Galantamine for dementia in people with Down syndrome

Mohan, Monica; Bennett, Cathy; Carpenter, Peter

doi:10.1002/14651858.cd007656

Cited by 26 publications

(23 citation statements)

References 43 publications

(9 reference statements)

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“…In part, these results in the animal model led to trials of several different acetylcholinesterase inhibitors in adults with DS and dementia. However, in DS, there appears to be no consistent or compelling evidence for efficacy of acetylcholinesterase inhibitors including donepezil, galantamine, and rivastigmine in preventing the cognitive decline associated with dementia (Mohan et al, 2009a–d). Likewise, a trial of donepezil in children and adolescents with DS failed to demonstrate cognitive benefit (Kishnani et al, 2010).…”

Section: Altering the Neurological Phenotype Through Treatmentmentioning

confidence: 99%

Neurological phenotypes for Down syndrome across the life span

Lott

2012

Progress in Brain Research

198

158

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This chapter reviews the neurological phenotype of Down syndrome (DS) in early development, childhood, and aging. Neuroanatomic abnormalities in DS are manifested as aberrations in gross brain structure as well as characteristic microdysgenetic changes. As the result of these morphological abnormalities, brain circuitry is impaired. While an intellectual disability is ubiquitous in DS, there is a wide range of variation in cognitive performance and a growing understanding between aberrant brain circuitry and the cognitive phenotype. Hypotonia is most marked at birth, affecting gait and ligamentous laxity. Seizures are bimodal in presentation with infantile spasms common in infancy and generalized seizures associated with cognitive decline observed in later years. While all individuals have the characteristic neuropathology of Alzheimer's disease (AD) by age 40years, the prevalence of dementia is not universal. The tendency to develop AD is related, in part, to several genes on chromosome 21 that are overexpressed in DS. Intraneuronal accumulation of β-amyloid appears to trigger a cascade of neurodegeneration resulting in the neuropathological and clinical manifestations of dementia. Functional brain imaging has elucidated the temporal sequence of amyloid deposition and glucose metabolic rate in the development of dementia in DS. Mitochondrial abnormalities contribute to oxidative stress which is part of AD pathogenesis in DS as well as AD in the general population. A variety of medical comorbidities threaten cognitive performance including sleep apnea, abnormalities in thyroid metabolism, and behavioral disturbances. Mouse models for DS are providing a platform for the formulation of clinical trials with intervention targeted to synaptic plasticity, brain biochemistry, and morphological brain alterations.

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Section: Altering the Neurological Phenotype Through Treatmentmentioning

confidence: 99%

Neurological phenotypes for Down syndrome across the life span

Lott

2012

Progress in Brain Research

198

158

View full text Add to dashboard Cite

show abstract

“…While some providers will use traditional pharmacologic agents to slow the rate of decline, multiple Cochrane reviews of pharmaceutical treatment for dementia in adults with Down's syndrome do not support this treatment owing to lack of evidence. [122][123][124][125] The largest trial of pharmaceutical intervention in adults with Down's syndrome and dementia used memantine, which showed no benefit and a trend toward worse behaviors in the treatment group. 122 Consequently, current recommendations focus on interventions to minimize caregiver burden, including respite care and creating an environment in which the patient can maintain function.…”

Section: Neurologymentioning

confidence: 99%

Managing the care of adults with Down's syndrome

Jensen

Bulova

2014

BMJ

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“…Sheehan, Afia, and Hassiotis () highlight that there are few clinical trials assessing the potential benefits of pharmacological treatment approved for use in dementia in the United Kingdom in people with learning disabilities and dementia, and that most trials have focused on dementia in Down's syndrome only (i.e., Hanney et al., ; Mohan, Bennett, & Carpenter, ,b; Mohan, Carpenter, & Bennett, ). Similarly, there is little research exploring the applicability of nonpharmacological interventions recommended by NICE and the BPS for people with learning disabilities and dementia.…”

Section: Introductionmentioning

confidence: 99%

Improving services for people with learning disabilities and dementia: Findings from a service evaluation exploring the perspectives of health and social care professionals

Chapman

Lacey

Jervis

2017

Brit J Learn Disabil

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Accessible summary• Dementia is an illness caused by damage to a person's brain.• People with learning disabilities, especially people with Down's Syndrome, are more likely to get dementia, and when they are younger.• We talked to people working in community learning disability teams to find out what they thought about services and support for people with learning disabilities and dementia and carers.• Screening and assessments mean that people get diagnosis and support more quickly and other problems are picked up.• More appropriate housing and support is needed so people can stay at home for longer.• Research needs to look at the best ways to support people with learning disabilities and dementia.• It is important to find ways to involve people with learning disabilities and dementia and carers in meetings about their support and future research. AbstractBackground: Dementia prevalence rates are higher amongst people with learning dis-

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Galantamine for dementia in people with Down syndrome

Abstract: As there are no included trials, recommendations cannot be made about galantamine for AD in DS. Well-designed, adequately powered studies are required.

Cited by 26 publications

References 43 publications

Neurological phenotypes for Down syndrome across the life span

Neurological phenotypes for Down syndrome across the life span

Managing the care of adults with Down's syndrome

Improving services for people with learning disabilities and dementia: Findings from a service evaluation exploring the perspectives of health and social care professionals

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