Does Serotonin Augmentation Have Any Effect on Cognition and Activities of Daily Living in Alzheimer’s Dementia?: A Double-blind Clinical Trial

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Mowla

Objective:Recent studies suggest that cholinergic dysfunction does not provide a complete account of age-related cognitive deficits and other neuronal systems like monoaminergic hypofunction are involved. In several studies selective serotonin reuptake inhibitors demonstrated promotion in neurogenesis in the hippocampus and enhanced memory and cognition. The aim of this study is to survey the effect of serotonin augmentation on cognition and activities of daily living in patients with Alzheimer's disease.Method:The trial was designed as a 12-week randomized, placebo-controlled, double-blind study. One hundred and twenty two patients aged 55-85 years, suffering from mild to moderate alzheimer's dementia were randomly allocated in one of the three treatment group: fluoxetine plus rivastigmine, rivastigmine alone or placebo group. Efficacy measures comprised assessments of cognition, activities of daily living and global functioning. Hamilton Depression Scale also was used to assess changes in mood throughout study.Result:Fluoxetine plus rivastigmine and rivastigmine groups demonstrated improvement on measures of cognitive and memory without any significant difference; however, the former group did better in their activities of daily living and global functioning. Patients taking placebo had significant deterioration in all the efficacy measures. Patients taking rivastigmine or rivastigmine plus fluoxetine had improvements in Hamilton Depression Scale without significant differences.Conclusion:Concomitant use of selective serotonin enhancing agents and acetyl cholinesterase inhibitors can provide greater benefit in activities of daily living and global functioning in patients with cognitive impairment. Although our study is preliminary and larger double blind studies are needed to confirm the results.

2007 ◽  
Vol 27 (5) ◽  
pp. 484-487 ◽  
Author(s):  
Arash Mowla ◽  
Masoud Mosavinasab ◽  
Hasan Haghshenas ◽  
Afshin Borhani Haghighi

2020 ◽  
Vol 17 (7) ◽  
pp. 680-686
Author(s):  
GyuChang Lee

Background: The deterioration of cognitive and motor functions and activities of daily living is common in Alzheimer's dementia. Objective: The purpose of this study was to investigate the correlation and the strength of the relationship between cognitive function and motor function and activities of daily living after a diagnosis of Alzheimer's disease dementia. Methods: Sixty-three patients with mild to moderate Alzheimer's disease dementia in a community setting of South Korea were examined for cognitive and motor functions, and functional levels. The test or measures used for cognitive function were the Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDS), and Clinical Dementia Rating (CDR). The 10-meter walking test (10MWT), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG) were used to examine motor function, while the Modified Barthel Index (MBI) and Katz Index (KI) were used to examining activities of daily living. Results: The MMSE had a positive correlation with that from the BBS (r=.338, p<.05), MBI (r=.363, p<.05), and KI (r=.276, p<.05). The GDS was negatively correlated with BBS (r=.319, p<.05). Multivariate regression analysis showed that MMSE was a major explanatory variable for BBS (R2 =.115, β=.338, p<.05) MBI (R2 =.131, β=.363, p<.05), and KI (R2 =.076, β=.276, p<.05). Conclusion: The results of the present study show that cognitive function by MMSE is correlated with balance by BBS and activities of daily living by MBI and KI, and MMSE, which are tests or measures for cognitive function, can be explanatory variable to explain variations in the BBS, MBI, and KI in the persons with mild to moderate Alzheimer’s dementia. It may mean that a decrease in cognitive function was found to affect motor function and activities of daily living. Based on this study, appropriate intervention approaches including physical exercise, should be considered for caring for persons with mild to moderate Alzheimer’s dementia in a community setting.


1987 ◽  
Vol 50 (2) ◽  
pp. 60-62 ◽  
Author(s):  
D Corless ◽  
M Ellis ◽  
E Dawson ◽  
F Fraser ◽  
S Evans ◽  
...  

Selected activities of daily living were used to measure improvement in independence of long-stay elderly patients known to have low concentrations of plasma 25-hydroxyvitamin D. This was a double-blind random controlled trial lasting between 8 and 40 weeks. No significant changes were found in either group.


2012 ◽  
pp. 261-268
Author(s):  
Salvatore La Carrubba ◽  
Loredana Manna ◽  
Carmelina Rinollo ◽  
Antonino Mazzone ◽  
Gualberto Gussoni ◽  
...  

Introduction: There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. Materials and methods: All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS), Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Charlson’s Comorbidity Index. Results: 1,947 subjects were included in the analyses. Of the patients, 509 (26.1%) showed depressive symptoms (indicated by GDS score > 15). Depression was significantly associated (univariate analyses) with hypertension (OR 1.45; CI 95% 1.18-1.79), diabetes (OR 1.48, CI 95% 1.17-1.87), cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07), cirrhosis (OR 1.49, CI 95% 1.01- 2.19), ADL score (OR 0.72: CI 95% 0.63-0.82), and IADL score (OR 0.83; CI 95% 0.78-0.87), but not with Charlson’s Comorbidity Index (OR 1.04; CI 95% 0.98-1.10). Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02), female gender (OR 2.29, CI 95% 1.83 - 2.87), and IADL score (OR 0.86, CI 95% 0.81 - 0.93). Conclusions: The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anup K. Mishra ◽  
Marjorie Skubic ◽  
Mihail Popescu ◽  
Kari Lane ◽  
Marilyn Rantz ◽  
...  

Abstract Background Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even though several geriatric assessments capture several aspects of functional health, there is limited research in longitudinally tracking personalized functional health of older adults using a combination of these assessments. Methods We used geriatric assessment data collected from 150 older adults to develop and validate a functional health prediction model based on risks associated with falls, hospitalizations, emergency visits, and death. We used mixed effects logistic regression to construct the model. The geriatric assessments included were Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Short Form 12 (SF12). Construct validators such as fall risks associated with model predictions, and case studies with functional health trajectories were used to validate the model. Results The model is shown to separate samples with and without adverse health event outcomes with an area under the receiver operating characteristic curve (AUC) of > 0.85. The model could predict emergency visit or hospitalization with an AUC of 0.72 (95% CI 0.65–0.79), fall with an AUC of 0.86 (95% CI 0.83–0.89), fall with hospitalization with an AUC of 0.89 (95% CI 0.85–0.92), and mortality with an AUC of 0.93 (95% CI 0.88–0.97). Multiple comparisons of means using Turkey HSD test show that model prediction means for samples with no adverse health events versus samples with fall, hospitalization, and death were statistically significant (p < 0.001). Case studies for individual residents using predicted functional health trajectories show that changes in model predictions over time correspond to critical health changes in older adults. Conclusions The personalized functional health tracking may provide clinicians with a longitudinal view of overall functional health in older adults to help address the early detection of deterioration trends and decide appropriate interventions. It can also help older adults and family members take proactive steps to improve functional health.


2003 ◽  
Vol 13 ◽  
pp. S315
Author(s):  
W. Deberdt ◽  
P.P. De Deyn ◽  
M.M. Carrasco ◽  
C. Jeandel ◽  
D.P. Hay ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document