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Dee Dee's Message Board > Dr. Salib and coauthor Jessica Thompson, cheap bea
Dr. Salib and coauthor Jessica Thompson, cheap bea
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Mar 31, 2013
7:19 PM  |
Dr. Salib and coauthor Jessica Thompson, MD, from Peasley Cross Hospital,cheap beats by dre uk St. Helens, United Kingdom, compared 127 patients who were prescribed cholinesterase inhibitors in 2006 with 212 patients who were not to see whether they had been placed in care or had remained in their own home during a 4-year period.
All patients were seen at a clinic that provided psychiatric services for the elderly. Participants' mean age was 82 years; 219 (65%) were women, and 120 (35%) were men.
The most commonly prescribed cholinesterase inhibitor was donepezil, which was given to 74% of patients, followed by galantamine in 14%, and rivastigmine in 8%. Four percent of patients received memantine in combination with a cholinesterase inhibitor.
Commenting on this study for Medscape Medical News, Anton P. Porsteinsson, MD, William B. and Sheila Konar professor of psychiatry and director, Alzheimer's Disease Care, Research and Education Program at University of Rochester School of Medicine and Dentistry, New York, called it a strong study, despite its limitations.cheap dr dre beats"A cautious interpretation of this study is that in an observational sample it appears that consistent use of cholinesterase inhibitors is associated with temporary delay in admission to a nursing home, and as published previously, more patients on the drugs were alive at the end of the 4-year observation period," Dr. Porsteinsson said.
"While there might be subtle differences between the groups that could explain the findings, they nevertheless support early and consistent use of these medications and suggest that there may be benefits beyond the short term," he said. "The fact that this is a community based observational study, independent of pharmaceutical company support, is a strength."
A diagnosis of probable Alzheimer's disease was made in 56% of the patients, 34% had a diagnosis of dementia possibly combined with Alzheimer's disease, and the remaining 10% had a diagnosis of Parkinson's disease-related dementia, Lewy body dementia, or other dementias.
In addition, patients who were not prescribed cholinesterase inhibitors had diagnoses that included senile dementia of Alzheimer's type, early-onset dementia, and dementia of combined etiology.
The mean survival from the time patients were first seen at the clinic was 33 months, and the mean survival time in a care home was 18 months.
The authors found that during the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those patients who took cholinesterase inhibitors compared with those who did not.
By 40 months, the probability of being placed in a nursing home was similar for both groups.
Treating patients who exhibit early signs of dementia with cholinesterase inhibitors has immense implications, Dr. Salib said.
"Treatment daily with drugs like Aricept would cost ?2 a day, so in a year it will cost about ?700. A year in a nursing home will cost ?25,000, so if I delay admission to a nursing home by using drugs, this means enormous savings, not just in money but in emotions and stress," he said.beats by dre uk Dr. Salib also pointed out that his study was observational and needs to be replicated using a larger sample of patients.
"The major deficiency here is the controls were not matched. Every case should be matched with controls, but if you select controls this way you will deprive people of treatment. So the matching wasn't perfect, but it was the best I could do," he said. |
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Mar 31, 2013
8:16 PM |
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