title: Comprehensive, Individualized, Person-Centered Management of Community-Residing Persons with Moderate-to-Severe Alzheimer Disease: A Randomized Controlled Trial.
abstract: The aim was to examine added benefits of a Comprehensive, Individualized, Person-Centered Management (CI-PCM) program to memantine treatment.
  
  
  
  This was a 28-week, clinician-blinded, randomized, controlled, parallel-group study, with a similar study population, similar eligibility criteria, and a similar design to the memantine pivotal trial of Reisberg et al. [N Engl J Med 2003;348:1333-1341]. Twenty eligible community-residing Alzheimer disease (AD) subject-caregiver dyads were randomized to the CI-PCM program (n = 10) or to usual community care (n = 10). Primary outcomes were the New York University Clinician's Interview-Based Impression of Change Plus Caregiver Input (NYU-CIBIC-Plus), assessed by one clinician set, and an activities of daily living inventory, assessed by a separate clinician set at baseline and at weeks 4, 12, and 28.
  
  
  
  Primary outcomes showed significant benefits of the CI-PCM program at all post-baseline evaluations. Improvement on the NYU-CIBIC-Plus in the management group at 28 weeks was 2.9 points over the comparator group. The memantine 2003 trial showed an improvement of 0.3 points on this global measure in memantine-treated versus placebo-randomized subjects at 28 weeks. Hence, globally, the management program intervention benefits were 967% greater than memantine treatment alone.
  
  
  
  These results are approximately 10 times those usually observed with both nonpharmacological and pharmacological treatments and indicate substantial benefits with the management program for advanced AD persons.
authors.affiliation: Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Reisberg
authors.forename: Yongzhao
authors.initials: Y
authors.lastname: Shao
authors.forename: James
authors.initials: J
authors.lastname: Golomb
authors.forename: Isabel
authors.initials: I
authors.lastname: Monteiro
authors.forename: Carol
authors.initials: C
authors.lastname: Torossian
authors.forename: Istvan
authors.initials: I
authors.lastname: Boksay
authors.forename: Melanie
authors.initials: M
authors.lastname: Shulman
authors.forename: Sloane
authors.initials: S
authors.lastname: Heller
authors.forename: Zhaoyin
authors.initials: Z
authors.lastname: Zhu
authors.forename: Ayesha
authors.initials: A
authors.lastname: Atif
authors.forename: Jaskirat
authors.initials: J
authors.lastname: Sidhu
authors.forename: Alok
authors.initials: A
authors.lastname: Vedvyas
authors.forename: Sunnie
authors.initials: S
authors.lastname: Kenowsky
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000628:therapy*; D017028:Caregivers; D019090:Case Management; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D057285:Precision Medicine / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018697:Nootropic Agents; D008559:Memantine