(photo supplied)
By Colleen Cullison, Pine Rest
Pine Rest has been chosen as one of five organizations to participate in a National Institute on Aging study.
The 5-year study will investigate the use of electroconvulsive therapy (ECT) to treat severe agitation and aggression in people with Alzheimer’s disease. The study was made possible by a 5-year award which is expected to total $11.8 million from the National Institute on Aging (NIA).
Researchers at McLean Hospital, a Harvard Medical School Affiliate, will lead the study. Pine Rest will receive a $1.3 million sub-award for the study from McLean. The NIA, part of the National Institutes of Health, leads scientific efforts to study aging and Alzheimer’s disease.
The study will be the first randomized, double-blind, controlled study of ECT for agitation and aggression in Alzheimer’s dementia. It will compare how ECT treatment plus standard treatments, such as antipsychotic medications and behavioral therapies, compares with standard therapies alone for individuals with Alzheimer’s dementia with severe aggression and anxiety.
For the study, 200 patients will be enrolled across the five sites. The study will be open to older adults or individuals who have been admitted to the inpatient geriatric psychiatry units of any of the five participating sites and who have moderate-to-severe Alzheimer’s disease, are experiencing agitation and aggression, and who have not been responsive to other forms of treatment. Enrollment is expected to begin in spring 2019.
“We have been interested in the use of ECT for the treatment of advanced dementia for many years and have been offering this treatment to patients and families for a long time,” said Eric Achtyes, M.D., M.S., D.F.A.P.A., staff psychiatrist, Pine Rest Christian Mental Health Services, and Michigan State University – College of Human Medicine, associate professor and chair, department of psychiatry west.
“Several years ago, we conducted a pilot study of ECT in this patient population which showed promising results for reducing agitation associated with dementia,” Achtyes said. “Now, thanks to this grant, we will be able to conduct a definitive study to assess the benefits and risks of using ECT for these individuals and the families who care for them.”
(photo supplied)
“Agitation and even aggression are unfortunately common in the context of the brain changes which occur in the late stages of Alzheimer’s dementia,” said Dr. Louis Nykamp, Pine Rest’s geriatric fellowship director and electroconvulsive therapy and transcranial magnetic stimulation clinic director.
“Many people can think of a family member or friend to whom this has occurred,” Nykamp said. “There are currently no approved treatments and the medications typically used for these complications of the illness can come with troublesome side effects and often they don’t work as well as we’d hope.”
A $20,000 grant from the Pine Rest Foundation will fund preliminary work to prepare Pine Rest’s ECT Clinic to participate in the NIA grant.
When the study begins this spring, the teams from the five hospitals will interact regularly with a data safety monitoring board composed of experts in geriatric psychiatry, biostatistics, and ECT who will review every piece of data as well as the overall conduct of the study to provide an independent objective review of safety. The researchers will also provide a yearly progress report to the NIA.
