Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses

Howard, Robert; McShane, Rupert; Lindesay, James; Ritchie, Craig W.; Baldwin, Ashley; Barber, Robert; Burns, Alistair; Dening, Tom; Findlay, D.J.S.; Holmes, Clive; Jones, Robert; Jones, Roy; McKeith, Ian G.; Macharouthu, Ajay; O’Brien, John T.; Sheehan, Bart; Juszczak, Edmund; Katona, Cornelius; Hills, Robert Kerrin; Knapp, Martín; Ballard, Clive; Brown, Richard G.; Banerjee, Sube; Adams, Jessica R.; Johnson, Tony; Bentham, Peter; Phillips, Patrick P. J.

doi:10.1016/s1474-4422(15)00258-6

Cited by 134 publications

(90 citation statements)

References 32 publications

(31 reference statements)

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“…Препарат хорошо переносится пациентами и способен корректировать не только мнестические рас-стройства и другие КН, но и положительно влиять на эмо-циональные и поведенческие нарушения у пациентов с БА [5,6,9,17]. Положительный эффект акатинола мемантина сохраняется и после прекращения его приема, что может свидетельствовать о способности препарата стимулировать компенсаторные механизмы в ЦНС [19].…”

Section: таблица 1 о с н о в н ы е х а р а к т е р и с т и к и иа х эunclassified

“…Безусловно, лечение деменции должно быть инди-видуальным, при этом золотым стандартом терапии явля-ется сочетание высокой эффективности препарата с ми-нимальным количеством побочных эффектов, этому стан-дарту в полной мере соответствует акатинол мемантин [12,17,19] …”

Section: таблица 1 о с н о в н ы е х а р а к т е р и с т и к и иа х эunclassified

“…Малочисленные исследования такой терапии показывают, что совместное использование этих препаратов дает более выраженный эффект, чем моно-терапия на более тяжелой стадии деменции [19].…”

Section: (табл 2)unclassified

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Current management tactics for patients with dementia

Ковров

Kosivtsova

Makhinov

2018

RJTAO

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Section: таблица 1 о с н о в н ы е х а р а к т е р и с т и к и иа х эunclassified

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Current management tactics for patients with dementia

Ковров

Kosivtsova

Makhinov

2018

RJTAO

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“…6 In the UK, the results of a recent trial showed that patients with moderate to severe Alzheimer's disease (AD) who continued donepezil treatment were at reduced risk of nursing home placement. 7 Early diagnosis can also assist in addressing anxiety about changes in memory, thinking, mood or behaviour for people with suspected dementia and their carers. 8 A number of pen-and-paper-based tools for cognitive assessment are currently used in the UK, for example the Mini-Mental State Examination (MMSE) and the General Practitioner Assessment of Cognition.…”

