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2.
Brain Sci ; 12(9)2022 Sep 07.
Article in English | MEDLINE | ID: mdl-36138943

ABSTRACT

Falls are common in patients with neurological diseases and can be very problematic. Recently, there has been an increase in fall prevention research in people with neurological diseases; however, these studies are usually condition-specific (e.g., only MS, PD or stroke). Here, our aim was to evaluate and compare the efficacy of an advanced and innovative dual-task, motor-cognitive rehabilitation program in individuals with different neurological diseases who are at risk of falling. We recruited 95 consecutive adults with neurological diseases who are at risk of falling and divided them into four groups: 31 with cerebrovascular disease (CVD), 20 with Parkinson's disease (PD), 23 with traumatic brain injury (TBI) and 21 with other neurological diseases (OND). Each patient completed a dual-task, motor-cognitive training program and underwent two test evaluations to assess balance, gait, fear of falling and walking performance at the pre-and post-intervention. We found that our experimental motor-cognitive, dual-task rehabilitation program was an effective method for improving walking balance, gait, walking endurance and speed, and fear of falling, and that it reduced the risk of falls in patients with different neurological diseases. This study presents an alternative approach for people with chronic neurological diseases and provides innovative data for managing this population.

3.
Brain Sci ; 12(2)2022 Jan 27.
Article in English | MEDLINE | ID: mdl-35203932

ABSTRACT

Falling is a frequent and major clinical problem among older adults, as well as in patients with chronic cerebrovascular diseases (CVD). At present, sequential (mixed) and simultaneously (dual-task) motor-cognitive trainings are the best approaches to affording patients more autonomy in their everyday motor independence while reducing fall risks and consequences. The objective of this study was to evaluate the efficacy of an advanced and innovative dual-task motor-cognitive rehabilitation program on fall risks in vulnerable older persons with chronic CVD. To this purpose, 26 consecutive older fallers with chronic CVD were recruited, and completed a mixed motor-cognitive or a dual-task motor-cognitive training program. Each patient also underwent two test evaluations to assess balance, gait, fear of falling, and walking performance at pre-and post-intervention. We found that our experimental motor-cognitive dual-task rehabilitation program could be an effective method to improve walking balance, gait, walking speed, and fear of falling, while reducing the risk of falls in older people with chronic CVD. Furthermore, results show that the simultaneous motor-cognitive training is more effective than the sequential motor-cognitive training. Therefore, our study brings innovative data, which can contribute positively to the management of this population.

4.
Sci Rep ; 9(1): 13434, 2019 09 17.
Article in English | MEDLINE | ID: mdl-31530855

ABSTRACT

Our research team previously developed an accelerometry-based device, which can be worn on the waist during daily life activities and detects the occurrence of dyskinesia in patients with Parkinson's disease. The goal of this study was to analyze the magnitude of correlation between the numeric output of the device algorithm and the results of the Unified Dyskinesia Rating Scale (UDysRS), administered by a physician. In this study, 13 Parkinson's patients, who were symptomatic with dyskinesias, were monitored with the device at home, for an average period of 30 minutes, while performing normal daily life activities. Each patient's activity was simultaneously video-recorded. A physician was in charge of reviewing the recorded videos and determining the severity of dyskinesia through the UDysRS for every patient. The sensor device yielded only one value for dyskinesia severity, which was calculated by averaging the recorded device readings. Correlation between the results of physician's assessment and the sensor output was analyzed with the Spearman's correlation coefficient. The correlation coefficient between the sensor output and UDysRS result was 0.70 (CI 95%: 0.33-0.88; p = 0.01). Since the sensor was located on the waist, the correlation between the sensor output and the results of the trunk and legs scale sub-items was calculated: 0.91 (CI 95% 0.76-0.97: p < 0.001). The conclusion is that the magnitude of dyskinesia, as measured by the tested device, presented good correlation with that observed by a physician.


