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Treatment with galantamine and time to nursing home placement in Alzheimer’s disease patients with and without cerebrovascular disease

Authors

Feldman, Howard H., Pirttila, Tuula, Dartigues, Jean-François, Everitt, Brian, Van Baelen, Bart, Schwalen, Susanne, Kavanagh, Shane

Journal

International Journal Of Geriatric Psychiatry, Volume: 24, No.: 5, Pages.: 479-488

Year of Publication

2009

Abstract

Objective: This study evaluated patient and treatment (galantamine and other acetylcholinesterase inhibitors (AChEIs)) factors associated with the time until nursing home placement (NHP) in patients with Alzheimer’s disease (AD) with and without cerebrovascular disease (CVD).; Methods: Re-contact follow-up study conducted in 2004 of 548 patients who had previously participated in RCTs with galantamine. Time to NHP was analyzed using Kaplan-Meier estimates and Cox regression analysed factors associated with NHP.; Results: There were 57% of female subjects and the mean age (SE) was 73.6 (+/-0.33) years. Within this cohort 78% of patients had AD, and 22% had AD with CVD. Overall, 59% of subjects had a NHP (median 42.4 months 95%CI: 38.0-48.0). The Cox regression model identified higher baseline Disability Assessment in Dementia (DAD) and Mini Mental State Examination (MMSE) scores, diagnosis (AD with CVD vs AD), living with caregiver, country, and treatment duration with galantamine or other AChEIs as factors associated with a reduced risk of institutionalization (p < 0.05). For each year of treatment with galantamine or other AChEI, the risk of being admitted to a nursing home within a given period was reduced by 31% (galantamine) and 29% (other AChEI).; Conclusions: Long-term treatment with galantamine or other AChEIs appears to be associated with a significant delay in the time to NHP in patients with AD and AD with CVD. Further prospective studies are needed to confirm these findings.; (c) 2008 John Wiley & Sons, Ltd.

Bibtex Citation

@article{Feldman_2009, doi = {10.1002/gps.2141}, url = {http://dx.doi.org/10.1002/gps.2141}, year = 2009, month = {may}, publisher = {Wiley-Blackwell}, volume = {24}, number = {5}, pages = {479--488}, author = {Howard H. Feldman and Tuula Pirttila and Jean Fran{c{c}}ois Dartigues and Brian Everitt and Bart Van Baelen and Susanne Schwalen and Shane Kavanagh}, title = {Treatment with galantamine and time to nursing home placement in Alzheimer{textquotesingle}s disease patients with and without cerebrovascular disease}, journal = {Int. J. Geriat. Psychiatry} }

Keywords

acetylcholinesterase, aged, alzheimer disease, cerebrovascular disorders, cholinesterase inhibitors, complications, drug therapy, drugs, female, galantamine, humans, institutionalisation, institutionalization, long term care, male, nursing homes, other, severity of illness index, statistics as topic, therapeutic use, time factors, treatment outcome

Countries of Study

Canada

Types of Dementia

Alzheimer’s Disease

Types of Study

Cohort Study

Type of Outcomes

Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Settings

Community

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime