Nakano Yumiko, Matsuzono Kosuke, Yamashita Toru, Ohta Yasuyuki, Hishikawa Nozomi, Sato Kota, Deguchi Kentaro, Abe Koji
J Alzheimers Dis. 2015;47(3):609-17. doi: 10.3233/JAD-150308.
Alzheimer's disease (AD) is one of the most significant diseases affecting an increasingly aging society.
To determine the long-term efficacy of galantamine treatment in a Japanese population.
We performed "Okayama Galantamine Study (OGS)" to retrospectively analyze the clinical effects of galantamine in 279 AD patients using 7 batteries for assessing dementia at baseline, 3, 6, 12, and 24 months. We further analyzed the effects of galantamine based on gender and the severity of their baseline cognitive, affective, and activity of daily living (ADL) functions.
In all 279 AD patients (80.6 ± 7.2 years old, MMSE 20.0 ± 4.5), cognitive functions were well preserved until 12 months and even frontal assessment battery improved after 12 months although Hasegawa dementia scale-revised finally worsened at 24 months ( *p < 0.05) with galantamine treatment. Affective and ADL functions were also well maintained after galantamine treatment with significant improvement of Geriatric Depression Scale scores at 3 months ( *p < 0.05). Subanalyses showed the better response to galantamine for male and lower baseline function subgroups.
Our present study (OGS) revealed a long-term efficacy of galantamine in very elderly AD patients, and suggested a better efficacy for male and baseline lower cognitive, affective, and ADL functions.
阿尔茨海默病(AD)是影响日益老龄化社会的最重要疾病之一。
确定加兰他敏治疗在日本人群中的长期疗效。
我们开展了“冈山加兰他敏研究(OGS)”,以回顾性分析加兰他敏对279例AD患者的临床效果,在基线、3个月、6个月、12个月和24个月时使用7套评估痴呆的量表。我们还根据性别以及基线认知、情感和日常生活活动(ADL)功能的严重程度分析了加兰他敏的效果。
在所有279例AD患者(80.6±7.2岁,简易精神状态检查表评分为20.0±4.5)中,认知功能在12个月前得到良好维持,尽管修订版长谷川痴呆量表最终在24个月时恶化(*p<0.05),但额叶评估量表在12个月后有所改善,加兰他敏治疗有效。情感和ADL功能在加兰他敏治疗后也得到良好维持,老年抑郁量表评分在3个月时显著改善(*p<0.05)。亚组分析显示男性和基线功能较低的亚组对加兰他敏反应更好。
我们目前的研究(OGS)揭示了加兰他敏对高龄AD患者的长期疗效,并表明对男性以及基线认知、情感和ADL功能较低者疗效更佳。