Remission of neuroleptic associated tardive dyskinesia in Alzheimer's disease following treatment with donepezil

Poster

REMISSION OF NEUROLEPTIC ASSOCIATED TARDIVE DYSKINESIA IN ALZHEIMER’S DISEASE FOLLOWING TREATMENT WITH DONEPEZIL Leslie

J Sheldon.

St Vincent’s

Hosp.

Vmcouver,

BC Cunado

FACTORIAL AND DISCRIMINANT ANALYSES OF NEUROFSY110471 CHOLOGICAL VARIABLES IN FAMILIAL AND SPORADIC LATE ONSET ALZHEIMER t runcisco Loprru, Medellin Sonia

Colombiu: Moreno,

Medellin

Melbin

Velazyuez,

Andres

Nicola~

Castuno,

Juramillo,

DISEASE.

Maria Upb,

Mauri&

Tom,

Univ

Colombia;

Arms-Burgos,

dr

Antioquiu.

Lucia

Madrigul,

Univ

de Antioquia,

Colombia

INTRODUCTION: The prevalence of Late Onset Alrheimer’a Diaeare (LOAD) whether Familial or Sporadic ia increasing in time taking into account the raising of the third age population. Evidence either supporting or rejecting the existence of differences in the clinical behavior of the neuropsychological varibles observed in the familial and sporadic cases. AIM: To identify neuropaychological variables discrimmating among familial and Sporadic cases affected by LOAD that offer information on the pathological process of the neurodegenerative dtsorder. MATERIALS AND METHODS: Using sequential sampling, individuals affected by LOAD according to the criteria of the DSM-IV and NINCS-ADRA were ascertained. The next protocol was used: CERAD, Wisconsin, Phological fluency, Rey’s figure,A Cancellation Teat,Wais-R, Arithmetic, GDS,FAST, Barhtel, and Yeaavage scales. Parametrical and no-parametrical univariate, factorial (principal components) and diacriminant analyses were performed in order to define differences among the two sets and to observe new variables explaining most of the variance. RESULTS: 52 Patients were analysed (average age = 74; mean of onset age of disease = 69 years; time of evolution of diwtse = 5 years; average of educational level = 6 years). There were not significant statistical differences between familial and sporadic cases of LOAD whether analyzing clinical or neuropsychological variables. Additionally neither variables nor models discriminating significantly between one an another. CONCLUSIONS: The Familial and Sporadic cases of LOAD presents the same clinical and neuropsychological phenotype that makes very probable the both being cawed by gnetical factor\ with low penetrance in the sporadic one\.

VASCULAR RISK FACTORS AND COGNITIVE MAASTRICHT AGING STUDY Jellemer hmds:

Jnlles, Hans

Mwtin

Bosmu,

PJ Van Aoxtel,

Maastricht

&iv,

Uni\’ Bruin

MEMORY IS PRESERVED IN ALZHEIMER’S IMPAIRED IN PARKINSON’S DISEASE

DIS-

Elizabeth

Deirdrr

MIT,

A Kensinger,

of Maastricht, and Behavior

AGING:

Maustricht Institute.

THE

The

Nether1und.s

Poster Presentation:

Clinical

Research

Suzanne

Corkin,

IV

pimy

TREATMENT OF AGITATION ASSOCIATED USING DIVALPROEX SODIUM

S Raker.

George

L?krtsos,

Copp’per Ridge

Johns Hopkins

Insntute,

S?kr.wille,

WITH DEMENTIA

Sch of”Medicine,

Bultimore,

MD;

A/w

MD

Behavioral disturbances are frequent in residents of long-term care (LCT) with dementia. Despite other interventions, pharmacologic treatments are often necessary. This study of a consecutive series of 29 residents of LTC investigated the effectiveness of Divalproex sodium (DVS) for behavioral disturbances. Outcomea were assessed in chart review by an independent geriatric physician, and rated on a seven point Clinical Global Impression (CGI) scale (I =much worse to ‘I=resolved). Participants had a mean age of 77 years (SD 9.1). 17 (59%) were male. They exhibited one or more behavioral disturbances as classified by the Cummings Neuropsychiatric Inventory. 26 were treated for agitation or irritability (n=24); one wab treated for aberrant motor behavior and two for disinhibition. Patients were treated for a mean of 487 days (SD 377). The mean peak dose was 1,121 mglday (SD 521; range 250.2625), with a mean blood level of 60 ng/dL (SD 24, range 16-102). Of the 29 patients, 15 (52%) were rated as being at least somewhat improved and 5 (17%) were rated as being much better. In one patient, there was complete resolution of the behavior disturbance. There was an association between peak treatment do\e and response: responders received on average 1310 mg of DVS (SD 487) as compared to 920 mg per day (SD 494) for patients who were not responders (p
piEq

