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Aliev, G., Palacios, H.H., Lipsitt, A.E., Fischbach, K., Lamb, B.T., Obrenovich, M.E., Morales, L., Gasimov, E. and Bragin, V. (2009) Nitric oxide as an initiator of brain lesions during the development of Alzheimer disease. Neurotoxicity Research, 16, 293-305. doi:10.1007/s12640-009-9066-5

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• TITLE: A 60-month follow-up of a naturalistic study of integrative treatment for real-life geriatric patients with depression, dementia and multiple chronic illnesses

  AUTHORS: Valentin Bragin, Marina Chemodanova, Ilya Bragin, Narmina Dzhafarova, Irina Mescher, Pavlo Chernyavskyy, Mark E. Obrenovich, Hector H. Palacios, Gjumrakch Aliev

  KEYWORDS: Dementia; Depression; Alzheimer Disease; Vascular Dementia; Naturalistic Observational Study; Integrative Treatment; Non Pharmacological Interventions; Physical Exercises; Memory Training; Cardiovascular Diseases

  JOURNAL NAME: Open Journal of Psychiatry, Vol.2 No.2, April 18, 2012

  ABSTRACT: Background: In the past we have shown the preservation and improvement of cognitive tasks in depressed and demented patients after 24 and 36 months of combined pharmacological and non-pharmacological treatment. Here we present the results of our ongoing, naturalistic study, in the same outpatient setting, at 60 month follow up. Materials and Methods: The study group consisted of 156 medically ill, physically disabled patients with mild to moderate dementia and depression. Patients were treated with antidepressants, cholinesterase inhibitors, and NMDA antagonists, along with their regular medication regimen. Non-pharmacological intervention was centered on a home-based program of physical and cognitive exercises paired with vitamins and supplements (multivitamins, vitamin E, L-methylfolate, alphalipoic acid, acetyl-L-carnitine, omega-3, and coenzyme Q-10) and diet modification. Cognitive assessments were performed yearly. Results: After 60 months of treatment, performance of all tasks remained at or above baseline. The MMSE, Cognistat-Attention, Cognistat-Judgment, and RFFT-Total Unique Designs demonstrated significant improvement. Conclusion: Our results, for the first time, demonstrate arrest in cognitive decline in demented/depressed patients with multiple medical co-morbidities for 60 months. Future investigations addressing the application of a combined, integrative treatment model are warranted.