LITTLE ROCK—Apathy is a common behavioral problem in Alzheimer’s disease and can lead to everything from functional impairment to higher medical costs to increased mortality.
A study published in the American Journal of Psychiatry reports on a promising new treatment, however. A team led by researchers from the Central Arkansas Veterans’ Healthcare System and the University of Arkansas investigated the effect on the drug methylphenidate for the condition.1
The 12-week, prospective, double-blind, randomized, placebo-controlled trial comparing methylphenidate vs. placebo was conducted in 60 community-dwelling veterans with mild Alzheimer’s disease. All participants were male with an average age of 77.
Apathy, the primary outcome, was determined using the Apathy Evaluation Scale–Clinician, while the secondary outcome, cognition was measured using the Mini-Mental State Examination, Modified Mini-Mental State Examination. The study also looked at functional status, improvement and severity and depression rates, with all indicators measured at baseline and four, eight and 12 weeks.
Results indicate that, after adjusting for baseline, the methylphenidate group had significantly greater improvement in apathy than the placebo group at four weeks, eight weeks and 12 weeks. By the final measurement, study authors also note greater improvement in cognition, functional status, caregiver burden, Clinical Global Impressions Scale scores and depression in the methylphenidate group compared with the placebo group.
“Methylphenidate improved apathy in a group of community-dwelling veterans with mild Alzheimer’s disease,” the researchers concluded. “Methylphenidate also improved cognition, functional status, caregiver burden, CGI scores, and depression.”
- Padala PR, Padala KP, Lensing SY, Ramirez D, Monga V, et. al. Methylphenidate for Apathy in Community-Dwelling Older Veterans With Mild Alzheimer’s Disease: A Double-Blind, Randomized, Placebo-Controlled Trial. Am J Psychiatry. 2017 Sep 15:appiajp201717030316. doi: 10.1176/appi.ajp.2017.17030316. [Epub ahead of
print] PubMed PMID: 28945120.
While veterans serving in the military during the Gulf War era (GWE) appear to have higher risk for multiple sclerosis and a range of neurological illnesses, little has been documented previously on prevalent types of MS or other clinical features.
With a long history of point of care testing at both of its predecessor organizations, the Walter Reed National Military Medical Center (WRNMMC) laboratory services staff were keenly aware of the advantages of using portable testing devices to obtain rapid patient assessments.