Objective To investigate the consultative status of patients with Alzheimer Disease (AD), and to evaluate the efficacy and safety of donepezil (Aricept) in the treatment of AD.Methods This survey was initiated by Chinese society of Geriatrics, and was sponsored by Eisai (China) Inc. It was conducted in 60 hospitals of 40 cities in China. The diagnosis of dementia was made according to ICD-10 and DSM-Ⅳ criteria. The cognition, behavior and ability of daily living of the patients were compared before and after 3-month treatment with donepezil. Results A total of 808 dementia patients were recruited. The main reasons for patients' seeing doctors included memory problem (n= 703, 87%), behavioral and psychological symptoms (n= 250, 31%), impairment of ability of daily living (n= 388, 48% ). The disease course was from 9 months to 16 months, and mean disease course was (13.0 ±0. 2) months. Patients mainly sought treatment from neurologist (74 % ),psychiatrist (6 % ) and geriatrics ( 19 %). They received dementia diagnosis at ( 14.4 ± 0.3) months after their dementia symptoms appeared. Treatment with donepezil for three months improved their cognition, ability of daily living and mental condtion (all P＜0.05). The main adverse effects were nausea, vomiting etc. Conclusions In China, the percentage of people with dementia seeking treatment is low. Most people with dementia see doctors when they reach moderate and severe stages,which affects the efficacy of treatment and daily activity of the patients. Treatment with donepezil for 3 months is effective in improving cognition, behavior and activity of daily living.

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BACKGROUND: As the second anti-Alzheimer disease drug approved by Food and Drug Administration(FDA), donepezil (Aricept) has been applied in European and American market. According to the regulation of Health Ministry of China, it needs conducting clinical trial of multiple center nationwide in order to come into Chinese market.OBJECTIVE: To evaluate the efficiency and safety of donepezil on treating mild and moderate Alzheimer disease (AD).DESIGN: Randomized, single blind and placebo control prospective study based on patients.SETTING: Neurological Department of Peking Hospital and Neurological Department of the 301 Hospital of Chinese PLA, and ect.PARTICIPANTS: Totally 188 patients with mild and moderate AD[with mini-mental state examination(MMSE) score of 10 to 24 points] from 15 big hospitals of Beijng, Shanghai and Guangzhou were conducted 12 weeks'clinical trial, among which 89 cases were of single blind and placebo control study while 99 cases were of self-controlled study. All the cases met the AD diagnostic standard of clinical neurology, linguistic dysfunction and stroke(NINCDS-ADRDA) and the 4th edition of Statistic Manual (DSM-IVR).INTERVENTIONS: Donepezil (5 rmg/tablet, ip, 5 rmg/time) or placebo with same color, shape, flavor and size with donepezil ( ip, 1 tablet/time)was taken orally for 12 consecutive weeks.MAIN OUTCOME MEASURES: MMSE, clinical dementia rating scale(CDR), activities of daily life scale(ADL), biochemical parameters, electrocardiograph(ECG) and chest x-ray were conducted once every 4 weeks before and after treatment.RESULTS: The random, single blind and placebo control study showed that the score of MMSE, CDR and ADL was greatly improved in donepezil group after 12 weeks' treatment when comparing with placebo group(P ＜ 0. 01,0.05, 0.01 ). Self-controlled study showed that the score of MMSE, CRD and ADL in donepezil group after 12 weeks' treatment increased 3.5, 0.6 and 7.1 points respectively compared with those before treatment(P ＜ 0.01,0.05, 0.01 ) . The score of MMSE was already improved in the 4th week of treatment. Among the 145 patients who took donepezil, 7 cases(4.8% )experienced side effect of mild cholinergic excitability. In the placebo group,2 of the 43 cases appeared dizziness and nausea. There was no difference between two groups( P ＞ 0.05).CONCLUSION: Donepezil can effectively treat mild and moderate AD patients and improve their cognitive functions, dementia level and daily living abilities with good tolerance and high safety.

Objective To investigate the value of Alzheimer-associated neuronal thread protein (AD7c-NTP) level in urine for diagnosing Alzheimer's disease (AD). Methods The urine samples of 450 subjects were collected from out-department of our hospital.There were 257 people with AD diseases (131 mild cases,126 moderate and severe cases) and 193 healthy control.ELISA was applied to test the level of AD7c-NTP in urine samples. Results The levels of AD7c-NTP were (1.94±0.74)μg/L,(3.92 ± 0.86 ) μg/L and (0.65 ± 0.80) μg/L in mild AD,moderate and severe AD,healthy control groups,respectively.There were differences among three groups(F=-13.520,P＜0.001),and between mild and moderate and severe AD(t =1.727,P＜ 0.001).The level of AD7c-NTP was negatively related with MMSE score in mild AD (r =- 0.23,P =0.006),while no correlation was found between AD7c-NTP and MMSE in moderate and severe AD(r=0.59,P =0.113).Using receiver operating characteristic curve(ROC curve),the optimal cutoff point of AD7cNTP in urine for diagnosis of AD was 1.50 μg/L,with 90.6％ sensitivity and 91.8％ specificity,area under the curve was 0.94(95％ CI:0.91-0.97). Conclusions The level of AD7c-NTP in urine may be one of parameters for diagnosing AD.

