Efficacy of SSRIs on cognition of Alzheimer's disease patients treated with cholinesterase inhibitors.

Background: This study examines the joint effect on cognition of selective serotonin re-uptake inhibitors (SSRIs) and cholinesterase inhibitors (AChEIs) in depressed patients affected by Alzheimer’s disease (AD) living at home. Methods: The study was conducted in two different outpatient neurological clinics. 338 patients with probable ADwere treated with ChEis (donepezil, rivastigmine and galantamine) as per the clinician’s judgment and were observed for nine months. At study entry, participants underwent a multidimensional assessment evaluating cognitive, functional and psychobehavioral domains. All patients were evaluated at baseline, after one (T1), three (T2) and nine months (T3). Patients were grouped in three different categories (patients not depressed and not treated with SSRIs, patients depressed and treated with SSRIs, and patients depressed but not treated with SSRIs). Results: At baseline 182 were diagnosed as not depressed and not treated with SSRIs, 66 as depressed and treated with SSRIs, and 90 as depressed but not treated with SSRIs. The mean change in MMSE score from baseline to nine months showed that depressed patients not treated worsened in comparison with those not depressed and not treated with SSRIs (mean change −0.8±2.3 vs 0.04±2.9; p = 0.02) and patients depressed and treated with SSRI (mean change −0.8±2.3 vs 0.1±2.5; p = 0.03). Conclusions: In AD patients treated with AChEIs, SSRIs may exert some degree of protection against the negative effects of depression on cognition

Delayed diagnosis of coeliac disease increases cancer risk

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Acetylcholinesterase inhibitors and depressive symptoms in patients with mild to moderate Alzheimer's disease

Acetylcholinesterase inhibitor (AChEis) therapy in Alzheimer Disease (AD) has been shown to provide cognitive benefits and to slow progression of the disease. AChEis have also been demonstrated to improve behavioral symptoms, although there seem to be subtle differences in the magnitude of response. The aim of our study was to evaluate the effect of 16 weeks treatment with AChEis on depressive symptoms in a selected sample of AD patients in routine clinical practice

Effects of cholinesterase inhibitors appear greater in patients on established antihypertensive therapy.

Introduction There is increasing evidence that hypertension may contribute to development of dementia. Studies show that blood pressure lowering therapy might protect against cognitive deterioration and that antihypertensive treatment reduce the incidence of dementia. Aim We hypothesize that administration of cholinesterase inhibitors (AChEis) to patients with Alzheimer’s Disease (AD) receiving antihypertensive medications therapy would result in clinical benefits for a period of 40 weeks in routine clinical practice. Methods and materials Patients with possible or probable AD were enrolled from 16 Alzheimer evaluation units (UVA) of Brescia and Cremona (Northern Italy). Patients treated with donepezil, rivastigmine and galantamine for 40 weeks independently of dosages were selected. Patients were evaluated at baseline (T0), 4 weeks (T1), 16 weeks (T2) and 40 weeks (T3). Results 416 patients completed the study at 40 weeks; of these 255 were ‘non users’ while 161 utilized antihypertensive drugs (‘users’). The mean change in MMSE score from baseline to week 40 demonstrate that antihypertensive-treated patients improved by 0.7 points while patients receiving only AChEis remain stables. Analyzing separately patients (n¼183) that ameliorate (responders) on cognition at T3 (1 point MMSE score increase) a significant differences in favor of ‘users’ antihypertensive drugs over ‘non users’ on cognition at weeks 16 and 40 has been demonstrated. In particular, at T2 the mean change of MMSE from baseline in ‘users’ was 3.22.6 vs ‘non users’ 2.22.3 ( p¼0.016) and at T3 was 3.52.5 vs ‘non users’ 2.0.2.71.6 ( p¼0.018). Antihypertensive drugs were independently associated with cognitive improvement in responder patients treated with AChEis (95% CI: 0.41–1.79; p¼0.002). Conclusion Antihypertensive medications in AD patients treated with AChEis are associated with an independent improvement on cognition after 40 weeks of treatment

Acetylcholinesterase inhibitors and depressive symptoms in patients with mild to moderate Alzheimer's disease

Acetylcholinesterase inhibitor (AChEis) therapy in Alzheimer Disease (AD) has been shown to provide cognitive benefits and to slow progression of the disease. AChEis have also been demonstrated to improve behavioral symptoms, although there seem to be subtle differences in the magnitude of response. The aim of our study was to evaluate the effect of 16 weeks treatment with AChEis on depressive symptoms in a selected sample of AD patients in routine clinical practice

Effects of cholinesterase inhibitors appear greater in patients on established antihypertensive therapy

There is increasing evidence that hypertension may contribute to development of dementia. Studies show that blood pressure lowering therapy might protect against cognitive deterioration and that antihypertensive treatment reduce the incidence of dementia