PMID- 17565435
OWN - NLM
STAT- MEDLINE
DCOM- 20090820
LR  - 20220409
IS  - 1435-1269 (Electronic)
IS  - 0948-6704 (Linking)
VI  - 40
IP  - 3
DP  - 2007 Jun
TI  - Actigraphy in agitated patients with dementia. Monitoring treatment outcomes.
PG  - 178-84
AB  - Especially in pharmacotherapeutic research, a variety of methods to monitor 
      behavioural and psychological symptoms of dementia (BPSD) are currently being 
      discussed. To date, the most frequently used of these are clinical scales, which, 
      however, are subjective and highly dependent on personnel resources. In our 
      study, we tested the usefulness of actigraphy as a more direct and objective way 
      to measure day-night rhythm disturbances and agitated behaviour. After a baseline 
      assessment, 24 patients with probable dementia of the Alzheimer type 
      (NINCDS-ADRDA) and agitated behaviour received either 3 mg melatonin (n=7), 2.5 
      mg dronabinol (n=7), or placebo (n=10) for two weeks. In addition, 10 young and 
      10 elderly healthy subjects were examined as a control group. Motor activity 
      levels were assessed using an actigraph worn continuously on the wrist of the 
      non-dominant hand. At the beginning and the end of the study, patients' 
      Neuropsychiatric Inventory (NPI) scores were also assessed. In the verum group, 
      actigraphic nocturnal activity (P=0.001), NPI total score (P=0.043), and NPI 
      agitation subscale score (P=0.032) showed significant reductions compared to 
      baseline. The treatment-baseline ratio of nocturnal activity (P=0.021) and 
      treatment-baseline difference of the nocturnal portion of 24 h activity (P=0.012) 
      were reduced. Patients' baseline activity levels were similar to those seen in 
      healthy elderly subjects. Younger healthy subjects exhibited higher motor 
      activity even at night. There was no correlation between actigraphy and NPI. Both 
      actigraphic measures and the gold standard clinical scale were able to 
      distinguish between the verum and placebo groups. However, because they did not 
      correlate with each other, they clearly represent different aspects of BPSD, each 
      of which reacts differently to therapy. As a result, actigraphy may well come to 
      play an important role in monitoring treatment success in BPSD.
FAU - Mahlberg, R
AU  - Mahlberg R
AD  - Psychiatrische Universitatsklinik der Charite im St. Hedwig-Krankenhaus, 
      Turmstrasse 21, 10559 Berlin, Germany. richard.mahlberg@charite.de
FAU - Walther, S
AU  - Walther S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Germany
TA  - Z Gerontol Geriatr
JT  - Zeitschrift fur Gerontologie und Geriatrie
JID - 9506215
RN  - 0 (Psychotropic Drugs)
RN  - 7J8897W37S (Dronabinol)
RN  - JL5DK93RCL (Melatonin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Dementia/complications/*diagnosis/*drug therapy
MH  - Dronabinol/therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Melatonin/therapeutic use
MH  - Middle Aged
MH  - Monitoring, Ambulatory/*methods
MH  - Motor Activity/drug effects
MH  - Outcome Assessment, Health Care/*methods
MH  - Psychomotor Agitation/*diagnosis/etiology/*prevention & control
MH  - Psychotropic Drugs/*therapeutic use
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2007/06/15 09:00
MHDA- 2009/08/21 09:00
CRDT- 2007/06/15 09:00
PHST- 2005/12/15 00:00 [received]
PHST- 2006/10/30 00:00 [accepted]
PHST- 2007/06/15 09:00 [pubmed]
PHST- 2009/08/21 09:00 [medline]
PHST- 2007/06/15 09:00 [entrez]
AID - 10.1007/s00391-007-0420-z [doi]
PST - ppublish
SO  - Z Gerontol Geriatr. 2007 Jun;40(3):178-84. doi: 10.1007/s00391-007-0420-z.