Objective To assess the efficacy and safety of aricept in treatment of mild to moderate Alzheimer disease(AD).Methods 188 patients with AD were followed up in a multicentre,with randomized study for 12 weeks. 89 patients had a single -blind,placebo-controlled trial and 99 a self-matched trial.Results The results of randomized single-blind,placebo-controlled trial showed that the improvements in MMSE、CDR and ADL were statistically significantly greater with aricept 5 mg/d than with placebo(P value respectively 0.05).Conclusion Aricept is effective in treating patients with mild to moderate AD. It could produce improvements in cognition and ability of daily life. Aricept was well tolerated and safe.

Objective To assess the diagnostic value of the single-photon-emission computed tomography (SPECT) and the magnetic resonance imaging (MRI) for Alzheimer's disease (AD) and vascular dementia (VD), and to explore the correlation between cerebral atrophy and cerebral regional blood flow and the degree of cognitive impairment in AD patients. Methods The temporal and frontal lobes and hippocampus were quantitatively detected by MRI and the cerebral regional blood flow in these regions was analysed semi-quantitatively by SPECT for 36 patients with AD, 32 with VD and 30 sex-matched non-demented elderly controls (NC). Results The hippocampal atrophy of AD and VD groups detected on MRI was significantly different from that of the NC group. Left hippocampal height was (9.27?3.43)mm in AD, (11.62?5.72)mm in VD and (12.13?2.97)mm in NC(P0.05, compared to that of NC), showing that hippocampal atrophy could not be detected by MRI. However, RAR of the left hippocampus by SPECT detection was 0.61?0.07 (P

Objective To study the mirror writing in elderly patients with senile dementia and vascular dementia. Methods Thirty-three senile dementia patients and 30 vascular dementia patients were studied. Age- and education-matched 63 healthy elder people were included in control groups. Ten items for determination of handedness, Mini Mental Status Examination(MMSE), Global Deterioration Scale (GDS) and the written language of Chinese Aphasia Examination Scale(draft) were adopted to examine all patients. Hachinski Ischemic Scale was used for differentiation between senile dementia and vascular dementia. Results Seventeen (51.51%) of senile dementia patients and 23 (76.60%) of vascular dementia patients were mirror writiers. In the corresponding control groups, these numbers were found to be 2(6.06%) and 7 (23.30%) respectively. The occurrence rate of mirror writing in senile dementia group and vascular dementia group was markedly higher than in the normal controls(P

Objective To evaluate the roles of plasma p-tau(~ 181P)protein for clinical diagnosis of Alzheimer′s Disease (AD). Methods Subjects including 23 mild AD(19≤MMSE≤26) and 35 moderate and severe AD(MMSE0.05). Level of p-tau(~ 181P) protein was significantly higher in the moderate and severe AD group(18.3?20.3)ng/L than that in HC( P

Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

Objective To explore the effectiveness and safety of deep brain magnetic stimulation technique (dTMS) for treatment of Alzheimer's disease (AD).Methods Totally 116 patients with AD were randomly divided into 4 groups:(1) dTMS:given dTMS really stimulation therapy,(2)medication group:treatment with donepezil 5 mg/d,(3) combination treatment group:given dTMS and donepezil therapy,(4) blank control group:given pseudorandom stimulation treatment.33 healthy control cases were given dTMS's stimulation treatment.The treatment course was 6 months.Application of mini mental state examination scale (MMSE),the Montreal cognitive assessment scale (MoCA),Hamilton Depression Scale (HAMD),ischemic scale (HIS),Boston naming test,activity of daily living(ADL) and neuropsychological questionnaire (NPI) were used to evaluate the cognitive function.All the participants received blood tests and ECG in order to evaluate the safety of dTMS.Results After 6 months treatment,compair with the blank control group,all scale scoresof dTMS group,medication group and combined treatment group were improved significantly in MMSE (t=2.49,2.46,2.20),MoCA(t=2.59,2.39,2.87),ADL(t=2.35,2.17,2.83),NPI(t=3.05,2.40,2.65) and sub-cognitive scale score (all P＜0.05).All scale scores of combination treatment group were better than dTMS group and medication group (P＜0.05).There's no significant difference between drug treatment groups and dTMS group (P＞0.05).After 6 months treatment,compared with healthy control group,the scale scores were aggravated in 4 groups of AD (P＜0.05)Conclusions dTMS can be effective and safe in the treatment of AD patients with cognitive and noncognitive symptoms.