Arnim, Christine A. F. von

[["dc.bibliographiccitation.artnumber","131"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Alzheimer's Research & Therapy"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Seibert, M."],["dc.contributor.author","Mühlbauer, V."],["dc.contributor.author","Holbrook, J."],["dc.contributor.author","Voigt-Radloff, S."],["dc.contributor.author","Brefka, S."],["dc.contributor.author","Dallmeier, D."],["dc.contributor.author","Denkinger, M."],["dc.contributor.author","Schönfeldt-Lecuona, C."],["dc.contributor.author","Klöppel, S."],["dc.contributor.author","von Arnim, C. A. F."],["dc.date.accessioned","2021-11-25T11:07:19Z"],["dc.date.accessioned","2022-08-18T12:39:00Z"],["dc.date.available","2021-11-25T11:07:19Z"],["dc.date.available","2022-08-18T12:39:00Z"],["dc.date.issued","2021-07-16"],["dc.date.updated","2022-07-29T12:17:49Z"],["dc.description.abstract","Abstract\r\n \r\n Background\r\n Many patients with Alzheimer’s disease (AD) are physically frail or have substantial functional impairments. There is growing evidence that such patients are at higher risk for medication-induced adverse events. Furthermore, frailty seems to be more predictive of poor clinical outcomes than chronological age alone. To our knowledge, no systematic review of clinical trials examining drug therapy of AD or behavioural and psychological symptoms of dementia (BPSD) has specifically focused on the topic of physical frailty. Our objective was to evaluate the efficacy and safety of pharmacotherapy in AD patients with frailty or significant functional impairments.\r\n \r\n \r\n Methods\r\n We performed a systematic literature search in MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of drug therapy of AD and BPSD in patients with significant functional impairments according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Cochrane research criteria. Significant functionally impaired patient populations were identified using the recommendations of the Medication and Quality of Life in frail older persons (MedQoL) Research Group. Screening, selection of studies, data extraction and risk of bias assessment were performed independently by two reviewers. Outcomes including functional status, cognitive function, changes in BPSD symptoms, clinical global impression and quality of life were analysed. For assessing harm, we assessed adverse events, drop-outs as a proxy for treatment tolerability and death. Results were analysed according to Cochrane standards and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.\r\n \r\n \r\n Results\r\n Of 45,045 search results, 38,447 abstracts and 187 full texts were screened, and finally, 10 RCTs were included in the systematic review. Selected articles evaluated pharmacotherapy with acetylcholinesterase-inhibitors (AChEI), anticonvulsants, antidepressants and antipsychotics. Studies of AChEIs suggested that patients with significant functional impairments had slight but significant improvements in cognition and that AChEIs were generally well tolerated. Studies of antidepressants did not show significant improvements in depressive symptoms. Antipsychotics and anticonvulsants showed small effects on some BPSD items but also higher rates of adverse events. However, due to the very small number of identified trials, the quality of evidence for all outcomes was low to very low.\r\n Overall, the small number of eligible studies demonstrates that significantly functional impaired older patients have not been adequately taken into consideration in most clinical trials investigating drug therapy of AD and BPSD.\r\n \r\n \r\n Conclusion\r\n Due to lack of evidence, it is not possible to give specific recommendations for drug therapy of AD and BSPD in frail older patients or older patients with significant functional impairments. Therefore, clinical trials focussing on frail older adults are urgently required. A standardized approach to physical frailty in future clinical studies is highly desirable."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2021"],["dc.identifier.citation","Alzheimer's Research & Therapy. 