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Implication of Integrative Treatment Strategies for Real-Life Geriatric Patients with Multiple, Chronic Illnesses: A 60-Month Follow-Up of a Naturalistic Study

Gjumrakch Aliev1*, George E. Barreto2* and Valentin Bragin3
  • 1 GALLY International Biomedical Research Consulting LLC, 7733 Louis Pasteur Drive, #328, San Antonio, TX, 78229 USA, United States
  • 2 Pontificia Universidad Javeriana, Colombia
  • 3 Stress Relief and Memory Training Center, United States

Neurodegeneration [Stroke and Alzheimer disease (AD)] is fastly becoming one of the leading causes of age-associated disability, dementia, and death. In addition, the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics recently reported that AD has surpassed diabetes as a leading cause of death and is now considered the sixth-leading cause of death in the United States. Unfortunately, currently no effective treatments are available against this devastating disease. 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 the 60 month follow up. 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 as well as with vitamins and supplements (multivitamins, vitamin E, L-methylfolate, alpha-lipoic acid, acetyl-l-carnitine, omega-3, and coenzyme Q-10) and diet modification. Cognitive assessments were performed yearly. 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. 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 models in clinical practices are warranted.

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References

1. Bragin V., Chemodanova M. Dzhafarova N., Bragin I., Czerniawski J.L. and G. Aliev. Integrated Treatment Approach Improves Cognitive Function in Demented and Clinically Depressed Patients. Am. J. Alz. Dis. & Other Dementia, 2005; 20(1): 21-26.

2. Aliev G., Gasimov E. Obrenovich M.E, Fischbach K., Shenk J.C., Smith M.A. and Perry G. Atherosclerotic lesions and mitochondria DNA deletions in brain microvessels: implication in the pathogenesis of Alzheimer’s disease. Vascular Health and Risk Management (VHRM), 2008:4(3), 721-730.

3. Aliev G, Liu J, Shenk JC, Fischbach K, Pacheco GJ, Chen SG, Obrenovich ME, Ward WF, Richardson AG, Smith MA, Gasimov E, Perry G, Ames BN. Neuronal mitochondrial amelioration by feeding acetyl-L-carnitine and lipoic acid to aged rats. Journal of Cellular and Molecular Medicine (JCMM). Volume13, Issue 2, 2009. 320-333. DOI 10.1111/j.1582-4934.2008.00324.x.

4. Aliev G., Shenk J.C., Fischbach K., and Perry G. Stem cell niches as clinical targets for anti-ischemic therapy. Nature Clinical Practice Cardiovascular Medicine. 2008, Vol 5, Sep; 5(9):590-1.

5. Aliev G, Obrenovich M.E., Reddy V.P., Shenk J.C., Moreira PI , Nunomura A, Zhu X , Smith MA, Perry G. Antioxidant Therapy in Alzheimer Disease: Theory and Practice. Mini-Reviews in Medicinal Chemistry, 2008, Nov;8(13):1395-406.

6. Shenk J.C., Liu J., Fischbach K., Xu K., Puchowicz M., Obrenovich M.E., Gasimov E., Alvarez L.M., Ames B.N., LaManna J.C. and Aliev G. The effect of Acetyl—L-Carnitine and R-alpha-Lipoic Acid Treatment in ApoE4 mouse as a model for human Alzheimer’s disease. Journal of the Neurological Sciences 2009, v. 283 (1-2), 199–206.

7. Bragin V. and Aliev G. Progression of Cognitive Function after Integrated Treatment Approach in Demented and Clinically Depressed Patients. In: The Role of oxidative stress, mitochondria failure and cellular hypoperfusion in the pathobiology of Alzheimer disease. 2010; ISBN: 978-81-308-0367-8; Editors: Aliev G., et al., Publisher Research Signpost, Inc. 2010, Chapter 15, PP. 317-325.

8. Aliev G., Li Y., Palacios H., and Obrenovich M.E. Oxidative Stress Induced Mitochondrial DNA Deletion as a Hallmark for the Drug Development in the Context of the Cerebrovascular Diseases. Recent Patents on Cardiovascular Drug Discovery, 2011, 6, 222-241.

9. Bragin V., Chemodanova M., Bragin I., Dzhafarova N., Mescher I., Chernyavskyy P., Obrenovich M.E., Palacios H.H. and Aliev G. A 60-month follow-up of a naturalistic study of integrative treatment for real-life geriatric patients with depression, dementia and multiple chronic illnesses. Open Journal of Psychiatry, 2012, vol.2, 129-140.

10. Aliev, G. “The Role of Oxidative Stress, Mitochondria Failure, and Cellular Hypoperfusion in the Context of Alzheimer Disease: Past, Present and Future”. Monograph Book: Nova Science Publishers, Inc., New York, 2013, ISBN: 978-1-61942-878-2. PP. 1-426. https://www.novapublishers.com/catalog/product_info.php?products_id=31801.

11. Aliev G., Ashraf G.Md., Kaminsky Y.G., Sheikh I.A., Sudakov S. K., Yakhno N.N., Benberin V.V. and Bachurin S.O. Implication of the Nutritional and Non-Nutritional Factor in the Context of the Preservation of The Cognitive Performance in Demented/Depressed and Alzheimer Patients. Am J Alzheimers Dis Other Demen. 2013, 28(7): 660-670.

Keywords: Alzheimer Disease, naturalistic decision making, Dementia, Depression, Cognition

Conference: Latin-American School on glial cells in the diseased brain (IBRO), Bogotá, Colombia, 13 Jul - 17 Jul, 2015.

Presentation Type: Oral Presentation

Topic: Neurodegenerative diseases

Citation: Aliev G, Barreto G and Bragin V (2015). Implication of Integrative Treatment Strategies for Real-Life Geriatric Patients with Multiple, Chronic Illnesses: A 60-Month Follow-Up of a Naturalistic Study. Conference Abstract: Latin-American School on glial cells in the diseased brain (IBRO). doi: 10.3389/conf.fncel.2015.35.00016

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Received: 21 Mar 2015; Published Online: 11 Jun 2015.

* Correspondence:
Prof. Gjumrakch Aliev, GALLY International Biomedical Research Consulting LLC, 7733 Louis Pasteur Drive, #328, San Antonio, TX, 78229 USA, San Antonio, United States, aliev03@gmail.com
Prof. George E. Barreto, Pontificia Universidad Javeriana, Bogotá, Colombia, gesbarreto@gmail.com