Effects of Memantine and One-on-One Caregiver Contact on Antipsychotic Medication Prescribed to Elderly Veterans with Dementia.

摘要

The reduction of antipsychotic medications for elderly patients diagnosed with dementia is an important goal for treatment because of the negative side effects and increased mortality risk associated with these drugs. Prior research has suggested the benefit of adding one-on-one caregiver intervention and memantine to a cholinesterase inhibitor protocol to reduce the amount of antipsychotic medication. This research examined the differences between these treatment protocols (cholinesterase inhibitor only and combination therapy) on antipsychotic drug dosage prescribed to 98 elderly male veteran outpatients with dementia. The theoretical foundations for this study are based on the neurochemical model, related to the cholingeric hypothesis of age-related cognitive decline, and cognitive behavioral therapy as a psychotherapeutic approach that seeks to reduce stress by altering problematic behavior and unhelpful thinking patterns. Using archival data of elderly veterans with a diagnosis of dementia, this study also examined whether differences in dosage were influenced by age and severity of dementia. An ex post facto design was used to evaluate changes over time, and the differences of age and severity of dementia. A series of ANOVA statistics were conducted, and a significant reduction from baseline to post-test was not found. There were no differences between patients receiving the additional treatment and those receiving cholinesterase inhibitors only. These finding have social change implications for bringing awareness to healthcare professionals about the appropriate use of antipsychotic medications, and recognizing the cautious use of antipsychotics medications in elderly dementia patients.