before and after a two-week in-hospital respite stay. Institutional respite care did not alter behavior problems in dementia patients, nor did changes in performance of activities of daily living (ADLs) by Alzheimer's disease (AD) patients exceed those expected from disease progression. Caregivers exhibited an improvement in burden and depression during the respite study, but levels returned to baseline following the patient's return home.

scholarly journals Alzheimer’s Disease Pharmacotherapy in Relation to Cholinergic System Involvement

Biomolecules ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 40 ◽  
Author(s):  
Gabriela Dumitrita Stanciu ◽  
Andrei Luca ◽  
Razvan Nicolae Rusu ◽  
Veronica Bild ◽  
Sorin Ioan Beschea Chiriac ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Disease Progression ◽  
Cholinergic System ◽  
Cholinesterase Inhibitors ◽  
Current Understanding ◽  
Brain Functioning ◽  
System Involvement ◽  
Global Health Challenge

Alzheimer’s disease, a major and increasing global health challenge, is an irreversible, progressive form of dementia, associated with an ongoing decline of brain functioning. The etiology of this disease is not completely understood, and no safe and effective anti-Alzheimer’s disease drug to prevent, stop, or reverse its evolution is currently available. Current pharmacotherapy concentrated on drugs that aimed to improve the cerebral acetylcholine levels by facilitating cholinergic neurotransmission through inhibiting cholinesterase. These compounds, recognized as cholinesterase inhibitors, offer a viable target across key sign domains of Alzheimer’s disease, but have a modest influence on improving the progression of this condition. In this paper, we sought to highlight the current understanding of the cholinergic system involvement in Alzheimer’s disease progression in relation to the recent status of the available cholinesterase inhibitors as effective therapeutics.

scholarly journals Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer’s Disease

2020 ◽  
Vol 9 (5) ◽  
pp. 1537
Author(s):  
Gwanghee Han ◽  
Michio Maruta ◽  
Yuriko Ikeda ◽  
Tomohisa Ishikawa ◽  
Hibiki Tanaka ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Mental State ◽  
Odds Ratio ◽  
Daily Living ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
The Relationship ◽  
State Examination

Mini-mental state examination (MMSE) subitems provide useful information about the cognitive status of patients with Alzheimer’s disease (AD). If the relationship between MMSE subitems and activities of daily living (ADL) can be shown, the performance of sub-items can predict ADL status and may provide useful information for early ADL intervention. Therefore, the purpose of this study was to investigate the relationship between MMSE subitem scores and ADL. The study sample consisted of 718 patients with AD. Logistic regression analysis using the Physical Self-maintenance Scale (PSMS) and Lawton’s Instrumental ADL (L-IADL) was performed with each of the subitems as the dependent variables and the MMSE subitem as the independent variable. As a result, the subitems of MMSE, which are strongly related to each item in PSMS differed (e.g., toilet: registration odds ratio 3.00, grooming: naming 3.66). In the case of L-IADL, most items were strongly associated with “writing” (e.g., shopping: odds ratio 4.29, laundry 3.83). In clinical practice, we often focus only on the total MMSE score in patients with AD. However, the relationship between each MMSE subitem and ADL suggested in this study may be useful information that can be linked to ADL care from the performance of the MMSE subitem.

scholarly journals Defeating dementia: Current approaches to potential amyloid-based Alzheimer's disease therapies

2008 ◽  
Vol 30 (5) ◽  
pp. 14-17 ◽  
Author(s):  
Ayesha Khan ◽  
Clive Ballard
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Receptor Antagonist ◽  
Disease Progression ◽  
Cholinesterase Inhibitors ◽  
Neurodegenerative Disorder ◽  
The Uk

Alzheimer's disease (AD) is a progressive neurodegenerative disorder, accounting for 700000 people in the UK and 25 million people worldwide with dementia1. Already licensed treatments, cholinesterase inhibitors and an NMDA (Nmethyldaspartate) receptor antagonist, confer important symptomatic benefits2, but at present, there are no treatments that can delay or halt the disease progression. This review outlines one of the main mechanisms currently thought to underpin the development of AD, and the treatments that are being developed based upon it.

scholarly journals New drugs for Alzheimer's disease and other dementias

2002 ◽  
Vol 180 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Roger Bullock
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Observational Studies ◽  
Cholinesterase Inhibitors ◽  
Treatment Options ◽  
Clinical Excellence ◽  
Good Evidence ◽  
New Drugs ◽  
Drug Treatments ◽  
Review Current

BackgroundAlzheimer's disease management involves symptomatic drug treatments passed by the National Institute for Clinical Excellence. Disease modification is now the goal.AimsTo review current and developmental drugs for Alzheimer's disease, their usage, and the clinical context of known facts and proposed specific models.MethodA brief evidence-based review was made, using literature where available, or evidence from consensus groups where it was absent.ResultsThere is good evidence to support the use of cholinesterase inhibitors, and perhaps vitamin E. Oestrogen and anti-inflammatory agents show possibility, but there is not enough evidence to support routine use.ConclusionsSymptomatic treatments exist for Alzheimer's disease. Observational studies and increasing knowledge of brain biology are leading towards further treatment options. Old age psychiatrists have valuable treatments they now have to learn to use.

Drug Design of Inhibitors of Alzheimer’s Disease (AD): POM and DFT Analyses of Cholinesterase Inhibitory Activity of β-amino di-Carbonyl Derivatives

2019 ◽  
Vol 19 (8) ◽  
pp. 688-705
Author(s):  
Taibi Ben Hadda ◽  
Abdur Rauf ◽  
Hsaine Zgou ◽  
Fatma Sezer Senol ◽  
Ilkay Erdogan Orhan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cholinesterase Inhibitors ◽  
Metal Accumulation ◽  
Microtiter Plate ◽  
Metal Chelation ◽  
Carbonyl Derivatives ◽  
Cholinesterase Inhibitory Activity ◽  
Inhibitory Potential

Background:Since deficit of acetylcholine has been evidenced in the Alzheimer’s disease (AD) patients, cholinesterase inhibitors are currently the most specified drug category for the remediation of AD.Method:In the present study, 16 compounds (1-16) with dicarbonyl skeletons have been synthesized and tested for their inhibitory potential in vitro against AChE and BChE using ELISA microtiter plate assays at 100 μg/mL. Since metal accumulation is related to AD, the compounds were also tested for their metal-chelation capacity.Results and Conclusion:All the investigated dicarbonyl compounds exerted none or lower than 30% inhibition against both cholinesterases, whereas compounds 2, 8 and 11 showed 37, 42, 41% of inhibition towards BChE, being the most active. The highest metal-chelation capacity was observed with compound 8 (53.58 ± 2.06%). POM and DFT analyses are in good harmonization with experimental data.

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