Subject(s)
Dyskinesias/etiology , Monitoring, Physiologic/methods , Parkinson Disease/physiopathology , Accelerometry/instrumentation , Accelerometry/methods , Aged , Algorithms , Cohort Studies , Female , Humans , Male , Middle Aged , Monitoring, Physiologic/instrumentation , Video Recording , Wearable Electronic Devices
5.
Gait Posture ; 59: 1-6, 2018 01.
Article in English | MEDLINE | ID: mdl-28963889

ABSTRACT

The treatment of Parkinson's disease (PD) with levodopa is very effective. However, over time, motor complications (MCs) appear, restricting the patient from leading a normal life. One of the most disabling MCs is ON-OFF fluctuations. Gathering accurate information about the clinical status of the patient is essential for planning treatment and assessing its effect. Systems such as the REMPARK system, capable of accurately and reliably monitoring ON-OFF fluctuations, are of great interest. OBJECTIVE: To analyze the ability of the REMPARK System to detect ON-OFF fluctuations. METHODS: Forty-one patients with moderate to severe idiopathic PD were recruited according to the UK Parkinson's Disease Society Brain Bank criteria. Patients with motor fluctuations, freezing of gait and/or dyskinesia and who were able to walk unassisted in the OFF phase, were included in the study. Patients wore the REMPARK System for 3days and completed a diary of their motor state once every hour. RESULTS: The record obtained by the REMPARK System, compared with patient-completed diaries, demonstrated 97% sensitivity in detecting OFF states and 88% specificity (i.e., accuracy in detecting ON states). CONCLUSION: The REMPARK System detects an accurate evaluation of ON-OFF fluctuations in PD; this technology paves the way for an optimisation of the symptomatic control of PD motor symptoms as well as an accurate assessment of medication efficacy.


Subject(s)
Monitoring, Physiologic/methods , Motor Disorders/diagnosis , Parkinson Disease/diagnosis , Aged , Female , Humans , Male , Middle Aged , Monitoring, Physiologic/instrumentation , Motor Disorders/etiology , Parkinson Disease/complications , Pilot Projects , Prospective Studies , Sensitivity and Specificity
7.
Front Neurol ; 8: 431, 2017.
Article in English | MEDLINE | ID: mdl-28919877

ABSTRACT

BACKGROUND: Our group earlier developed a small monitoring device, which uses accelerometer measurements to accurately detect motor fluctuations in patients with Parkinson's (On and Off state) based on an algorithm that characterizes gait through the frequency content of strides. To further validate the algorithm, we studied the correlation of its outputs with the motor section of the Unified Parkinson's Disease Rating Scale part-III (UPDRS-III). METHOD: Seventy-five patients suffering from Parkinson's disease were asked to walk both in the Off and the On state while wearing the inertial sensor on the waist. Additionally, all patients were administered the motor section of the UPDRS in both motor phases. Tests were conducted at the patient's home. Convergence between the algorithm and the scale was evaluated by using the Spearman's correlation coefficient. RESULTS: Correlation with the UPDRS-III was moderate (rho -0.56; p < 0.001). Correlation between the algorithm outputs and the gait item in the UPDRS-III was good (rho -0.73; p < 0.001). The factorial analysis of the UPDRS-III has repeatedly shown that several of its items can be clustered under the so-called Factor 1: "axial function, balance, and gait." The correlation between the algorithm outputs and this factor of the UPDRS-III was -0.67 (p < 0.01). CONCLUSION: The correlation achieved by the algorithm with the UPDRS-III scale suggests that this algorithm might be a useful tool for monitoring patients with Parkinson's disease and motor fluctuations.

8.
Brain Sci ; 7(5)2017 Apr 29.
Article in English | MEDLINE | ID: mdl-28468232

ABSTRACT

Alzheimer's disease (AD) alters the functional connectivity of the default mode network (DMN) but also the topological properties of the functional connectome. Cognitive training (CT) is a tool to slow down AD progression and is likely to impact on functional connectivity. In this pilot study, we aimed at investigating brain functional changes after a period of CT and active control (AC) in a group of 26 subjects with mild AD (mAD), 26 with amnestic mild cognitive impairment (aMCI), and a control group of 29 healthy elderly (HE) people. They all underwent a CT and AC in a counterbalanced order following a crossover design. Resting-state functional MRI and neuropsychological testing were acquired before and after each period. We tested post-CT and post-AC changes of cognitive abilities, of the functional connectivity of the DMN, and of topological network properties derived from graph theory and network-based statistics. Only CT produced functional changes, increasing the functional connectivity of the posterior DMN in all three groups. mAD also showed functional changes in the medial temporal lobe and topological changes in the anterior cingulum, whereas aMCI showed more widespread topological changes involving the frontal lobes, the cerebellum and the thalamus. Our results suggest specific functional connectivity changes after CT for aMCI and mAD.

