%0 Journal Article %J J Alzheimers Dis %D 2018 %T A Survey of Patient and Partner Outcome and Treatment Preferences in Mild Cognitive Impairment. %A Smith, Glenn E %A Chandler, Melanie %A Fields, Julie A %A Aakre, Jeremiah %A Locke, Dona E C %X

BACKGROUND: The patient-centered movement in health care is increasing efforts to design studies and interventions that address the outcomes that matter most to patients and their families. Research has not adequately addressed Alzheimer's disease patient and caregiver preferences.

OBJECTIVE: To survey the outcome and treatment preferences of patients and caregivers who had completed a multicomponent behavioral intervention for mild cognitive impairment (MCI).

METHODS: Extending prior work, we conducted an online survey regarding outcome and intervention preferences. Participants were patients with MCI and partners who completed the HABIT Healthy Action to Benefit Independence & Thinking ® program.

RESULTS: Both patient and partner respondents ranked patient quality of life as the highest priority, followed by patient self-efficacy, functional status, patient mood, and patient memory performance. Distressing behaviors and caregiver outcomes (burden, mood, and self-efficacy) had low rankings. Regarding the importance of HABIT ® program components, memory compensation training was ranked highest and wellness education lowest by all groups.

CONCLUSION: Additional research should compare patient preference for patient reported outcomes, traditional neuropsychological and clinician outcomes, and modern biomarker outcomes.

%B J Alzheimers Dis %V 63 %P 1459-1468 %8 2018 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/29843239?dopt=Abstract %R 10.3233/JAD-171161 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Early Postmenopausal Transdermal 17β-Estradiol Therapy and Amyloid-β Deposition. %A Kantarci, Kejal %A Lowe, Val J %A Lesnick, Timothy G %A Tosakulwong, Nirubol %A Bailey, Kent R %A Fields, Julie A %A Shuster, Lynne T %A Zuk, Samantha M %A Senjem, Matthew L %A Mielke, Michelle M %A Gleason, Carey %A Jack, Clifford R %A Rocca, Walter A %A Miller, Virginia M %X

BACKGROUND: It remains controversial whether hormone therapy in recently postmenopausal women modifies the risk of Alzheimer's disease (AD).

OBJECTIVE: To investigate the effects of hormone therapy on amyloid-β deposition in recently postmenopausal women.

METHODS: Participants within 5-36 months past menopause in the Kronos Early Estrogen Prevention Study, a randomized, double blinded placebo-controlled clinical trial, were randomized to: 1) 0.45 mg/day oral conjugated equine estrogens (CEE); 2) 50μg/day transdermal 17β-estradiol; or 3) placebo pills and patch for four years. Oral progesterone (200 mg/day) was given to active treatment groups for 12 days each month. 11C Pittsburgh compound B (PiB) PET imaging was performed in 68 of the 118 participants at Mayo Clinic approximately seven years post randomization and three years after stopping randomized treatment. PiB Standard unit value ratio (SUVR) was calculated.

RESULTS: Women (age = 52-65) randomized to transdermal 17β-estradiol (n = 21) had lower PiB SUVR compared to placebo (n = 30) after adjusting for age [odds ratio (95% CI) = 0.31(0.11-0.83)]. In the APOEɛ4 carriers, transdermal 17β-estradiol treated women (n = 10) had lower PiB SUVR compared to either placebo (n = 5) [odds ratio (95% CI) = 0.04(0.004-0.44)], or the oral CEE treated group (n = 3) [odds ratio (95% CI) = 0.01(0.0006-0.23)] after adjusting for age. Hormone therapy was not associated with PiB SUVR in the APOEɛ4 non-carriers.

CONCLUSION: In this pilot study, transdermal 17β-estradiol therapy in recently postmenopausal women was associated with a reduced amyloid-β deposition, particularly in APOEɛ4 carriers. This finding may have important implications for the prevention of AD in postmenopausal women, and needs to be confirmed in a larger sample.

%B J Alzheimers Dis %V 53 %P 547-56 %8 2016 May 07 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/27163830?dopt=Abstract %R 10.3233/JAD-160258