[P5.221] Effectiveness of Cognitive Enhancers in Alzheimer's Disease with Concomitant Small Vessel Cerebrovascular Disease.
Kok Pin Ng, A. Ng, E. Heng, S. Huang, P. Assam, Nagaendran Kandiah
OBJECTIVE: To study the effectiveness of cognitive enhancers for patients with mild to moderate AD+svCVD in a clinic cohort.
BACKGROUND: The prevalence of Alzheimer's disease (AD) is increasing worldwide. Among Asians, high prevalence of small vessel cerebrovascular disease (svCVD) has resulted in AD+svCVD to be a major cause of dementia. There is limited data on the effectiveness of cognitive enhancers in these patients.
DESIGN/METHODS: Retrospective analysis of a prospective clinical database. Demographics, cerebrovascular risk factors, medications and cognitive scores were studied. Patients with mild to moderate AD were included. AD was diagnosed using NINCDS-ADRDA criteria. White Matter Hyperintensities scored using the modified Fazekas scale, was used to diagnose svCVD. AD patients with a modified Fazekas score of ≥6 were classified as AD+svCVD. Effectiveness of cognitive enhancers was compared between AD and AD+svCVD group using regression analyses.
RESULTS: 192 patients were identified, 31 patients with AD and 161 patients with AD+svCVD. Mean age was 71.8 (SD 8.66) years. 84.9% of the patients were Chinese. 60.4% of the cohort had a diagnosis of hypertension. Baseline MMSE for AD+svCVD and pure AD were 20.0 (SD 5.38) and 22.9 (SD 4.68) respectively. Despite patients with AD+svCVD having significantly lower baseline MMSE scores, the rate of decline in MMSE in this group was lower compared to patients with pure AD and by month 24, the difference in MMSE between patients with AD+svCVD and pure AD were no longer significantly different. Based on 48 month data, with cognitive enhancer treatment, the annual change in MMSE among pure AD patients was -0.2 points/year while the change in MMSE score among AD+svCVD patients was +0.15 points/year.
CONCLUSIONS: Our findings demonstrated a trend towards greater benefit with cognitive enhancers among patients with AD+svCVD compared to pure AD. These findings would need to be confirmed in randomized clinical trials.
Category - Aging, Dementia, and Cognitive and Behavioral Neurology: Treatment/Interventions
Wednesday, April 30, 2014 3:00 PM
P5: Poster Session V: Aging, Dementia, and Cognitive and Behavioral Neurology: Cerebrovascular Ischemia, Metabolism, and Epidemiology (3:00 PM-6:30 PM)