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P3‐455: A randomized, placebo‐controlled trial of intranasal insulin in amnestic MCI and early Alzheimer's
Author(s) -
Craft Suzanne,
Baker Laura D.,
Green Pattie S.,
Minoshima Satoshi,
Cross Donna,
Montine Thomas J.,
Watson G. Stennis,
Van Fossen Brian,
Bonner Laura,
Wilkinson Charles W.,
Plymate Stephen R.,
Tsai Elaine,
Callaghan Maureen,
Leverenz James,
Gerton Brooke,
Trittschuh Emily
Publication year - 2010
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.2010.05.1998
Subject(s) - medicine , insulin , hypoglycemia , placebo , nasal administration , insulin receptor , insulin resistance , endocrinology , pharmacology , pathology , alternative medicine
Background: Although not acknowledged by DSM-IV for example, attentional dysfunction is now recognised as a core cognitive symptom in Alzheimer’s disease (AD). The deficits are pronounced, directly related to disease severity, progress at a comparable rate to other deficits and respond well to treatment. In other dementias, such as Dementia with Lewy Bodies (DLB) and Parkinson’s Disease Dementia (PDD), recent consensus criteria recognize deficits to attention as central features of the conditions which should be evaluated in therapeutic trials. Methods: Much of the evidence for these deficits has been generated by the CDR System, an integrated set of automated tests of attention and memory. This paper will present the largest database of attentional deficits ever assembled from computerised testing in various dementia populations. Results: Data from over 3000 patients identifies differing profiles of attention deficits in AD, DLB, PDD, vascular dementia, Huntington’s disease and delirium. The rates of declines vary between the different groups as do the behavioural implications. The deficits to attention in AD, DLB and PDD respond to various treatments including donepezil, rivastigmine and galantamine. Conclusions: It will be concluded that attention is a major component of the cognitive dysfunction in all types of dementia, and that tests of attention should be part of the assessment profile in all therapeutic trials in the various conditions.