9.
PLoS One ; 12(2): e0171764, 2017.
Article in English | MEDLINE | ID: mdl-28199357

ABSTRACT

Among Parkinson's disease (PD) symptoms, freezing of gait (FoG) is one of the most debilitating. To assess FoG, current clinical practice mostly employs repeated evaluations over weeks and months based on questionnaires, which may not accurately map the severity of this symptom. The use of a non-invasive system to monitor the activities of daily living (ADL) and the PD symptoms experienced by patients throughout the day could provide a more accurate and objective evaluation of FoG in order to better understand the evolution of the disease and allow for a more informed decision-making process in making adjustments to the patient's treatment plan. This paper presents a new algorithm to detect FoG with a machine learning approach based on Support Vector Machines (SVM) and a single tri-axial accelerometer worn at the waist. The method is evaluated through the acceleration signals in an outpatient setting gathered from 21 PD patients at their home and evaluated under two different conditions: first, a generic model is tested by using a leave-one-out approach and, second, a personalised model that also uses part of the dataset from each patient. Results show a significant improvement in the accuracy of the personalised model compared to the generic model, showing enhancement in the specificity and sensitivity geometric mean (GM) of 7.2%. Furthermore, the SVM approach adopted has been compared to the most comprehensive FoG detection method currently in use (referred to as MBFA in this paper). Results of our novel generic method provide an enhancement of 11.2% in the GM compared to the MBFA generic model and, in the case of the personalised model, a 10% of improvement with respect to the MBFA personalised model. Thus, our results show that a machine learning approach can be used to monitor FoG during the daily life of PD patients and, furthermore, personalised models for FoG detection can be used to improve monitoring accuracy.


Subject(s)
Accelerometry/methods , Parkinson Disease/physiopathology , Support Vector Machine , Walking , Activities of Daily Living , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged
10.
Brain Sci ; 7(2)2017 Feb 10.
Article in English | MEDLINE | ID: mdl-28208604

ABSTRACT

BACKGROUND: Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. METHODS: In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). RESULTS: Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention. CONCLUSIONS: This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.

11.
J Neuroeng Rehabil ; 13(1): 47, 2016 May 26.
Article in English | MEDLINE | ID: mdl-27225043

ABSTRACT

BACKGROUND: Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke. METHODS: Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks. Twenty sessions of standard therapy were performed by both groups. In the other 20 sessions the subjects enrolled in the i-Walker-Group (iWG) performed with the i-Walker and the Control-Group patients (CG) performed the same amount of conventional walking oriented therapy. Clinical and instrumented gait assessments were made pre- and post-treatment. The follow-up observation consisted of recording the number of fallers in the community setting after 6 months. RESULTS: Treatment effectiveness was higher in the iWG group in terms of balance improvement (Tinetti: 68.4 ± 27.6 % vs. 48.1 ± 33.9 %, p = 0.033) and 10-m and 6-min timed walking tests (significant interaction between group and time: F(1,40) = 14.252, p = 0.001; and F(1,40) = 7.883, p = 0.008, respectively). When measured, latero-lateral upper body accelerations were reduced in iWG (F = 4.727, p = 0.036), suggesting increased gait stability, which was supported by a reduced number of falls at home. CONCLUSIONS: A robotic servo-assisted i-Walker improved walking performance and balance in patients affected by mild/moderate stroke, leading to increased gait stability and reduced falls in the community. TRIAL REGISTRATION: This study was registered on anzctr.org.au (July 1, 2015; ACTRN12615000681550 ).


