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Long-term effects of Alzheimer's disease treatment by Mind Map: Long-term effects of Alzheimer
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Long-term effects of Alzheimer's disease treatment

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EFNS Conference overview

Previous Presentation

Management of language and communication deficits in Alzheimer's disease, Professor Emre

Author

A. Atri

1. Overview

Cost of AD to society & families

picture

www.alz.org/media/newsreleases/current/062602ADcosts.pdf

wimo et al pharmacoeconomics 2003

bird's eye view of impact of AD

Clinical efficacy

etc. see pic

2. Clinical Efficacy

Domains

Cognitive, ADAS-Cog/SIB

Global

Behaviour

Functional

Global overview of the 4 key domains - significant differences favouring memantine

Effect sizes

Memantine reduces caregiver burden

Expectations for treatments

multiple ways to define treatment benefits, picture

Treatment expectations vs expectated decline, picture, Geldmacher et al J Nut Health Aging 2006

3. Clinical Effctiveness & Need for long term studies

examples

picture

Pharma-sponsored OLEX trials in AD

Publicly sponsored RCTs, AD2000 study, picture, picture, criticism on study

Rationale for naturalistic longitudinal studies

missed slide

Drug efficacy vs effectiveness clinical studies

missed slide

Compare real-life clinical trajectory of cognition and function between three treatment groups of AD patients

Atri et al, Alzheimer Dis Associ Disord 2008; 22: 209-221

http://www.ncbi.nlm.nih.gov/pubmed/18580597

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Scales, picture, Assessment Methods - function, atri et al. Alzheimer Dis. Assoc. Disord 2008; 22: 209-221, Johnson et al. Alzheimer Dis Assoc Disord 2004; 18: 223-230, Weintraub Am J Alzheimer Care 1986; 1: 35-39

Baseline patient demographics

Results, Combination of ChEI and memantine (Combo) provides sustained benefit - cognition (BDS), Predictive cognitive scores and effect sizes, picture, Combination of ChEI and Memantine (Combo, provides sustained benefit - function - Weintraub ADL), Predictive functional dependence and effect sizes

Discussion, Strengths and limitations, Strength, Limitations

Conclusions

4. Does getting onto and staying on therapies matter?

Study: Persistent treatment with cholinesterase inhibitors and/or memantine slows clinical progression of Alzheimer's Disease

Results, Results Summary

Rountree et al Alzheimer's research and Therapy 2009

Link to paper:

Why diagnose and treat as early as possible - principles of medical ethics

Does memantine treatment provide long-term benefits delaying time to institutionalisation?

Study: Memantine augments the effects of cholinesterase inhibition in the treatment of Alzheimer's Disease, Study results

When to stop treatment

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5. communication problems have an impact on everyday life of patients and caregivers

Concluding remarks

6. Acknowledgements

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