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September 26, 2001
Reminyl™ (galantamine), the newest medication approved to treat mild to moderate Alzheimer’s disease, can ease the burden on family caregivers by reducing the amount of time required for supervision and assistance, and help alleviate the stress associated with these responsibilities. This was according to data presented at the Tenth Congress of the International Psychogeriatric Association (IPA).
"A reduction in time required for assistance isn't just a convenience and relief for the caregiver, it's also a reflection of increased independence for the person with Alzheimer's, which makes it a 'win-win' situation," comments Prof. Gordon Wilcock of the Frenchay Hospital of the University of Bristol (UK). “The longer we can preserve independent functioning for the patient, the more dignity and quality social interaction is possible."
Several IPA research presentations assessed the impact of Reminyl treatment on patient functioning by exploring the resulting impact on time required of family caregivers. One analysis led by Dr. Wilcock, focused on the time caregivers spent supervising their family members or assisting them with activities of daily living, such as dressing and bathing.
The analysis found that the time required supervising patients who received placebo increased by approximately two hours per day over the six months. In contrast, the time spent supervising individuals who took Reminyl did not increase significantly. In addition, the time that caregivers spent assisting patients on placebo with daily-living activities increased steadily throughout the trial, totaling an average of 23 extra minutes per day by the end of six months. On the other hand, caregivers of patients taking Reminyl reported a decrease in the amount of time spent assisting their charges by an average of 38 minutes per day.
The analysis included 435 patients with mild to moderate Alzheimer's disease who had been randomly assigned to receive either 24 mg of Reminyl daily (220) or placebo (215) for six months as part of a larger study conducted in Europe and Canada. The results were assessed using tools that measured the patients' ability to learn, think and reason. In addition, the treating physician’s overall impression of the patients' function, along with input from caregivers was used to assess the patient. Primary caregivers in the patient’s families were also asked to complete a questionnaire on the time they spent on supervision and assistance.
Another study focused on caregiver distress and was conducted by Pierre Tariot, MD, from New York's University of Rochester Medical Center. He examined the data from a five-month study in which 286 U.S. patients with mild to moderate Alzheimer's disease were assigned to receive placebo, 279 took a maximum daily Reminyl dose of 16 mg and 273 received a maximum of 24 mg of Reminyl daily.
Caregiver distress was assessed using a subscale of the Neuropsychiatric Inventory (NPI), one of the secondary measures of efficacy used in the study. Participating caregivers rated the degree of distress they experienced in response to 10 types of patient symptoms, such as hallucinations, delusions and agitation.
The analysis found that after five months, distress significantly increased among those caring for patients who took placebo. In contrast, distress scores were not significantly different at the end of the study than at the beginning for those caring for persons who received either one of the two Reminyl doses.
"This relative decrease in distress levels among caregivers with family members taking Reminyl may be due at least in part to the ability of the medication to delay the emergence of behavioral disturbances in many patients, including agitation, anxiety and hallucinations," said Dr. Tariot. "The ultimate benefit may be that patients can stay at home longer, before full-time institutionalization or other types of chronic, professional care is required."
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