New research is focused on the treatment of non-cognitive symptoms of dementia

The characteristic symptoms of dementia, such as memory loss and impaired thinking, are well known, but these are often the behavioral and psychological symptoms of the psychological symptoms of dementia (BPSD) such as agitation, anxiety, apathy, depression, wanderings, hallucinations, insomnia, incontinence and disinhibition are the main barriers to caregiving . Left untreated, these symptoms can accelerate mental deterioration and impair quality of life.

U.S. Pat. The Food and Drug Administration (FDA) has not approved any drug treatment for these symptoms in people with Alzheimer's disease. All currently used drugs are intended for other indications and are prescribed for patients with Alzheimer's. "

" These underestimated and under-treated symptoms in people with Alzheimer's and other forms of dementia are often very difficult to bear and difficult. "says Maria Carrillo, Ph.D., Scientific Director of the Alzheimer's Association." There is little mention of how these symptoms, which occur frequently, affect and overwhelm people's lives. of Alzheimer's disease and their loved ones. "

" It is very important that we get involved The progress we are making in the treatment and prevention of memory function and thinking in the disease of d & # 39; Alzheimer's and other forms of dementia are also focusing on therapeutic strategies for behavioral and non-cognitive symptoms, "continues Carrillo. Approaches such as psychosocial interventions as an alternative to pharmacological therapy with respect to the treatment of dementia-related behaviors. These therapies include validation, reminiscence and other personalized psychosocial intervention approaches.

The examples are:

• Validate that the person concerned seems to be angry about something.
• Separate the person from what seems to bother him.
• Regular physical activity to reduce irritability and aggressive behavior.
• Determine if pain or constipation or other physical problems exist.

Psychotropic drugs (antipsychotics, antidepressants, anticonvulsants and others) may be considered when non-pharmacological approaches do not improve, especially if dementia-related behavior threatens physical or mental injury, whether for the patient or the caregiver. However, the use of such drugs should be done with the utmost care and should be evaluated regularly to determine the appropriate time to terminate the treatment. The FDA has found that the use of antipsychotics to treat dementia-related behavior in older people with dementia is badociated with increased mortality.

Treatment with the synthetic cannabinoid shows the effect of agitation-reduction in Alzheimer's patients

The results of a randomized clinical study, double-blind suggest that nabilone – a synthetic cannabinoid – can be effective in the treatment of agitation in Alzheimer's patients, "agitation – and this includes verbal and physical explosions, emotional distress general, agitation and wandering – is one of the most common behavioral changes that accompany the onset of Alzheimer's disease and can cause significant stress for nurses ". Lanctôt, Ph.D., Principal Scientist at the Sunnybrook Health Sciences Center and Professor of Psychiatry and Pharmacology and Toxicology at the University of Toronto

Lanctôt and colleagues studied the potential benefit of nabilone for adults with moderate to severe Alzheimer's disease. suffered from clinically significant agitation. During the 14-week study period, the 39 participants (77% of men, mean age 87 years) received nabilone in capsule form (mean therapeutic dose = 1.6 ± 0.5 mg) for six weeks, followed by a six-week treatment. each treatment period. In addition to agitation, general behavioral symptoms, memory, physical changes and safety were also determined. The researchers said:

• Taking nabilone significantly reduced agitation compared with placebo. The Cohen-Mansfield agitation inventory (p = 0.003) was used for measurement.
• Nabilone also significantly improved general behavioral symptoms compared with placebo. The neuropsychiatric inventory (p = 0.004) was used for the measurement.

The researchers also found a small advantage in cognition and nutrition in the study. Under nabilone, subjects were more sedated (45 percent) than placebo (16 percent).

"Currently prescribed treatments for Alzheimer's agitation do not work for everyone, and have little or no effect The risk of adverse side effects is high, including Including the increased risk of death, so there is an urgent need for safer drug options, "says Lanctôt." These results indicate that nabilone can be effective in treating agitation, but the risk of sedation should be carefully monitored, and a larger clinical trial would allow us to confirm our results on the efficacy and safety of the drug. in the treatment of Alzheimer's agitation. "

Note: Marijuana is not approved by the FDA for the treatment or management of Alzheimer's disease and other dementias. With the increasing use of marijuana for medical purposes, it is important to note that there is a lack of clear evidence to use in Alzheimer's patients or other forms of dementia.

Marijuana is a largely untested drug in the Alzheimer's disease There is currently no solid and consistent clinical trial data supporting the use of marijuana for the treatment of Alzheimer's dementia or related disorders. The Alzheimer's Association believes that further research in this area is needed.

Illumination Can Improve Sleep, Mood and Behavior of Alzheimer's Disease [19659002] Many people with Alzheimer's disease and Other forms of dementia develop a disturbed sleep characterized by interruptions, insomnia and drowsiness. Mariana G. Figueiro, Ph.D., director of the Rensselaer Polytechnic Institute's Lighting Research Center in Troy, NY, and her colleagues tested whether a bespoke lighting system could improve sleep, mood and behavior in nursing homes.