2021 Jul 16;13(1):131"],["dc.identifier.doi","10.1186/s13195-021-00867-8"],["dc.identifier.pii","867"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/93531"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112966"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-448"],["dc.publisher","BioMed Central"],["dc.relation.eissn","1758-9193"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.subject","Frail elderly"],["dc.subject","Alzheimer’s disease"],["dc.subject","Dementia"],["dc.subject","BPSD"],["dc.subject","Systematic review"],["dc.subject","Drug therapy"],["dc.title","Efficacy and safety of pharmacotherapy for Alzheimer’s disease and for behavioural and psychological symptoms of dementia in older patients with moderate and severe functional impairments: a systematic review of controlled trials"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","299"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Cardiovascular Disorders"],["dc.bibliographiccitation.volume","22"],["dc.contributor.author","Sadlonova, Monika"],["dc.contributor.author","Vogelgsang, Jonathan"],["dc.contributor.author","Lange, Claudia"],["dc.contributor.author","Günther, Irina"],["dc.contributor.author","Wiesent, Adriana"],["dc.contributor.author","Eberhard, Charlotte"],["dc.contributor.author","Ehrentraut, Julia"],["dc.contributor.author","Kirsch, Mareike"],["dc.contributor.author","Hansen, Niels"],["dc.contributor.author","Esselmann, Hermann"],["dc.contributor.author","Timäus, Charles"],["dc.contributor.author","Asendorf, Thomas"],["dc.contributor.author","Breitling, Benedict"],["dc.contributor.author","Chebbok, Mohammed"],["dc.contributor.author","Heinemann, Stephanie"],["dc.contributor.author","Celano, Christopher"],["dc.contributor.author","Kutschka, Ingo"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Baraki, Hassina"],["dc.contributor.author","von Arnim, Christine A. F."],["dc.date.accessioned","2022-08-04T12:01:17Z"],["dc.date.available","2022-08-04T12:01:17Z"],["dc.date.issued","2022-06-30"],["dc.date.updated","2022-07-25T11:18:49Z"],["dc.description.abstract","Background Postoperative delirium is a common complication of cardiac surgery associated with higher morbidity, longer hospital stay, risk of cognitive decline, dementia, and mortality. Geriatric patients, patients undergoing cardiac surgery, and intensive care patients are at a high risk of developing postoperative delirium. Gold standard assessments or biomarkers to predict risk factors for delirium, cognitive decline, and dementia in patients undergoing cardiac surgery are not yet available. Methods The FINDERI trial (FINd DElirium RIsk factors) is a prospective, single-center, observational study. In total, 500 patients aged ≥ 50 years undergoing cardiac surgery at the Department of Cardiovascular and Thoracic Surgery of the University of Göttingen Medical Center will be recruited. Our primary aim is to validate a delirium risk assessment in context of cardiac surgery. Our secondary aims are to identify specific preoperative and perioperative factors associated with delirium, cognitive decline, and accelerated dementia after cardiac surgery, and to identify blood-based biomarkers that predict the incidence of postoperative delirium, cognitive decline, or dementia in patients undergoing cardiac surgery. Discussion This prospective, observational study might help to identify patients at high risk for delirium prior to cardiac surgery, and to identify important biological mechanisms by which cardiac surgery is associated with delirium. The predictive value of a delirium screening questionnaire in cardiac surgery might be revealed. Finally, the identification of specific blood biomarkers might help to predict delirium, cognitive decline, and dementia in patients undergoing cardiac surgery. Trial registration: Ethics approval for this study was obtained from the IRB of the University of Göttingen Medical Center. The investigators registered this study in the German Clinical Trials Register (DRKS; https://www.drks.de ) (DRKS00025095) on April 19th, 2021."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2022"],["dc.identifier.citation","BMC Cardiovascular Disorders. 2022 Jun 30;22(1):299"],["dc.identifier.doi","10.1186/s12872-022-02732-4"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112643"],["dc.language.iso","en"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.subject","Delirium"],["dc.subject","Cognitive decline"],["dc.subject","Dementia"],["dc.subject","Delirium risk assessment"],["dc.subject","Cardiac surgery"],["dc.subject","Biomarkers"],["dc.title","Identification of risk factors for delirium, cognitive decline, and dementia after cardiac surgery (FINDERI—find delirium risk factors): a study protocol of a prospective observational study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]