Literature DB >> 25504466

A pilot randomized controlled trial evaluating an integrated treatment of rivastigmine transdermal patch and cognitive stimulation in patients with Alzheimer's disease.

Grazia D'Onofrio1, Daniele Sancarlo1, Filomena Addante1, Filomena Ciccone1, Leandro Cascavilla1, Francesco Paris1, Anna Chiara Elia1, Claudia Nuzzaci1, Michele Picoco1, Antonio Greco1, Francesco Panza1,2, Alberto Pilotto1,3.   

Abstract

OBJECTIVE: To evaluate in a pilot single-blind randomized controlled clinical trial the efficacy of an integrated treatment with rivastigmine transdermal patch (RTP) and cognitive stimulation (CS) in Alzheimer's disease (AD) patients at 6-month follow-up.
METHODS: We enrolled 90 patients with an age ≥65 years admitted to the outpatient Alzheimer's Evaluation Unit with diagnosis of AD. Patients were randomized to enter in the Group-1 (RTP + CS) or in the Group-2 (RTP). All patients at baseline and after 6 months were evaluated with the following tools: Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Hamilton Rating Scale for Depression (HAM-D), Geriatric Depression Scale (GDS-15), Neuropsychiatric Inventory (NPI), Neuropsychiatric Inventory-Distress (NPI-D), and a standardized Comprehensive Geriatric Assessment, including also activities of daily living (ADL), instrumental activities of daily living (IADL), and the Mini Nutritional Assessment (MNA). Mortality risk was assessed using the Multidimensional Prognostic Index (MPI).
RESULTS: At baseline no significant difference was shown between the two groups. After 6 months of follow-up, there were significant differences between Group-1 and Group-2 in: MMSE: +6.39% vs. +2.69%, CDR: +6.92% vs. +1.54%, HDRS-D = -60.7% vs. -45.8%, GDS: -60.9% vs. -7.3%, NPI: -55.2% vs. -32.7%%, NPI-D: -55.1% vs. -18.6%, ADL: +13.88% vs. +5.95%, IADL: +67.59% vs. +18.28%, MNA: +12.02% vs. +5.91%, and MPI: -29.03% vs. -12.90%.
CONCLUSION: The integrated treatment of RTP with CS in AD patients for 6 months improved significantly cognition, depressive and neuropsychiatric symptoms, functional status, and mortality risk in comparison with a group of AD patients receiving only RTP.
Copyright © 2014 John Wiley & Sons, Ltd.

Entities:  

Keywords:  Alzheimer's disease; cognitive stimulation; comprehensive geriatric assessment; multidimensional prognostic index; rivastigmine transdermal patch

Mesh:

Substances:

Year:  2014        PMID: 25504466     DOI: 10.1002/gps.4247

Source DB:  PubMed          Journal:  Int J Geriatr Psychiatry        ISSN: 0885-6230            Impact factor:   3.485


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