Subject(s)
Exercise Therapy/instrumentation , Robotics/instrumentation , Self-Help Devices , Stroke Rehabilitation/instrumentation , Walking/physiology , Aged , Female , Gait/physiology , Humans , Male , Middle Aged , Postural Balance , Stroke , Treatment Outcome
12.
Artif Intell Med ; 67: 47-56, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26831150

ABSTRACT

BACKGROUND: After several years of treatment, patients with Parkinson's disease (PD) tend to have, as a side effect of the medication, dyskinesias. Close monitoring may benefit patients by enabling doctors to tailor a personalised medication regimen. Moreover, dyskinesia monitoring can help neurologists make more informed decisions in patient's care. OBJECTIVE: To design and validate an algorithm able to be embedded into a system that PD patients could wear during their activities of daily living with the purpose of registering the occurrence of dyskinesia in real conditions. MATERIALS AND METHODS: Data from an accelerometer positioned in the waist are collected at the patient's home and are annotated by experienced clinicians. Data collection is divided into two parts: a main database gathered from 92 patients used to partially train and to evaluate the algorithms based on a leave-one-out approach and, on the other hand, a second database from 10 patients which have been used to also train a part of the detection algorithm. RESULTS: Results show that, depending on the severity and location of dyskinesia, specificities and sensitivities higher than 90% are achieved using a leave-one-out methodology. Although mild dyskinesias presented on the limbs are detected with 95% specificity and 39% sensitivity, the most important types of dyskinesia (any strong dyskinesia and trunk mild dyskinesia) are assessed with 95% specificity and 93% sensitivity. CONCLUSION: The presented algorithmic method and wearable device have been successfully validated in monitoring the occurrence of strong dyskinesias and mild trunk dyskinesias during activities of daily living.


Subject(s)
Accelerometry/instrumentation , Antiparkinson Agents/therapeutic use , Dyskinesias/diagnosis , Levodopa/therapeutic use , Parkinson Disease/drug therapy , Antiparkinson Agents/adverse effects , Dyskinesias/etiology , Humans , Levodopa/adverse effects , Monitoring, Physiologic , Parkinson Disease/complications , Support Vector Machine
13.
Med Biol Eng Comput ; 54(1): 223-33, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26429349

ABSTRACT

Freezing of gait (FOG) is a common motor symptom of Parkinson's disease (PD), which presents itself as an inability to initiate or continue gait. This paper presents a method to monitor FOG episodes based only on acceleration measurements obtained from a waist-worn device. Three approximations of this method are tested. Initially, FOG is directly detected by a support vector machine (SVM). Then, classifier's outputs are aggregated over time to determine a confidence value, which is used for the final classification of freezing (i.e., second and third approach). All variations are trained with signals of 15 patients and evaluated with signals from another 5 patients. Using a linear SVM kernel, the third approach provides 98.7% accuracy and a geometric mean of 96.1%. Moreover, it is investigated whether frequency features are enough to reliably detect FOG. Results show that these features allow the method to detect FOG with accuracies above 90% and that frequency features enable a reliable monitoring of FOG by using simply a waist sensor.


Subject(s)
Accelerometry/methods , Gait , Parkinson Disease/physiopathology , Humans , Machine Learning , Support Vector Machine
14.
Int J Geriatr Psychiatry ; 31(4): 340-8, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26205305

ABSTRACT

OBJECTIVE: The aim of this paper was to assess the efficacy of process-based cognitive training (pb-CT) combined with reminiscence therapy (RT) in patients with mild Alzheimer's disease (mAD) and mild cognitive impairment (MCI) and in healthy elderly (HE) subjects. METHODS: This multicenter, randomized, controlled trial involved 348 participants with mAD, MCI, and HE from four European countries. Participants were randomly assigned to two arms of a crossover design: those in arm A underwent 3 months of computerized pb-CT for memory and executive functions combined with RT and 3 months of rest; those in arm B underwent the reverse. The primary outcome was the effect of the training on memory and executive functions performance. The secondary outcome was the effect of the training on functional abilities in mAD assessed with the instrumental activities of daily living. RESULTS: We found a significant effect of the training for memory in all three groups on delayed recall of the Rey Auditory Verbal Learning Test and for executive functions in HE on the phonological fluency test. MCI and HE participants maintained these effects at follow-up. MCI and mAD participants also showed a significant effect of the training on the Mini-mental state examination scale. Participants with mAD showed more stable instrumental activities of daily living during the training versus the rest period. CONCLUSIONS: Our results corroborate the positive effect of pb-CT and its maintenance primarily on memory in HE and MCI participants that did not seem to be potentiated by RT. Moreover, our results are very promising for the mAD participants.


