Sano Mary, Wilcock Gordon K, van Baelen Bart, Kavanagh Shane
Mount Sinai School of Medicine/Veterans Affairs Hospital, Bronx, NY 10468, USA.
Int J Geriatr Psychiatry. 2003 Oct;18(10):942-50. doi: 10.1002/gps.1000.
The aim of the study was to determine whether the clinical benefits of galantamine for patients with Alzheimer's disease lead to benefits for caregivers.
Data were pooled from two concurrent, multi-centre, randomized, double-blind, placebo-controlled, 6-month trials. Time caregivers spent assisting with activities of daily living (ADL) and time patients could be left unsupervised each day were assessed using the Allocation of Caregiver Time Survey. In total, 825 patients with mild-to-moderate Alzheimer's disease were included.
At endpoint, caregivers of galantamine-treated patients were more likely to report reductions (41% vs 37%), maintenance (19% vs 14%) or smaller increases (26% vs 34% reporting an increase >30 minutes) in time assisting with ADL compared with the placebo group (p=0.026; Wilcoxon rank-sum test). The mean daily time difference was 32 minutes (p=0.011). Among patients with moderate Alzheimer's disease, caregivers of galantamine-treated patients were even more likely to report reductions (46% vs 37%), maintenance (15% vs 6%) or smaller increases (25% vs 42% for increases >30 min) vs placebo (p=0.004), with a mean daily time saving of 53 minutes (p=0.021). Caregivers of galantamine-treated patients were more likely to report increases (22% vs 18%), maintenance (45% vs 43%) or smaller reductions (30% vs 37% for reductions >30 minutes) in time the patient could be left unsupervised compared with placebo (p=0.027). Mean daily time saving was 27 minutes. Among patients with moderate Alzheimer's disease, the treatment effect was greater (p=0.029), with caregivers in the galantamine group reporting the change in time left unsupervised as 68 minutes longer each day than caregivers of patients receiving placebo.
The clinical benefits of galantamine for patients with Alzheimer's disease are also associated with benefits to caregiving.
本研究旨在确定加兰他敏对阿尔茨海默病患者的临床益处是否也能给照料者带来益处。
数据来自两项同时进行的、多中心、随机、双盲、安慰剂对照的6个月试验。使用照料者时间分配调查评估照料者每天协助患者进行日常生活活动（ADL）所花费的时间以及患者每天可无人监督的时间。总共纳入了825例轻至中度阿尔茨海默病患者。
在研究终点，与安慰剂组相比，加兰他敏治疗组患者的照料者更有可能报告在协助ADL的时间上有所减少（41%对37%）、维持不变（19%对14%）或增加幅度较小（报告增加>30分钟的比例为26%对34%）（p=0.026；Wilcoxon秩和检验）。平均每日时间差异为32分钟（p=0.011）。在中度阿尔茨海默病患者中，加兰他敏治疗组患者的照料者更有可能报告时间减少（46%对37%）、维持不变（15%对6%）或增加幅度较小（增加>30分钟时为25%对42%），与安慰剂组相比（p=0.004），平均每日节省时间53分钟（p=0.021）。与安慰剂组相比，加兰他敏治疗组患者的照料者更有可能报告患者可无人监督的时间增加（22%对18%）、维持不变（45%对43%）或减少幅度较小（减少>30分钟时为30%对37%）（p=0.027）。平均每日节省时间27分钟。在中度阿尔茨海默病患者中，治疗效果更大（p=0.029），加兰他敏组的照料者报告患者无人监督的时间变化比接受安慰剂治疗患者的照料者每天长68分钟。
加兰他敏对阿尔茨海默病患者的临床益处也与照料方面的益处相关。
