Abstract：
OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodopa medication withdrawal (experimental group) and the other group continued on their levodopa (control group). Patients were evaluated weekly over the course of a month with a neurologic examination and a series of assessment tools, including the motor UPDRS (Unified Parkinson's disease rating scale), Hoehn and Yahr staging scale, the Mini-Mental State Examination (MMSE) and the Nursing Assistant Behavioral Detection Form. SETTING:An academic nursing home in New York City. RESULTS:The patients had a mean age of 82.00 +/- 10.14 years, with a mean MMSE score of 9.50 +/- 6.60 out of 30.00 maximum. The control and experimental groups did not differ significantly with respect to age (P = .52), dementia severity (P = .35), nor severity of PD symptoms as measured by the UPDRS (P = .22) and Hoehn and Yahr staging (P = .65). Overall, no significant changes were observed between the control and experimental groups in cognitive, behavioral, and motor function across each time period. Of interest, 2 of the drug withdrawal patients showed modest improvements in cognitive function as measured by the MMSE. CONCLUSION:Our findings suggest that in patients with advanced parkinsonism and dementia, dopaminergic medication withdrawal may be a feasible way to reduce polypharmacy and potential medication-related side effects, with a minimal risk of worsening motor deterioration. Therefore, our findings may have potential implications for a medication intervention that could prevent potential deleterious side effects and improve health-related quality of life in this frail population.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Tse W,Frisina PG,Hälbig TD,Gracies JM,Liang L,Tarshish C,Lesser G,Neufeld R,Koller WC,Libow LSdoi
10.1016/j.jamda.2008.07.001subject
Has Abstractpub_date
2008-11-01 00:00:00pages
670-5issue
9eissn
1525-8610issn
1538-9375pii
S1525-8610(08)00260-0journal_volume
9pub_type
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journal_title：Journal of the American Medical Directors Association
pub_type： 共识发展会议,杂志文章,评审
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journal_title：Journal of the American Medical Directors Association
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pub_type： 杂志文章,评审
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.07.023
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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pub_type： 杂志文章
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更新日期：2018-05-01 00:00:00
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pub_type： 杂志文章,评审
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