Subject(s)
Alzheimer Disease/therapy , Cognition/physiology , Cognitive Dysfunction/therapy , Memory/physiology , Psychotherapy/methods , Activities of Daily Living , Aged , Aged, 80 and over , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Cognitive Behavioral Therapy/methods , Cognitive Dysfunction/physiopathology , Cognitive Dysfunction/psychology , Cross-Over Studies , Executive Function/physiology , Female , Humans , Male , Mental Recall/physiology , Middle Aged , Neuropsychological Tests
15.
Stud Health Technol Inform ; 207: 115-24, 2014.
Article in English | MEDLINE | ID: mdl-25488217

ABSTRACT

This paper presents REMPARK system, a novel approach to deal with Parkinson's Disease (PD). REMPARK system comprises two closed loops of actuation onto PD. The first loop consists in a wearable system that, based on a belt-worn movement sensor, detects movement alterations that activate an auditory cueing system controlled by a smartphone in order to improve patient's gait. The belt-worn sensor analyzes patient's movement through real-time learning algorithms that were developed on the basis of a database previously collected from 93 PD patients. The second loop consists in disease management based on the data collected during long periods and that enables neurologists to tailor medication of their PD patients and follow the disease evolution. REMPARK system is going to be tested in 40 PD patients in Spain, Ireland, Italy and Israel. This paper describes the approach followed to obtain this system, its components, functionalities and trials in which the system will be validated.


Subject(s)
Biofeedback, Psychology/methods , Parkinson Disease/diagnosis , Parkinson Disease/therapy , Quality of Life , Telemedicine/methods , Therapy, Computer-Assisted/methods , Antiparkinson Agents/administration & dosage , Biofeedback, Psychology/instrumentation , Drug Monitoring/instrumentation , Drug Monitoring/methods , Equipment Design , Humans , Monitoring, Ambulatory/instrumentation , Monitoring, Ambulatory/methods , Systems Integration , Telemedicine/instrumentation , Therapy, Computer-Assisted/instrumentation
16.
IEEE Trans Neural Syst Rehabil Eng ; 21(6): 917-27, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23475373

ABSTRACT

Assisted wheelchair navigation is of key importance for persons with severe disabilities. The problem has been solved in different ways, usually based on the shared control paradigm. This paradigm consists of giving the user more or less control on a need basis. Naturally, these approaches require personalization: each wheelchair user has different skills and needs and it is hard to know a priori from diagnosis how much assistance must be provided. Furthermore, since there is no such thing as an average user, sometimes it is difficult to quantify the benefits of these systems. This paper proposes a new method to extract a prototype user profile using real traces based on more than 70 volunteers presenting different physical and cognitive skills. These traces are clustered to determine the average behavior that can be expected from a wheelchair user in order to cope with significant situations. Processed traces provide a prototype user model for comparison purposes, plus a simple method to obtain without supervision a skill-based navigation profile for any user while he/she is driving. This profile is useful for benchmarking but also to determine the situations in which a given user might require more assistance after evaluating how well he/she compares to the benchmark. Profile-based shared control has been successfully tested by 18 volunteers affected by left or right brain stroke at Fondazione Santa Lucia, in Rome, Italy.


Subject(s)
Algorithms , Man-Machine Systems , Motor Skills , Robotics/methods , Stroke Rehabilitation , Therapy, Computer-Assisted/methods , Wheelchairs , Artificial Intelligence , Humans , Robotics/instrumentation , Stroke/physiopathology
17.
Stud Health Technol Inform ; 180: 14-8, 2012.
Article in English | MEDLINE | ID: mdl-22874143

ABSTRACT

In nowadays aging society, many people require assistance for activity of daily living. In most cases technologies have the potential to improve the quality of life for the older and disabled. We show how the use of a robotic platform with some embedded intelligence, the i-Walker, can help to improve the performance of the post-stroke individuals' rehabilitation.


