Research in Dementia
A double-blind placebo-controlled trial of Donepezil in Vascular dementia (n=707 completers) showed evidence of a small but significant improvement on ADAS-cog scores (0.6-1.15 points) at 54 weeks (Wilkinson et al, 2009). In a survey of hospice Medical Directors in the USA anticholinesterase inhibitors and NMDA receptor antagonists were prescribed in a small subset of people with advanced Alzheimer’s Disease and reasons given included stabilising cognition and addressing problematic behaviours suggesting a benefit for formal studies to address these issues (Shega et al, 2009). A small study (n=29) in female Chinese caregivers of people with dementia in Hong Kong found a significant improvement in self-efficacy of managing problematic behaviours in the people they were caring for (Au et al, 2009). In a retrospective analysis of data from an RCT of Rivastigmine in Mild Cognitive Impairment (n=1018) there was found to be a significant reduction in the rate of cognitive decline of male BuChE-K carriers (a variant of the Butylcholinesterase Enzyme Gene) and also in female BuChE wt/wt carriers (Ferris et al, 2009). The authors of a recent randomised double-blind study of Donepezil in young adults with Down Syndrome treated over a 12-week period concluded that the results supported the safety of Donepezil in people with Down syndrome although the efficacy results were more difficult to interpret (Kishani et al, 2009).
News In Brief
In a rather ingenious study (which is open access and freely available here) cognitive impairment and depressive were assessed in 16,800 participants in a cohort study and the results were correlated with data on ‘two-week average sunlight exposure’. The researchers did find a significant association between cognitive impairment and the sunlight exposure so it will be very interesting to see if this is replicated and if so how such a relationship might be working. In another study published in the Proceedings of the National Academy of Sciences, alpha-synuclein has been found to be transmitted from one cell to another within cell cultures and there was further supporting evidence for such an association and this has implications for therepeutic approaches in Parkinson’s Disease and related conditions. There has been a presentation on work on lucid dreaming and the relation to dissociation at a recent European Science Foundation workship and there is also a discussion of a threat simulation theory which states that part of the role of dreaming is to recreate the threats that a person has experienced presumably so that they can learn to deal with these threats more effectively (almost like a virtual reality training simulation!). In a relatively small study (n=51) people with and without depression were placed on a weight reduction program and an average 8% weight loss in the depression group was significantly association with an improvement in depression scores although it will be interesting to see the results in the final published form. In an EEG study, the response to value-laden words was found to occur within milliseconds of presentation if this clashed with the person’s values and such information is of relevance to other areas including neuroimaging.
Au A, Li S, Lee K, Leung P, Pan PC, Thompson L, Gallagher-Thompson D. The Coping with Caregiving Group Program for Chinese caregivers of patients with Alzheimer’s disease in Hong Kong. Patient Educ Couns. 2009 Jul 18. [Epub ahead of print]
Ferris S, Nordberg A, Soininen H, Darreh-Shori T, Lane R.Progression from mild cognitive impairment to Alzheimer’s disease: effects of
sex, butyrylcholinesterase genotype, and rivastigmine treatment.Pharmacogenet Genomics. 2009 Jul 16. [Epub ahead of print]
Kishnani PS, Sommer BR, Handen BL, Seltzer B, Capone GT, Spiridigliozzi GA,Heller JH, Richardson S, McRae T.
The efficacy, safety, and tolerability of donepezil for the treatment of young adults with Down syndrome.Am J Med Genet A. 2009 Jul 15;149A(8):1641-1654. [Epub ahead of print]
Shega JW, Ellner L, Lau DT, Maxwell TL.Cholinesterase Inhibitor and N-Methyl-D-Aspartic Acid Receptor Antagonist Use in Older Adults with End-Stage Dementia: A Survey of Hospice Medical Directors. J Palliat Med. 2009 Jul 21. [Epub ahead of print]
Wilkinson D, Róman G, Salloway S, Hecker J, Boundy K, Kumar D, Posner H, Schindler R.The long-term efficacy and tolerability of donepezil in patients with vascular dementia. Int J Geriatr Psychiatry. 2009 Jul 21. [Epub ahead of print]
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