Alzheimer disease and associated disorders
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Alzheimer Dis Assoc Disord · Oct 2008
Multicenter Study Clinical TrialEffect of exercise on negative affect in residents in special care units with moderate to severe dementia.
Approximately 35% of individuals with dementia exhibit depression and/or anxiety symptoms, often manifested by symptoms of negative affect. Exercise has been associated with improved affect but has not been demonstrated to improve affect in residents of secured dementia units in long-term care facilities. This pilot study determined whether moderate-intensity, chair-based exercise was associated with changes in negative affect in residents in secured units. ⋯ At week 3, anxiety was significantly lower immediately after the exercise session when adjusted for level of participation (P=0.02) compared with immediately before the exercise session, indicating immediate changes in affect. Anxiety and depression were significantly reduced at week 12, when compared with week 3, after adjusting for level of participation (P=0.01; P=0.03), indicating long-term effects of the exercise intervention. The study revealed the feasibility of conducting a moderate-intensity exercise program and the potential for exercise as a nonpharmacologic intervention for reducing symptoms of negative affect and depression in this vulnerable population.
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Alzheimer Dis Assoc Disord · Oct 2006
Randomized Controlled Trial Multicenter Study Clinical TrialActivities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment.
In moderate-to-severe Alzheimer disease (AD), there are significant losses of activities of daily living (ADL). In a recent prospective, randomized, placebo-controlled trial, memantine treatment lessened the overall functional decline in AD patients already on stable donepezil therapy. In this trial, patients (n=404) with Mini-Mental State Examination scores of 5 to 14 receiving stable donepezil treatment were randomized to double-blind treatment with memantine (10 mg b.i.d.; n=203) or placebo (n=201). ⋯ An item analysis revealed statistically significant benefits of memantine on grooming, toileting, conversing, watching television, and being left alone. Statistically significant improvements were noted in subscales evaluating higher-level functions and connectedness/autonomy with memantine compared with placebo. These post hoc analyses in moderate-to-severe AD patients receiving stable donepezil treatment suggest that memantine may impact overall functional levels, and some of the cognitive processing underlying ADL performance.