scholarly journals Safety and Efficacy of Memantine Extended-Release in the Management of Alzheimer's Disease

2013 ◽  
Vol 5 ◽  
pp. CMT.S7794 ◽  
Author(s):  
Anne Corbett ◽  
Paul Francis ◽  
Clive Ballard
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Extended Release ◽  
Randomized Clinical Trials ◽  
Psychological Symptoms ◽  
Treatment Options ◽  
Evidence Base ◽  
Release Formulation ◽  
Extended Release Formulation ◽  
People With Dementia

Alzheimer's disease (AD) affects the majority of the 35 million people with dementia worldwide. Four pharmacological treatment options are available for this patient group, of which memantine is licensed for treatment of people with moderate to severe stages of the condition. Memantine acts through its function as an NMDA-glutamate receptor blocker and has an established safety profile. The evidence supporting its efficacy in people with AD includes a number of large randomized clinical trials showing benefit to cognition, function, and overall clinical outcome. Additional favorable health economics analyses have confirmed the clinical and cost-effectiveness of this drug. More recently an extended-release formulation has been developed. This review outlines the key evidence base supporting memantine as a treatment for moderate to severe AD, in addition to discussing the conditions under which it may provide additional value in combination with other drugs. The review also discusses the use of memantine to address behavioral and psychological symptoms of dementia (BPSD) arising in people with AD and the limited evidence around its use in AD in people with Down's syndrome. Finally the review considers the potential value of the extended release formulation in AD.

Impact of brief education on healthy seniors’ attitudes and healthcare choices about Alzheimer's disease and associated symptoms

2018 ◽  
Vol 30 (12) ◽  
pp. 1889-1897
Author(s):  
Robyn E. Waxman ◽  
Barbara J. Russell ◽  
Oscar C. T. Iu ◽  
Benoit H. Mulsant
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Advance Directives ◽  
Psychological Symptoms ◽  
Treatment Options ◽  
A Priori ◽  
Educational Background ◽  
Primary Objective ◽  
University Education ◽  
Wide Range

ABSTRACTObjective:The primary objective of this study was to determine whether a brief education session about Alzheimer's disease (AD) stages and associated behavioral and psychological symptoms of dementia (BPSD) changes healthy seniors’ treatment choices. A secondary objective was to determine whether pharmacotherapy to reduce BPSD would be preferred over other potentially more restrictive interventions.Methods:Participants (n = 32; 8 men; aged > 64years; no self-reported dementia diagnosis) were assigned to one of ten group sessions during which they received information about AD and BPSD. Our a-priori hypotheses were: (1) education about AD stages significantly changes care preferences in moderate and severe stages, i.e. less active treatment options (no CPR/hospitalization) are chosen as the disease progresses; and (2) most participants prefer pharmacotherapy over restraints and seclusion to manage BPSD. The main outcome measure was a change in the interventions chosen including CPR and hospitalization. Participants completed three questionnaires and two decisional grids before and after the information session. Qualitative data were derived from discussions during the session.Results:Participants expressed a wide range of attitudes about AD, BPSD, and their management. Those who are born in Canada, had a proxy, and a university education, each have around half of the odds of receiving treatment compared to those in the complementary group. (OR 0.47, 0.40, 0.43) Finally, not knowing someone with AD increases the odds of wanting a treatment by around six times (OR 6.4). Pharmacological measures were preferred over restraints.Conclusions:Education about dementia and advance directives should consider the person's educational background and experience with dementia. Discussing BPSD may impact a person's advance directives and preferences.

Molecular biology of Alzheimer's disease

2000 ◽  
Vol 6 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Clive Holmes ◽  
David Wilkinson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Molecular Biology ◽  
Psychological Symptoms ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Disease Prevalence ◽  
Disease Modification ◽  
Realistic Option ◽  
Behavioural And Psychological Symptoms

At present, the treatment options for Alzheimer's disease are largely symptomatic giving rise to temporary remissions in cognitive decline or the amelioration of troublesome behavioural and psychological symptoms. However, as more is becoming known about the molecular biology of Alzheimer's disease, there is a clear movement to treatments directed towards disease modification. Disease modification is now a realistic option and its importance is highlighted by the fact that a delay in the progression of the disease by just five years would halve the disease prevalence. Ultimately, however, drug therapy based on the molecular biology of Alzheimer's disease will be preventive. These treatment strategies are still in their infancy, but our understanding of the processes requiring therapeutic manipulation is improving at a dramatic rate.

