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P4‐316: Choices for 2008 one day at a time: A cognitive therapy calendar
Author(s) -
Gang Vanessa N.
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.2008.05.2386
Subject(s) - conversation , psychology , narrative , dementia , interpersonal communication , social psychology , medicine , disease , communication , linguistics , philosophy , pathology
impairment and the pattern of neuropsychiatric symptoms (NPS) in AD has been generally characterized. Better understanding of this relationship could help predict NPS symptom targets as well as their potential responsiveness to treatment intervention. The objective of these analyses was to investigate a novel analytical technique relating NPS across individual strata of MMSE scores in patients with AD treated with placebo or donepezil. Methods: Data were pooled from 1106 patients with mild to severe AD (MMSE: 5-26) who were enrolled in 5 randomized, double-blind, placebo-controlled studies of donepezil and who had available data collected using the 10/12-item Neuropsychiatric Inventory (NPI). Bubble matrices were generated for the placebo and donepezil groups by plotting individual baseline MMSE scores (y-axis) against the 12 NPI items (x-axis). A bubble was fitted into each matrix cell with the size of bubble representing the magnitude of effect size (NPI raw mean change/SD at week 24 for corresponding NPI item and MMSE score). Treatment effects were then analyzed by evaluating differences between the placebo and donepezil matrices and measuring the number and magnitude of positive and negative changes. Statistical analyses were performed using the McNemar and Wilcoxon Signed-Rank tests. Results: Comparing overall bubble patterns between placebo and donepezil (N 241 pairs) showed a significant donepezil treatment effect (57% of bubble cells showed a positive change, P 0.024). Changes between the placebo and donepezil matrices were predominantly positive for 10 of the 12 NPI items. When the magnitude of positive and negative changes was analyzed, an overall positive treatment effect was observed (P 0.049). Nine of the 12 NPI items showed an overall positive change in item score. Conclusions: Using this bubble plot analytic technique, it is possible to evaluate an overall effect on individual NPS at each level of MMSE score, as well as evaluate each individual item in a novel way. This approach may assist in the challenge of identifying target symptoms and evaluating their responsiveness to treatment intervention.