Pharmacological modulation of cognitive and behavioral symptoms in patients with dementia due to Alzheimer's disease

Pharmacological modulation of cognitive and behavioral symptoms in patients with dementia due to Alzheimer's disease

Author Oliveira, Fabricio Ferreira de Autor UNIFESP Google Scholar
Bertolucci, Paulo Henrique Ferreira Autor UNIFESP Google Scholar
Chen, Elizabeth Suchi Autor UNIFESP Google Scholar
Smith, Marilia de Arruda Cardoso Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract To evaluate correlations of pharmacological treatment with cognitive and behavioral symptoms in patients with dementia due to Alzheimer's disease with low schooling, subjects were assessed for demographic features, neuropsychiatric symptoms, cognitive decline, functionality, caregiver burden, APOE haplotypes and pharmacological treatment. Among 217 patients, use of cholinesterase inhibitors with or without Memantine was associated with less neuropsychiatric symptoms, while anti-psychotics and/or antiepileptic drugs were associated with lower instrumental functionality. Anti-psychotics were also associated with more neuropsychiatric symptoms in moderately impaired patients, possibly reflecting the greater need for such treatment when behavioral symptoms are present. Patients receiving more medications were usually younger, obese, married, with higher schooling and more neuropsychiatric symptoms. APOE4+ haplotypes were correlated with earlier dementia onset, but not with pharmacological treatment. Higher caregiver burden was associated with more psychotropic drugs. A trend was found for treatment with cholinesterase inhibitors and Memantine to be associated with longer lengths of dementia for moderately impaired but not for severely impaired patients, regardless of APOE haplotypes, translating into a synergistic effect among such medications for slowing cognitive decline but not for prolonging survival. Further longitudinal studies may be required to assess dose-response relationships regarding treatment with psychotropics for patients with dementia. (C) 2013 Elsevier B.V. All rights reserved.
Keywords Alzheimer disease
Cognitive disorders
Dementia
Neurodegenerative diseases
Neuropsychiatry
Drug therapy
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Date 2014-01-15
Published in Journal of the Neurological Sciences. Amsterdam: Elsevier B.V., v. 336, n. 1-2, p. 103-108, 2014.
ISSN 0022-510X (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 103-108
Origin http://dx.doi.org/10.1016/j.jns.2013.10.015
Access rights Closed access
Type Article
Web of Science ID WOS:000331025400018
URI http://repositorio.unifesp.br/handle/11600/37314

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