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The Impact of Pharmacological Treatments on Cognitive Function and Severity of Behavioral Symptoms in Geriatric Elder Patients with Dementia

Nian-Sheng Tzeng, Wei-Shan Chiang, Shun-Yi Chen, Yu-Ching Chou, Kun-Ming Lee,San-Yuan Huang, Chin-Bin Yeh, Chun-Yen Chen, Hsin-An Chang, Yu-Chen Kao

Objective: This study was to determine the impact of different pharmacological treatments on cognitive functions and the severity of the behavioral and psychological symptoms (BPSD) in elderly patients with dementia. Methods: The study was a prospective, and observational study. We examined 70 older patiens with dementia with the Mini-Mental Status examination (MMSE) and the Neuropsychiatric Inventory (NPI) Scale at each time of the outpatient visits at the 1st, 4th, and 12th week, to find out the impacts of antipsychotic drugs, mood stabilizers/antidepressants, hypno-sedative, and cognitive enhancers/anti-dementia drugs. Results: The majority of dementia types were Alzheimer’s dementia (AD, n = 40, 57.1%) and vascular dementia (VaD, n = 28, 40%). The caregivers were their spouses (n = 10, 14.3%), or children (n = 53, 75.7%). We found that psychotropic medications, 27 (38.6%) of the patients used antipsychotic drugs, 25 (35.7%) mood stabilizers/antidepressants, 27 (38.6%) hypno-sedatives, and 48 (68.6%) cognitive enhancers/anti-dementia drugs. Those medications did not show any significant improvements of the MMSE at 12th weeks. Mood stabilizers/antidepressants reached a significant decrease in both the NPI severity and the caregiver distress scores. Conclusion: In this study, we found that patients with BPSD, receiving antipsychotics, mood stabilizers/antidepressants, hypno-sedative and cognitive enhancers/anti-dementia drugs did not improve the MMSE scores at the end of study, but that those receiving mood stabilizer/antidepressants showed a significant decrease on the behavioral disturbances measured by the NPI scale.
Key Word cognitive function, mini-mental status examination, behavioral and psychological symptoms, neuropsychiatric inventory
Editorial Committe, Taiwanese Journal of Psychiatry
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