effects beyond cognition.
Neurology Department, Hospital Clinic,
University of Barcelona, Spain. email@example.com
Dement Geriatr Cogn Disord 2000 Sep;11 Suppl 1:28-34
Decline in cognitive function, especially memory, is the core feature of
Alzheimer's disease (AD). However, other characteristic aspects of the disease
are also important. These include patients' activities of daily living (ADL),
including quality of sleep, behavioural disturbances and the impact of the
disease on the caregiver. Therefore, increasing attention is being paid to
clinically meaningful outcome measures, such as the Disability Assessment for
Dementia (DAD) scale, the Neuropsychiatric Inventory (NPI), caregiver time and
the Pittsburgh Sleep Quality Index (PSQI). Galantamine is a new treatment for AD
that combines modulation of nicotinic receptors with inhibition of
acetylcholinesterase. The present review outlines the positive and sustained
effects of this agent on patients' behaviour and daily functioning as well as on
caregiver time. In studies of up to 5 months' duration, galantamine-treated
patients had a significantly better outcome on ADL than placebo-treated
patients, and after 12 months of treatment with galantamine, patients'
functional ability was preserved. Galantamine also significantly benefits
behavioural disturbances in patients with AD. These functional and behavioural
benefits are associated with a decrease in the burden on caregivers, as
indicated by a reduction, relative to placebo, in the time spent supervising and
assisting patients. These clinical benefits are not offset by disruption of
patients' sleep, as has been reported with other cholinergic treatments.