Effect of antihypertensive drugs on cognition and behavioral symptoms of patients with Alzheimer’s disease: A meta-analysis

2020 ◽  
Vol 21 ◽  
Author(s):  
Roja Rahimi ◽  
Shekoufeh Nikfar ◽  
Masoud Sadeghi ◽  
Mohammad Abdollahi ◽  
Reza Heidary Moghaddam ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Randomized Clinical Trials ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Behavioral Symptoms ◽  
Cochrane Library ◽  
Mean Differences ◽  
Global Impression Of Change ◽  
State Examination

Background: It has been found that there is a link between hypertension and elevated risk of Alzheimer’s disease (AD). Herein, a meta-analysis based on randomized clinical trials (RCTs) was used to assess the effect of antihypertensive drugs on cognition and behavioral symptoms of AD patients. Method: The three databases – PubMed/Medline, Scopus, and Cochrane Library- were searched up to March 2020. The quality of the studies included in the meta-analysis was evaluated by the Jadad score. Clinical Global Impression of Change (CGIC) included in two studies, Mini-Mental State Examination (MMSE) included in three studies, and Neuropsychiatric Inventory (NPI) in three studies were the main outcomes in this systematic review. Results: Out of 1506 studies retrieved in the databases, 5 RCTs included and analyzed in the meta-analysis. The pooled mean differences of CGIC, MMSE, and NPI in patients with AD receiving antihypertensive drugs compared to placebo was -1.76 with (95% CI = -2.66 to -0.86; P=0.0001), 0.74 (95% CI = 0.20 to 1.28; P= 0.007), and -9.49 (95% CI = -19.76 to 0.79; P = 0.07), respectively. Conclusion: The findings of the present meta-analysis show that antihypertensive drugs may improve cognition and behavioral symptoms of patients with AD. However, more well-designed RCTs with similar drugs are needed to achieve more conclusive results.

Extended-release Formulation Attenuates the Impacts of Fluvastatin on Serum PCSK9 Levels in Humans

2017 ◽  
Vol 14 (7) ◽  
Author(s):  
Yuan-Lin Guo ◽  
Wei Zhang ◽  
Qian Dong ◽  
Geng Liu ◽  
Cheng-Gang Zhu ◽  
...  
Keyword(s):  
Extended Release ◽  
Release Formulation ◽  
Extended Release Formulation

Lifestyle intervention to prevent Alzheimer’s disease

2020 ◽  
Vol 31 (8) ◽  
pp. 817-824 ◽  
Author(s):  
Yi Ko ◽  
Soi Moi Chye
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Lifestyle Intervention ◽  
Social Engagement ◽  
Treatment Options ◽  
Cognitive Stimulation ◽  
Systemic Review ◽  
Lifestyle Interventions ◽  
Alternative Approaches ◽  
The Brain

AbstractAlzheimer’s disease (AD) is the most common neurodegenerative disease that leads to significant morbidities in elderly. The major pathological hallmark of AD is beta-amyloid plaques (Aβ) and intracellular neurofibrillary tangles (NFTs) deposition in hippocampus of the brain. These abnormal protein deposition damages neuronal cells resulting in neurodegeneration and cognitive decline. As a result of limited treatment options available for this disease, there is huge economic burden for patients and social health care system. Thus, alternative approaches (lifestyle intervention) to prevent this disease are extremely important. In this systemic review, we summarized epidemiological evidence of lifestyle intervention and the mechanisms involved in delaying and/or preventing AD. Lifestyle interventions include education, social engagement and cognitive stimulation, smoking, exercise, depression and psychological stress, cerebrovascular disease (CVD), hypertension (HTN), dyslipidaemia, diabetes mellitus (DM), obesity and diet. The methods are based on a literature review of available sources found on the research topic in four acknowledged databases: Web of Science, Scopus, Medline and PubMed. Results of the identified original studies revealed that lifestyle interventions have significant effects and our conclusion is that combination of early lifestyle interventions can decrease the risk of developing AD.

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