Section: Fundingmentioning

confidence: 99%

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Aslam

Bates

Dündar

et al. 2016

Health Technol Assess

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BackgroundCognitive impairment is a growing public health concern, and is one of the most distinctive characteristics of all dementias. The timely recognition of dementia syndromes can be beneficial, as some causes of dementia are treatable and are fully or partially reversible. Several automated cognitive assessment tools for assessing mild cognitive impairment (MCI) and early dementia are now available. Proponents of these tests cite as benefits the tests’ repeatability and robustness and the saving of clinicians’ time. However, the use of these tools to diagnose and/or monitor progressive cognitive impairment or response to treatment has not yet been evaluated.ObjectivesThe aim of this review was to determine whether or not automated computerised tests could accurately identify patients with progressive cognitive impairment in MCI and dementia and, if so, to investigate their role in monitoring disease progression and/or response to treatment.Data sourcesFive electronic databases (MEDLINE, EMBASE, The Cochrane Library, ISI Web of Science and PsycINFO), plus ProQuest, were searched from 2005 to August 2015. The bibliographies of retrieved citations were also examined. Trial and research registers were searched for ongoing studies and reviews. A second search was run to identify individual test costs and acquisition costs for the various tools identified in the review.Review methodsTwo reviewers independently screened all titles and abstracts to identify potentially relevant studies for inclusion in the review. Full-text copies were assessed independently by two reviewers. Data were extracted and assessed for risk of bias by one reviewer and independently checked for accuracy by a second. The results of the data extraction and quality assessment for each study are presented in structured tables and as a narrative summary.ResultsThe electronic searching of databases, including ProQuest, resulted in 13,542 unique citations. The titles and abstracts of these were screened and 399 articles were shortlisted for full-text assessment. Sixteen studies were included in the diagnostic accuracy review. No studies were eligible for inclusion in the review of tools for monitoring progressive disease. Eleven automated computerised tests were assessed in the 16 included studies. The overall quality of the studies was good; however, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that meaningful synthesis or statistical analysis was not possible.LimitationsThe main limitation of this review is the substantial heterogeneity of the tests assessed in the included studies. As a result, no meta-analyses could be undertaken.ConclusionThe quantity of information available is insufficient to be able to make recommendations on the clinical use of the computerised tests for diagnosing and monitoring MCI and early dementia progression. The value of these tests also depends on the costs of acquisition, training, administration and scoring.Future workResearch is required to establish stable cut-off points for automated computerised tests that are used to diagnose patients with MCI or early dementia. Additionally, the costs associated with acquiring and using these tests in clinical practice should be estimated.Study registrationThe study is registered as PROSPERO CRD42015025410.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…28 A recent British study was designed to compare withdrawal of donepezil vs memantine in patients with moderate to severe AD to see whether either of these drugs was more or less effective in preventing nursing home placement. 29 In a clinical trial involving 295 participants, the authors learned that withdrawal of donepezil significantly increased the risk of nursing home placement during the first 12 months of the study, but not in the following 3 years. In a prospective cohort study, patients with AD who were treated with donepezil appeared to have less progression of hippocampal atrophy over a year's time than those not treated with that drug.…”

Section: Healthy Eating and Regular Exercise To Prevent Dementiamentioning

confidence: 99%

Memory loss

et al. 2016

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Purpose of review: Memory loss can be due to a wide variety of causes. We provide new information about the biology of common genetic and acquired causes of memory loss in older adults. Recent findings:New data are available about the genetics of Alzheimer disease (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia. Amyloid PET, FDG-PET, and MRI have improved our understanding of how mild cognitive impairment evolves to AD. Several studies have shown links between concussion and chronic traumatic encephalopathy. Healthy eating and regular exercise have been demonstrated to slow cognitive decline in older adults. Randomized trials continue to show benefits for cholinesterase inhibitors and memantine in patients with AD and DLB. Summary: New causes of memory loss are still being identified. More sophisticated diagnostic tools have improved our ability to make earlier diagnoses in older adults with memory loss. Neurol Clin Pract 2016;6:523-529 R ecent large neuropathologic studies have shown that Alzheimer disease (AD) is still the most common of the chronic neurodegenerative memory disorders, but it is often associated with several comorbid histologic findings, such as cortical Lewy bodies, hippocampal sclerosis, and microinfarcts. Amyloid hypothesis and the genetics of AD While it is well-accepted that memory loss and other cognitive impairments in AD are the result of dysfunction in neuronal networks and synapses, the exact molecular and pathologic steps generating the clinical symptoms of AD remain an issue of some debate. Some have argued that b-amyloid (Ab) is a necessary but insufficient factor to explain the etiology of AD, arguing that Ab aggregations in the brain and decreased Ab levels in spinal fluid are detectable 15-20 years before the clinical symptoms of AD.2 Contradicting this view are recent findings from the Alzheimer's Disease Neuroimaging Initiative (ADNI), which demonstrated that decreases in CSF Ab levels are often not apparent until after there is a noticeable decline in cognitive function, a decline in metabolic activity on FDG-PET, and

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Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses

Cited by 134 publications

References 32 publications

Current management tactics for patients with dementia

Current management tactics for patients with dementia

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Memory loss

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