"Considering that the rhythm of chiaroscuro is the primary clock of our internal clock, the constant low light that we usually find in healthcare facilities may be one of the causes sleep disorders so prevalent in this population Figueiro says

To test this hypothesis, changing lighting conditions were created over a four-week period in areas where nursing home residents spent most of the time. This type of lighting remained on from waking hours until 6:00 pm 43 residents (including 31 women and 12 men) attended This short-term study: Thirty-seven residents (25 women, 12 men) recruited from 10 nursing homes in New York's Capital District, Bennington, VT, and South Bend, IN, completed the study. long-term up to now

which provided a stimulus strong or weak at the circadian rhythm. The short-term study lasted four weeks, the long-term study six months (consecutive four-week periods separated by a four-week elimination period). The Stimulus Circadian metric (CS) developed by the Lighting Research Center characterizes the effectiveness of a light source to stimulate the circadian system, measured by its ability to greatly increase the production of the hormone melatonin (a well established circadian system marker) after one hour of exposure.

The two parts of the study used either a custom table equipped with LED light, or an individual lighting to perform the intervention, depending on where the participants were most of the time. Personalized photometers were used to determine the exposure to light of the participants' eyes. Sleep disorders, mood and agitation were badessed using standardized questionnaires.

The researchers showed that participants showed significant improvement in terms of sleep disorders, depression, and agitation when the circadian stimulus was strong. The positive effects observed in the short-term study have further improved during the long-term study.

More Than Antipsychotics: A Study of the Efficacy or Harmfulness of Z-Medications in Sleep Disorders

Many people with dementia suffer from sleep disturbances, affecting their quality of life and that of their loved ones. Agonists other than benzodiazepines, which include the drugs Zolpidem, Zopiclone and Zaleplon, are widely prescribed to treat insomnia in the elderly, but it is believed that these medications can cause problems such as falls, fractures and can cause a confused state. Since patients with dementia are generally at higher risk, it is not known whether Z drugs are particularly harmful for this group.

Chris Fox, MD, Professor of Psychiatry at Norwich Medical School, University of East Anglia, Norwich, UK. and colleagues badyzed existing UK Clinical Practice Research Datalink data and three clinical trials with patients with dementia. They compared data from 2,952 dementia patients who were re-prescribed Z drugs with data from 1651 patients who did not receive Z drugs to evaluate the benefits and harms of these drugs for two years .

that Z drug use is badociated with an increased risk of 40% of any type of fracture – the higher the dose, the higher the risk. The use of Z medications was specifically badociated with an increased risk of hip fracture. "Fractures of dementia can have disastrous consequences such as a loss of mobility, an even greater dependency and a growing dementia," says Fox. "We urgently need better alternatives to currently prescribed drugs for insomnia and other non-cognitive symptoms of dementia, and where possible, appropriate non-pharmacological alternatives should be considered, and whether Z-medications are prescribed , patients must take care

International Conference of the Alzheimer's Association® (AAIC®) The International Conference of the Alzheimer's Association (AAIC) is the largest convention in the world for researchers the most prominent of Alzheimer's Disease and other dementias from around the world.As part of the Alzheimer's Association's research program, the AAIC serves as a catalyst to generate new insights into dementia and promote a vibrant and collaborative research community.
AAIC 2018 Home Page: alz.org/aaic
AAIC 2018 Newsroom: alz.org / aaic / press e

About the Alzheimer's Association®

The Alzheimer's Association is the leading voluntary badociation of health professionals in treatment, research and management of Alzheimer's disease. Our mission is to eradicate Alzheimer's disease through advances in research, to provide and improve treatment and support to all stakeholders, and to reduce the risk of dementia by promoting Alzheimer's disease. physical condition of the brain. Our vision is a world without Alzheimer's. Visit us on alz.org or
contact us at 800.272.3900

• Krista Lanctôt, PhD, et al. Nabilon improves agitation in patients with moderate to severe Alzheimer's disease: preliminary results from a double-blind, placebo-controlled crossover trial. Funded by: Alzheimer's Foundation & # 39; s Drug Discovery; Alzheimer Society of Canada Research Program (Grant 15-17).
• Mariana Figueiro, PhD, et al. Customized lighting intervention to improve sleep, mood and behavior in patients with Alzheimer's disease. Funded by: United States National Institute on Aging.
• Chris Fox, MD, et al. Beyond antipsychotics: Exploring the efficacy and harmful effects of Z-drugs on sleep disturbance on the progression of major outcomes of dementia. Funded by: British National Institute for Health Research

Logo – https://mma.prnewswire.com/media/721324/AAIC_2018_Logo.jpg

References and Contact:

Press Office of the United Kingdom. AAIC Alzheimer's Association
Nil Frantz
Alzheimer's Association
312-335-5777
niles.frantz @ alz.org