Poster Presmtution: Drug Studies II S240

STRATEGIC OF PSYCHOEDUCATIVE INTERVENTION ON

CAREGIVERS OF PATIENTS WITH ALZEIMER’S DISEASE.

Anu Akquritu E.\pin Andrude, Univ Hasp Calixto Garcia, La Huhuna Cuba

The constant care of patient wth ALrheimer’s disease supposes an affection from a physical, psychial and socio economic point of view in the family, aminly in persons giving most of care. This results in inadequate dealing of the situation whcih has an unfavorable impact on disease course. The alternate non pharmacological treatment such as orientation, education and support to families the critis in a great measure, the care giver burden and improves the patients quality of live. In the present paper a group intervention methodology linking therapuetic and educative elements in care givers of those patients is given. A strategic approach in the elabortaion of this program from the technique of focal groups, for the identification of care givers learning needs is used. An assessment system for the progress effectiveness and impact of the program is shown. This strategy was applied to a group of care givers (relatives) and t was very effectove due to the knowledge and skills got over that time. Pychoemotional stress in this persons was also reduced. The program had a good impact both in the quality of life of care givers and on patients with Alzheimer’s disease.

pi&q GALANTAMINE POSTPONES THE EMERGENCE OF BEHAV- IORAL SYMPTOMS IN ALZHEIMER’S DISEASE: A 5-MONTH, RANDOMIZED, PLACEBO-CONTROLLED STUDY

Pirrre N Tariot, Univ of Rochestrr Mrd Ctr, Rochrster. NY; Paul KPrshmv. CNS C/in Research, Jmsserr Research Fdn. Brrrsr Belgium

Objective: Galantamine, a novel treatment for Alzheimer’s disease (AD), inhibits acetylcholinesterase and modulates cholinergic nicotinic receptors. This 5.month study evaluated the efficacy and tolerability of galantamine. Method: A multicenter, double-blind, placebo-controlled study was undertaken in patients with mild-to- moderate AD. Patients were randomly assigned to one of four treatment arms: placebo (n = 286). galantamine 8 m&/day (n = 140). galantamine 16 mglday (n = 279) or galantamine 24 mg/day (n = 273). The 16. and 24-mg doses of galantamine were escalated over a 4. and &week period, respectively. Efficacy measures were the cognitive wbscale of the Alaheimer’s Disease Assessment Scale (ADAS-cog), the Neuropsychiatric Inventory (NPI). the 23-item version of Alzheimer’s Disease Cooperative Study Actwities of Daily Living (ADCS-ADL) inventory and the Clinician’s Interview-Based Impression of Change plus Caregiver Input (CIBIC- plus). Safety evaluations included monitoring for adverse events (AEa), ECG and standard laboratory tests. Results: After 5 months, patients in the galantamine 16 mg/day and 24 mg/day groups had significantly better outcomes on ADAS-cog, ADCS-ADL and CIBIC-plus compared with placebo 0, < 0.01 for all comparisons vs. placebo). The NPI scores for the 16. and 24.mg/day groups were maintained at baseline level\, wherea the placebo group had significantly deteriorated compared with baseline (/, < 0.05, both doses vs. placebo). NPI analysis showed that anxiety, disinhibition, aberrant motor behavior and hallucinations contributed to galantamine’s favorable effects on behavioral symptoms (/, < 0.05, both doses vs. placebo, except for hallucinations p < 0.05, 24.mg dose vs. placebo). Treatment discontinuations due to AEs were low in all galantamine group? (6-10%) and comparable with the discontinuation rate in the placebo group (7%). The incidence of AEs was low, and most AEs were mild. Conclusion: This 5.month study showed that as well a< alleviating cognitive and functional symptoms of AD, galantamine postpones the emergence of behavioral symptomr.

110981 WITHDRAWN

110991 WITHDRAWN

RIVASTIGMIN TREATMENT EFFECT ON THE PERFORMANCE

OF AD PATIENTS IN A COMPUTERIZED NEUROPSYCHOLOG- ICAL TEST BATTERY: A PRELIMINARY STUDY.

H&nice Charchat Fichman, Ricardo Nitrini, Paula Caramrlli, Valrria Bahia, Univ of&a Paulo. Sao Paulo Brazil; Luis Henrique Fichman, Koichi Sameshimu, Univ of Sue Poulo. sue Paldo Rruzil

Rivastigmin treatment effect on the performance of Alzheimer’s Diseae patients in a Computerized Neuropsychological teat Battery: a preliminary study. Charchut- Fichman H, Nitrini R. Caramel/i P, Bahra V, Fichmm LH. Sumeshima K. Behavioral and Cognitive Neurology Unit and Functional Neurosurgery Lab., Department of Neurology, University of Slo Palo School of Medicine. Objective: To investigate what is the effect of the rivastlgmin treatment on the performance of Alzheimer‘s

Disease (AD) patients in a Computerized Neuropsychological Test Battery (CNTB) and the possibility of prediction, prior the treatment, which are the patients who will benefit from the drug. Methods: Thirteen AD patients defined with NINCDS- ADRDA criteria were studied (55 79 years old, 1 18 year of education, 8 men and 5 women). Four had moderate (CDR:2) and 9 mild (CDR: I) dementia. The bubjectb were submitted to a CNTB before and after 6 months of treatment. The CNTB evaluated episodic memory with face, word and picture recogmtion tests and attention with choice reaction time teats using geometric shapes and numbers. In each test response latency (reaction time RT) and percentage of correct response (PCR) were regirtered. The change in performance in CNTB was measured by the mean difference of PCR, RT and AD probability. Results: Hierarchical cluster analysis usmg the three variables that measured change m perfomxmce divided the subjects withm two groups. The group I showed an improvement of 12% in the PCR and the group 2 0.39%. The RT and AD probability didn t change with the treatment. The mean of PCR was the best variable to qhow improvement in performance on CNTB. The group I had 63.4.56 PCR mean and the group 2 had 78.25% before the treatment (t = 4.16, piO.05). After 6 month?, the group one has 76.86% and the group two 79.05% (t=O.462. p>O.OS). All patients that improved the performance in CNTB (group I) had PCR mean lower than 70% before the treatment. Conclusion: The rivastigmin treatment improved ( group 1) or stahllized (group 2) the performance on CNTB in AD patients. Further, the PCR mean before the treatment WBF a useful tool to predict which group would maximize the benefits of rivastigmin treatment.