Subject(s)
Gait Disorders, Neurologic/rehabilitation , Quality of Life , Robotics/instrumentation , Self-Help Devices , Therapy, Computer-Assisted/instrumentation , Therapy, Computer-Assisted/methods , Walkers , Humans , Male , Middle Aged , User-Computer Interface
18.
J Biomed Inform ; 45(3): 429-46, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22269224

ABSTRACT

Chronically ill patients are complex health care cases that require the coordinated interaction of multiple professionals. A correct intervention of these sort of patients entails the accurate analysis of the conditions of each concrete patient and the adaptation of evidence-based standard intervention plans to these conditions. There are some other clinical circumstances such as wrong diagnoses, unobserved comorbidities, missing information, unobserved related diseases or prevention, whose detection depends on the capacities of deduction of the professionals involved. In this paper, we introduce an ontology for the care of chronically ill patients and implement two personalization processes and a decision support tool. The first personalization process adapts the contents of the ontology to the particularities observed in the health-care record of a given concrete patient, automatically providing a personalized ontology containing only the clinical information that is relevant for health-care professionals to manage that patient. The second personalization process uses the personalized ontology of a patient to automatically transform intervention plans describing health-care general treatments into individual intervention plans. For comorbid patients, this process concludes with the semi-automatic integration of several individual plans into a single personalized plan. Finally, the ontology is also used as the knowledge base of a decision support tool that helps health-care professionals to detect anomalous circumstances such as wrong diagnoses, unobserved comorbidities, missing information, unobserved related diseases, or preventive actions. Seven health-care centers participating in the K4CARE project, together with the group SAGESA and the Local Health System in the town of Pollenza have served as the validation platform for these two processes and tool. Health-care professionals participating in the evaluation agree about the average quality 84% (5.9/7.0) and utility 90% (6.3/7.0) of the tools and also about the correct reasoning of the decision support tool, according to clinical standards.


Subject(s)
Chronic Disease/epidemiology , Decision Support Systems, Clinical/standards , Precision Medicine , Delivery of Health Care/statistics & numerical data , Health Personnel , Humans
19.
Recenti Prog Med ; 100(7-8): 343-7, 2009.
Article in Italian | MEDLINE | ID: mdl-19725473

ABSTRACT

The purpose of this article is to evaluate the possibility of introducing the Assistive Technology for elderly persons at home in order to provide intermediate care as the range of services aimed at facilitating the transfer from hospital, and the transition from a situation of dependency on the medical staff to a situation of functional independence. Improvements in this area would allow an approach focused on the user and reduce the waste of economic resources. Once it achieves the objectives of strictly medical care, the discharge of patients can be anticipated. We believe that one possible solution is represented by the introduction and use of the intelligent agents for the support of the activities of daily living. We report some examples.


Subject(s)
Activities of Daily Living , Aging , Frail Elderly , Patient Discharge , Self-Help Devices , Aged , Geriatric Assessment , Humans , Quality of Life , Spain
20.
Ther Clin Risk Manag ; 3(6): 1113-23, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18516265

ABSTRACT

Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by a progressive loss of cognitive and functional abilities associated with various behavioral disturbances. Its impact on public health and society as a whole is devastating. Slowing of the cognitive impairment, and improvements in disease duration, self-sufficiency and behavioral disturbances represent the best outcomes of pharmacologic therapy. Cholinesterase inhibitors (ChE-I) have been shown to be effective in treating the cognitive, behavioral, and functional deficits of AD. Rivastigmine is a dual inhibitor of both acetylcholine esterase (AChE) and butyrylcholinesterase (BuChE), enzymes involved in the hydrolysis of acetylcholine. Although this drug has been shown to be beneficial in patients with AD, its benefits are limited and their long-term effectiveness has not been well demonstrated.

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