Behavioral Expressions in Alzheimer's Disease
| Status: | Completed |
|---|---|
| Conditions: | Alzheimer Disease |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 65 - Any |
| Updated: | 4/17/2018 |
| Start Date: | April 2016 |
| End Date: | February 2018 |
An Analgesic Trial to Reduce Pain and Behavior Disruptions in Nursing Home Residents With Alzheimer's Disease
Behavioral expressions, such as agitation and aggression, affect up to 90% of persons with
dementia and are a major source of patient and caregiver distress, nursing home placement,
anti-psychotic medication use, restraints, and increased health care costs. The purpose of
the research study is to investigate whether reducing pain reduces behavioral expressions of
Alzheimer's disease (agitation and aggression).
dementia and are a major source of patient and caregiver distress, nursing home placement,
anti-psychotic medication use, restraints, and increased health care costs. The purpose of
the research study is to investigate whether reducing pain reduces behavioral expressions of
Alzheimer's disease (agitation and aggression).
The research study will investigate if routine analgesic use will reduce behavioral
expressions of dementia and pain in older adults with Alzheimer's disease or other dementias.
Using a randomized, placebo-controlled, double-blind, cross-over design, the investigators
will compare effects of a routine acetaminophen intervention (650 mg administered routinely
by mouth three times per day for 4 weeks) to those of routine placebo (methylcellulose), also
given for 4 weeks. The maximum dose to be administered will be 1,950 mg per 24 hours, which
is below the current FDA recommendations (maximum dose of 3,000 mg/day).
Participants will be randomly assigned to either treatment or placebo group. The initial
treatment phase will last for 4 weeks. At the end of the first 4 weeks, the treatment will be
reversed after a 3 day washout period. During the 2nd intervention period, the study drug
will be reversed (those receiving acetaminophen will receive the placebo drug and vice
versa). The second treatment phase will last for 4 weeks. At the end of 2nd treatment phase,
all study treatments will be discontinued
expressions of dementia and pain in older adults with Alzheimer's disease or other dementias.
Using a randomized, placebo-controlled, double-blind, cross-over design, the investigators
will compare effects of a routine acetaminophen intervention (650 mg administered routinely
by mouth three times per day for 4 weeks) to those of routine placebo (methylcellulose), also
given for 4 weeks. The maximum dose to be administered will be 1,950 mg per 24 hours, which
is below the current FDA recommendations (maximum dose of 3,000 mg/day).
Participants will be randomly assigned to either treatment or placebo group. The initial
treatment phase will last for 4 weeks. At the end of the first 4 weeks, the treatment will be
reversed after a 3 day washout period. During the 2nd intervention period, the study drug
will be reversed (those receiving acetaminophen will receive the placebo drug and vice
versa). The second treatment phase will last for 4 weeks. At the end of 2nd treatment phase,
all study treatments will be discontinued
Inclusion Criteria:
- documented diagnosis of Alzheimer's Disease or other dementia
- history of a typically painful condition, such as osteoarthritis, back pain, or other
chronic musculoskeletal pain
- able to swallow oral medication
- history of aggressive or agitated behavior (defined as score of > 39 on the
Cohen-Mansfield Agitation Inventory),
- Mini Mental State Exam (MMSE) score < 23
Exclusion Criteria:
- currently taking acetaminophen or opioid medication on a routine (regularly-scheduled,
round the clock) basis
- receiving hospice care
- history of liver or renal disease
- drinks more than 3 alcoholic beverages per day
- known allergy or adverse reaction to acetaminophen
- bed-ridden or comatose
- currently taking warfarin
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