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P2‐436: The neuropsychiatric practitioner's experience with Alzheimer's disease and treatment thereof: A survey on general impressions in everyday routine
Author(s) -
Ibach Bernd,
Riepe Matthias W.
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1515
Subject(s) - dementia , medicine , disease , depression (economics) , everyday life , psychiatry , alzheimer's disease , clinical psychology , psychology , family medicine , political science , law , economics , macroeconomics
[89.3/65.3], men 71,1 [81.6/62.6]).Co-existing dementia prior to ECT was diagnosed in 10 (23.8%) patients, mild cognitive imparment (MCI) in 7 (16.7%). Advanced vascular or neurodegenerative disease was found in 50% of patients. The affective symtoms were rated with Hamilton Depressions Scale 24 (HAMD 24) before, during and after finishing ECT. All patients achieved complete or partial remission of affective symptoms in HAMD 24. During ECT-treatment, patients with dementia or MCI showed more distinctive cognitive deficits than geriatric participiants without preexisting cognitive deficits in rating MMSE. In patients with cerebrovascular lesions, neurodegeneration or both in cranial MRI transient cognitive impairments were induced faster than in patients without cerebral changes. About 75% of these patients had not achieved baseline levels in cognitive functioning 8 weeks after finishing treatment. In 1/3 MCI or dementia were diagnosed in follow-up. Geriatric patients without cognitive impairment before treatment and no or only mild neuroimaging findings achieved full cognitive functioning during follow-up. Conclusions: Our results show that ECT is effective in refractory geriatric depression. Severe cognitive side-effects occur mainly in patients with pre-diagnosed cognitive impairment or MRI signs of neurodegenerative or vascular disease.