A Retrospective Study on the Benefits of Combined Citicoline, Memantine, and Acetylcholinesterase Inhibitor Treatments in Older Patients Affected with Alzheimer’s Disease

2021 ◽  
Vol 79 (4) ◽  
pp. 1509-1515
Author(s):  
Alberto Castagna ◽  
Andrea Fabbo ◽  
Ciro Manzo ◽  
Roberto Lacava ◽  
Carmen Ruberto ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Mmse Score ◽  
Acetylcholinesterase Inhibitor ◽  
Control Group ◽  
Case Group

Background: Background: Citicoline has been proven to have beneficial effects in patients with cognitive impairment. In previous studies, combined treatment with memantine and acetylcholinesterase inhibitors (AChEIs) maintained cognitive function in patients with Alzheimer’s disease (AD) better than memantine or AChEIs alone. Objective: To evaluate the effectiveness and safety of a combination therapy of oral citicoline, memantine, and an AChEI in AD when compared with memantine and an AChEI without citicoline. Methods: This was a retrospective multi-centric case-control study, conducted in Italian Centers for Cognitive Impairment and Dementia. Overall, 170 patients were recruited (34.11%of men, mean age 76,81±4.93 years): 48.8%treated with memantine and donepezil; 48.2%with memantine and rivastigmine; 2.9%with memantine and galantamine. 89 patients (control-group) were treated with memantine and an AChEI, whereas 81 patients (case-group) were treated with oral citicoline 1000 mg/day added to memantine and an AChEI given orally. Cognitive functions, activities of daily living, instrumental activities of daily living, comorbidities, mood and behavioral disturbances were assessed at baseline, month 6, and month 12. Results: In the case group, MMSE score had a statistically significant increasing trend between T0 and T2 (14.88±2.95 versus 15.09±3.00; p = 0.040), whereas in the control group, MMSE score showed a statistically significant decrease trend (14.37±2.63 versus 14.03±2.92 p = 0.024). Conclusion: In older patients with AD, a triple therapy with citicoline, memantine, and AChEI was more effective than memantine and AChEI without citicoline in maintaining the MMSE total score after 12 months.

scholarly journals Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease

2011 ◽  
Vol 7 (3) ◽  
pp. 300-308 ◽  
Author(s):  
Gad A. Marshall ◽  
Dorene M. Rentz ◽  
Meghan T. Frey ◽  
Joseph J. Locascio ◽  
Keith A. Johnson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Instrumental Activities

Associations Between Psychotic Symptoms and Dependence in Activities of Daily Living Among Older Adults With Alzheimer's Disease

2003 ◽  
Vol 15 (2) ◽  
pp. 171-179 ◽  
Author(s):  
Mun Tran ◽  
Michel Bédard ◽  
D. William Molloy ◽  
Sacha Dubois ◽  
Judith A. Lever
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Independent Living ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Depression Symptoms ◽  
Additional Contribution

Background: Alzheimer's disease (AD) is associated with dependence in activities of daily living (ADL). In addition to the cognitive impairment resulting from AD, the presence of psychotic symptoms may further increase this dependence. The objective of this study was to quantify the additional contribution of psychotic symptoms to dependence in ADL. Method: We analyzed data from 558 individuals with AD referred to a memory clinic. Information on ADL, psychotic symptoms, depression symptoms, and cognition was collected with standardized instruments. Results: The frequency of psychotic symptoms was correlated with dependence in ADL (r = −.44, p < .001). The independent contribution of psychotic symptoms to ADL (basic and instrumental) after consideration for cognitive impairment and depression symptoms was assessed with hierarchical regression models. Twenty-five percent of basic ADL variance was explained by cognition; psychotic symptoms accounted for an additional 7% of the variance (b = −0.12, p < .001). Cognitive impairment explained 31% of instrumental ADL variance; psychotic symptoms accounted for an additional 6% (b = −0.21, p < .001). Discussion: Psychotic symptoms are associated with dependence in ADL after controlling for cognitive impairment and depression symptoms. Future research should investigate possible causal linkages between psychotic symptoms and dependence in ADL. This may have implications regarding interventions to maintain independent living in people with AD.

Variables Associated with High Caregiver Stress in Patients with Mild Cognitive Impairment or Alzheimer's Disease: Implications for Providers in a Co-Located Memory Assessment Clinic

2014 ◽  
Vol 36 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Daniel Hall ◽  
Joseph Wilkerson ◽  
James Lovato ◽  
Kaycee Sink ◽  
Dana Chamberlain ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Caregiver Burden ◽  
Daily Living ◽  
Functional Independence ◽  
Assessment Clinic ◽  
Behavioral Disturbances ◽  
Memory Assessment

Caregiver burden—the stress associated with caring for a loved one with chronic illness—is rated as high or very high by about two-thirds of Alzheimer's caregivers. At Wake Forest School of Medicine, both patients with memory loss or cognitive impairment and caregivers are evaluated at a geriatrician-led co-located Memory Assessment Clinic (MAC). In a sample of 100 MAC-evaluated patient-caregiver dyads this study assessed both patient severity of Alzheimer's disease or other dementia, self-reported behavioral disturbances, degree of functional independence in general activities of daily living and instrumental activities of daily living (IADLs), and caregiver stress as measured by the Caregiver Burden Scale (CBS). Several patient factors were found to be related to high caregiver stress (CBS score &gt; 25), in particular moderate-severe dementia; inability to perform most IADLs, especially managing medications; and most behavioral disturbances, especially agitation/aggression and appetite/eating problems. The article also suggests ways medical and mental health providers and researchers can help reduce caregiver stress.

scholarly journals Age-Related Changes in Instrumental and Basic Activities of Daily Living Impairment in Older Adults with Very Mild Alzheimer’s Disease

2020 ◽  
Vol 10 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Takayuki Tabira ◽  
Maki Hotta ◽  
Miki Murata ◽  
Kazuhiro Yoshiura ◽  
Gwanghee Han ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Mmse Score ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Age Related ◽  
Age Related Changes

Background/Aims: Age-related changes in impairments in activities of daily living (ADL) in older adults with very mild Alzheimer’s disease (vmAD) have been scarcely explored. We clarified the characteristics of ADL impairment and examined how ADL impairments differed by age in such patients compared with community-dwelling cognitively normal older adults. Methods: The participants were 107 older adults with vmAD (Mini-Mental State Examination [MMSE] score ≥24), all of whom were first-visit outpatients at the Dementia Clinic of the Department of Neuropsychiatry, Kumamoto University Hospital. The controls were 682 community-dwelling older adults who participated in the 3rd Nakayama Study with MMSE score ≥24. We examined the association of instrumental and basic ADL (IADL and BADL, respectively) independence with the odds of vmAD using multiple logistic regression analysis and determined differences in ADL impairment by age using age- and sex-matched analysis. Results: Impairments in handling finances (OR 57.08), managing medication (OR 5.13), and dressing (OR 3.35; BADL) were associated with greater odds of vmAD. Among those aged 65 years and above, there were fewer patients with vmAD than healthy controls who could independently handle finances and medication. Among patients with vmAD, the percentages of those who could independently manage shopping, food preparation, and housekeeping only decreased after age 74. Age-related decreases in independence were observed in few BADL items; these, however, were temporary. Conclusions: Patients with vmAD show significantly decreased IADL independence from early old age.

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