Long-term effects of Alzheimer's disease treatment

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

1. Navigation

1.1. EFNS Conference overview

1.2. Previous Presentation

1.2.1. Management of language and communication deficits in Alzheimer's disease

1.2.1.1. Professor Emre

2. Author

2.1. A. Atri

3. 1. Overview

3.1. Cost of AD to society & families

3.1.1. picture

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

3.1.3. wimo et al pharmacoeconomics 2003

3.2. bird's eye view of impact of AD

3.3. Clinical efficacy

3.4. etc. see pic

4. 2. Clinical Efficacy

4.1. Domains

4.1.1. Cognitive

4.1.1.1. ADAS-Cog/SIB

4.1.2. Global

4.1.3. Behaviour

4.1.4. Functional

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

4.2.1. Effect sizes

4.3. Memantine reduces caregiver burden

4.4. Expectations for treatments

4.4.1. multiple ways to define treatment benefits

4.4.1.1. picture

4.4.2. Treatment expectations vs expectated decline

4.4.2.1. picture

4.4.2.2. Geldmacher et al J Nut Health Aging 2006

5. 3. Clinical Effctiveness & Need for long term studies

5.1. examples

5.1.1. picture

5.1.2. Pharma-sponsored OLEX trials in AD

5.1.3. Publicly sponsored RCTs

5.1.3.1. AD2000 study

5.1.3.1.1. picture

5.1.3.1.2. picture

5.1.3.2. criticism on study

5.2. Rationale for naturalistic longitudinal studies

5.2.1. missed slide

5.3. Drug efficacy vs effectiveness clinical studies

5.3.1. missed slide

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

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

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

5.4.3. picture

5.4.4. Scales

5.4.4.1. picture

5.4.4.2. Assessment Methods - function

5.4.4.2.1. atri et al. Alzheimer Dis. Assoc. Disord 2008; 22: 209-221

5.4.4.2.2. Johnson et al. Alzheimer Dis Assoc Disord 2004; 18: 223-230

5.4.4.2.3. Weintraub Am J Alzheimer Care 1986; 1: 35-39

5.4.5. Baseline patient demographics

5.4.6. Results

5.4.6.1. Combination of ChEI and memantine (Combo) provides sustained benefit - cognition (BDS)

5.4.6.2. Predictive cognitive scores and effect sizes

5.4.6.2.1. picture

5.4.6.3. Combination of ChEI and Memantine (Combo, provides sustained benefit - function - Weintraub ADL)

5.4.6.4. Predictive functional dependence and effect sizes

5.4.7. Discussion

5.4.7.1. Strengths and limitations

5.4.7.1.1. Strength

5.4.7.1.2. Limitations

5.4.8. Conclusions

6. 4. Does getting onto and staying on therapies matter?

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

6.1.1. Results

6.1.1.1. Results Summary

6.2. Rountree et al Alzheimer's research and Therapy 2009

6.2.1. Link to paper:

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

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

6.4.1. Study: Memantine augments the effects of cholinesterase inhibition in the treatment of Alzheimer's Disease

6.4.1.1. Study results

6.5. When to stop treatment

6.5.1. picture

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

7.1. Concluding remarks

8. 6. Acknowledgements

8.1. picture