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- Wallin, Anders, 1950, et al.
(författare)
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Donepezil in Alzheimer's disease : What to expect after 3 years of treatment in a routine clinical setting
- 2007
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Ingår i: Dementia and Geriatric Cognitive Disorders. - Basel : S. Karger AG. - 1420-8008 .- 1421-9824. ; 23:3, s. 150-160
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Clinical short-term trails have shown positive effects of donepezil treatment in patients with Alzheimer's disease. The outcome of continuous long-term treatment in the routine clinical settings remains to be investigated. Methods: The Swedish Alzheimer Treatment Study (SATS) is a descriptive, prospective, longitudinal, multicentre study. Four hundred and thirty-five outpatients with the clinical diagnosis of Alzheimer's disease, received treatment with donepezil. Patients were assessed with Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), global rating (CIBIC) and Instrumental Activities of Daily Living (IADL) at baseline and every 6 months for a total period of 3 years. Results: The mean MMSE change from baseline was positive for more than 6 months and in subgroups of patients for 12 months. After 3 years of treatment the mean change from baseline in MMSE-score was 3.8 points (95% CI, 3.0-4.7) and the ADAS-cog rise was 8.2 points (95% CI, 6.4-10.1). This is better than expected in untreated historical cohorts, and better than the ADAS-cog rise calculated by the Stern equation (15.6 points, 95% CI, 14.5-16.6). After 3 years with 38% of the patients remaining, 30% of the them were unchanged or improved in the global assessment. Conclusion: Three-year donepezil treatment showed a positive global and cognitive outcome in the routine clinical setting. Copyright © 2007 S. Karger AG.
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- Palmblad, J, et al.
(författare)
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Omega- 3 fettsyror i fet fisk skyddar mot demens.
- 2007
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Ingår i: Läkartidningen. - 0023-7205. ; 104, s. 3268-3271
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Tidskriftsartikel (refereegranskat)abstract
- Fleromättade fettsyror av marint ursprung, främst omega-3-fettsyrorna eikosapentaen- (EPA) och dokosahexaensyra (DHA), har många medicinska effekter. De är inflammationshämmande, mildrar symtomen vid reumatoid artrit, motverkar manifestationer av ateroskleros mm. Nyligen har intresset fokuserats på om de motverkar neurodegeneration vid Alzheimers sjukdom. Epidemiologiska longitudinella studier indikerar att regelbundet intag av fisk med mycket EPA och DHA, liksom höga plasmanivåer av DHA, minskar risken att insjukna i alzheimer. I djurmodeller av alzheimer förbättrar tillförd DHA minnesfunktioner. En prospektiv studie av behandling med omega-3-fettsyra, mest DHA, till patienter med etablerad alzheimer visade dock inga entydiga effekter på kognition. Men hos patienter med lindrig alzheimer verkar omega-3-fettsyror bromsa upp den fortlöpande kognitiva försämringen. Större studier behövs för att verifiera effekten. Flera internationella studier pågår.
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