THE RELIABILITY AND VALIDITY OF THE ALZHEIMER’S DISEASES ASSESSMENT SCALE COGNITIVE SUBSCALE (ADAS-COG) AMONG CHINESE ELDERLY PEOPLE IN HONG KONG

Lertn,q-wing Sau Lan Hong

Vascular risk factors have been implicated in cognitive change during adult life. Estimation of the impact of such factors, including blood pressure status, diabetes, and physical activity level on different aspects of cognitive function in a normal aging population (24-81 year at baseline) is one of the main themes of the Maastricht Aging Study (MAAS). The paper will discuss the cross-sectional and longitudinal findings (3.year follow up in individuals aged 50 years and older) in MAAS with respect to their capacity to explain individual differences m performance on memory and information processing tasks. A special reference is made to blood pressure and diabetes.

Joseph J Lncascio,

This study addressed the issue of whether the components of working memory (WM) (short-term storage, monitoring/manipulation, and executive processes) are differentially affected by early Alzheimer’s disease (AD) and early Parkinson’s disease (PD). We tested IO AD. IO PD, and 82 age- and education-matched healthy volunteers. Participants were given two storage tasks, four updating/manipulation tasks, two executive function tasks, and two processing speed/reaction time tasks. ANOVAs were performed to compare the performance of the three groups on each task. The AD group performed comparably to healthy volunteers on the majority of tasks; they were significantly impaired on one test of updating/manipulation and ooe test of reaction time (p<.OOOl). In contrast, PD participants performed worse than healthy volunteers on at least one task for each component (p < .05). The PD group performed Eignificantly worse than the AD group on one executive function task, when scores were controlled for accuracy (p<.O5). These results suggest that AD and PD differentially affect WM. wth AD having little effect on any component of WM, and PD having a more pronounced effect on all components.

The NetherMaustrichr

K Mill&m,

MA

Constantine

Eugenirr Medellin

WORKING 11049( EASE BUT

Cumbndge,

Tardive dyskinesia (TD) is generally regarded as a chronic condition with a portion of individuals at risk being affected each year. Neuroleptic expowre, increasing age, female gender, brain injury and the presence of a primary mood disorder are generally accepted risk factors. To date, atyplcal neuroleptio appear to have a lower incidence and prevelance of TD associated with their use. A 72 year male Caucasian suffering AD entered residential care with beliefs not shared by others and dysfunctional behavior. Treatment with risperidone was successful without causing dystonia. Ongoing surveillance for abnormal involuntary movements (AIM) detected lingual and chewiog movements after 27 months. Thirty three months after commencing treatment the beliefs and dysfunctional behavior returned. After 24 weeks treatment with donepezil the AIM was continuously remitted. An 82 year female Caucasian suffering AD entered residential care due to functional incapacity. Bruxism, side to ctde jaw movement, abnormal facial movements, athetoid movements of the limb\ and truncal rocking were noted. Intermittent agitation and wandering in the community had been treated with loxapine. Primary agitation progressed, eventually reaching an extreme level of distress and dysfunctional behavior. No effective treatment plan was found. After 12 week5 treatment with donepezil minimal AIM could be provoked on specific testing. The author proposes a hypothesis to explain this novel observation.

Clinical Research IV

Presentation:

Chu. Patrick

Hui,

Queen

Kc Chiu.

Mary

Hasp

The Univ Hong

of Hong

Kong;

Peter

Kong

Hong

Kong;

Lee, The Univ

Wilson

qf Hong

Tcui. Kong

Kong

Introduction The Alzhelmer’s Disease Assessment Scale cognitive subscale (ADAScog) was reported to be a sensitive cognitive function assessment scale for AlLheimer’s Disease (AD). The English, Greek, Spanish but not Chinese versions had been validated previously. Objectives The objectives of the present study were to Investigate the reliability and validity of an adapted Chmese version of the ADAS-cog among Chinese elderly AD patients in Hong Kong. Method Thirty-nine subjects were recruited during the period July to December 1998. Twenty were AD patients while 19 were non-demented normal subjects. Two rater5 admimstered the ADAS-cog scale