Galantamine maintains ability to perform activities of daily living in patients with Alzheimer's disease
Galantamine maintains ability to perform activities of daily living in patients with Alzheimer's disease
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DOI：
10.1111/j.1532-5415.2004.52303.x
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发表时间：
2004-07-01
影响因子：
6.3
通讯作者：
Tariot, PN
中科院分区：
文献类型：
--
作者：
Galasko, D;Kershaw, PR;Tariot, PN
目的：从基线痴呆严重程度、与认知和整体功能的相关性、受影响的特定ADL和维持ADL独立性等方面考察加兰他明对日常生活活动能力(ADL)的影响。设计：一项为期5个月的随机、安慰剂对照试验。设置：多个美国临床中心。配对：659名轻至中度阿尔茨海默病(AD)患者，完成5个月的治疗。干预：加兰他明维持剂量为16或24 mg/d。测量：AD合作研究日常生活能力量表。结果：无论基线痴呆严重程度如何，加兰他明都比安慰剂有更多的ADCS/ADL评分改善，差异最大的是有更严重疾病的患者。ADCS/ADL评分的变化与AD评定量表中认知分量表的变化显著相关(r=-0.24)。加兰他明治疗可以维持或改善基础ADL和仪器性ADL，在6个基本ADL中的3个和17个仪器性ADL中的6个ADL中，每个单独ADL项目的得分从基线到5个月的变化均优于安慰剂。结论：加兰他明对AD患者的ADL表现有良好的影响，无论痴呆的严重程度如何，治疗5个月后即可检测到。与认知评估相比，ADCS/ADL似乎更好地衡量了不同的能力，这些能力不仅与临床试验有关，而且与个体患者有关。
OBJECTIVES: To examine the effect of galantamine on activities of daily living (ADLs) with respect to baseline dementia severity, correlation with cognitive and global function, specific ADLs affected, and maintenance of ADL independence.DESIGN: Secondary analysis of a 5-month randomized, placebo-controlled trial.SETTING: Multiple U.S. clinical centers.PARTICIPANTS: Six hundred fifty-nine patients with mild to moderate Alzheimer's disease (AD) who completed 5 months of treatment.INTERVENTION: Galantamine at a maintenance dose of 16 or 24 mg/d.MEASUREMENTS: The AD Cooperative Study ADL Inventory (ADCS/ADL).RESULTS: Galantamine resulted in more improvement in ADCS/ADL scores than placebo regardless of baseline dementia severity, with the greatest differences occurring in patients with more severe disease. Changes in ADCS/ADL scores correlated significantly with change scores on the cognitive subscale of the AD Assessment Scale (r=-0.24). Galantamine treatment resulted in maintenance or improvement of basic and instrumental ADLs, and change from baseline to Month 5 in scores for each individual ADL item favored galantamine over placebo in three of six basic ADLs and six of 17 instrumental ADLs.CONCLUSION: Galantamine has a favorable effect on ADL performance in patients with AD, detectable after 5 months of treatment, regardless of dementia severity. The ADCS/ADL appears to better measure distinct abilities that may be relevant not only in clinical trials but also in individual patients than do cognitive assessments.