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Donepezil in the Prevention of Post-Operative Cognitive Decline

28. februar 2008 opdateret af: Pfizer

Preventing Post-Operative Cognitive Decline

The purpose of this study is to evaluate the feasibility of using Donepezil to prevent post-operative cognitive decline (POCD) among individuals aged 65 and older who have a baseline mild cognitive impairment (MCI) and are undergoing elective hip or knee replacement.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Medicin: Donepezil

Detaljeret beskrivelse

Up to 65% of elderly patients undergoing hip or knee surgery suffer from declining brain function known as post-operative cognitive decline (POCD). These individuals often stay in the hospital longer, have more complications, and are more likely to die. Recent clinical studies have shown the potential benefit of enhancing the cholinergic system among patients with both Alzheimer's disease and / or vascular dementia. Donepezil is currently being used to treat memory loss in patients with Alzheimer's disease.

This study will recruit 30 cognitively impaired adults aged 65 or older who are scheduled to have elective hip or knee replacement surgery at University Hospital. Participants will be randomized to receive either a three to six week supply of Donepezil or a matching placebo approximately 4 weeks prior to surgery. This study will evaluate the effect of Donepezil on delirium incidence and severity during hospitalization, global cognitive function, length of hospitalization, site of discharge, and adverse drug effects.

All material to be collected will be from interviews, questionnaires, and medical chart review. Some will be at baseline, during hospitalization, and 12 weeks post hospitalization and others will be daily during hospitalization. The International Study of Post-Operative Cognitive Decline battery of tests will be used in assessment, as will the CogHealth computerized battery.

Undersøgelsestype

Interventionel

Tilmelding

Fase

Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Forenede Stater
- Indiana
  - Indianapolis, Indiana, Forenede Stater, 46202
    - University Hospital, Clarian Health Partners

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

65 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

Community-dwelling individuals aged 65 or older
Scheduled for elective hip or knee replacement at University Hospital
Mild cognitive impairment, defined as:
- MMSE total score of 27 or less;
- normal performance of the activities of daily living tasks of the Bristol scale after excluding mobility related difficulties;
- no chart-based dementia diagnosis; and
- no history of ever being on dementia medications such as Memantine or any cholinesterase inhibitors
Consent to participate in the study

Exclusion Criteria:

Chart-based dementia diagnosis
MMSE score greater than 27
Difficulty performing the activities of daily living not related to mobility as measured by the Bristol scale
Current or past history of receiving dementia medications such as Memantine or any cholinesterase inhibitors (Tacrine, Donepezil, Rivastigmine, or Galantamine)
Metastatic cancer or other comorbid illnesses likely to reduce life expectancy to under 6 months
Multiple trauma or pathological fractures requiring acute hip or knee replacement
Aphasic, blind, or deaf
Use of neuroleptics one month prior to surgery
Allergy to donepezil
Inability to read and complete study tests and forms
Alcohol or drug dependence, defined as intake of more than 5 units of alcohol daily during the past 3 months
Not expected to be discharged from hospital or able to complete the 3-month postoperative test
Not competent to make medical decisions

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Primært formål: Forebyggelse
Tildeling: Randomiseret
Interventionel model: Parallel tildeling
Maskning: Dobbelt

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Changes in the International Study of Post-Operative Cognitive Decline (ISPOCD) and the CogHealth computerized battery tests at 1 week and 12 weeks after surgery

Sekundære resultatmål

Resultatmål
Bivirkninger
Delirium status measured by the Confusion Assessment Method (CAM) and the Memorial Delirium Assessment Scale (MDAS) daily during the post-operative period
Global cognitive status assessed using the Mini Mental Status Exam (MMSE)
Length of stay in the hospital post-operatively
Discharge site

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Pfizer

Efterforskere

Ledende efterforsker: Malaz Boustani, MD, MPH, Regenstrief Institute, Indiana University Center for Aging Research

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. februar 2005

Primær færdiggørelse (Faktiske)

1. april 2007

Studieafslutning (Faktiske)