Valentin Bragin, M.D., PhD, Marina Chemodanova, MEd,? Narmina Dzhafarova D.O. M.D., Ilya Bragin,BS,? Pavlo Chernyavskyy,BS, Gjumrakch Aliev, M.D., Ph.D. Stress Relief and Memory Training Center, Brooklyn, NY, USA.and Electron Microscopy Research Center, San Antonio, TX, USA. Poster presented at the Alzheimer’s Association International Conference on Alzheimer’s Disease, Vienna, Austria. 2009, July 11-16
Background: It is well known that the majority of geriatric patients with depression and mixed dementia have cardiovascular co-morbidities, which have an additional negative impact on cognition. There have been no studies hitherto which have investigated the long-term effect of combined treatment (medications and non-pharmacological interventions) in this group of patients. This study is a part of an ongoing naturalistic study to investigate the possibility of preventing cognitive decline in demented, depressed seniors by implementing our multifaceted treatment model. Here we presented the data related to efficacy of 36 months of treatment of demented, depressed geriatric patients with cardiovascular co-morbidities.
Methods: The study group consists of 38 patients (17 male, 21 female) with an average age of 72.34, who were diagnosed with mild dementia and depression and had history of hypertension, CAD and dyslipidemia. Additionally, 18 (47.38%) had diabetes mellitus and 8 (21%) had prior strokes and head trauma. These patients were evaluated at baseline and in one, two, and three years of treatment. The medications included antidepressants (sertraline, citalopram, or venlafaxine XR, alone or in combination with bupropion XR), cholinesterase inhibitors (donepezil, rivastigmine or galantamine alone or in combination with memantine) along with their regular medications.? Non-pharmacological interventions included vitamins and supplements (multivitamins, vitamin E, Deplin, Alpha-Lipoic Acid, Acetyl-L-Carnitine, Omega-3 and Coenzyme Q-10), diet changes, and our recently developed brain activation program (a home-based protocol involving mild physical exercises and cognitive training). The assessment battery consisted of 6 tests for evaluation of attention, memory and executive functions.
Results: The maximum significant cognitive improvement was seen by the end of 24 months of the treatment in MMSE, attention, memory, naming, construction, clock drawing, verbal fluency, and Ruff Frontal Fluency tests. By the end of 36 months of the treatment, significant improvement was still observed on attention, construction and clock drawing. The rest of the tests showed no signs of decline below base line for the entire period of the treatment.
Conclusion: Our integrative treatment model in depressed, demented patients with cardiovascular co-morbidities was effective in delaying cognitive decline for 36 months of the treatment.?