Effect of CYP2D6 and CYP3A4 Genotypes on the Efficacy of Cholinesterase Inhibitors in Southern Chinese Patients With Alzheimer's Disease.

Alzheimer's disease (AD) is the most prevalent form of dementia, and age is strongly associated with the incidence of AD. This study aimed to investigate the association between the genotypes of CYP2D6, CYP3A4, and CYP2C9 genes to the clinical efficacy and tolerability of cholinesterase inhibitors (ChEIs) in Chinese patients with AD. One hundred seventy-nine patients with AD with newly prescribed with ChEIs were recruited. The clinical response and tolerability were evaluated at baseline, 3rd-, 6th-, and 12th-month follow-ups and were compared according to their genotypes of CYP2D6, CYP3A4, and CYP2C9. Among patients prescribed with donepezil/galantamine, CYP2D6*10 carriers showed significantly less side effects (P = .009). CYP2D6*10 carriers responded better to ChEIs and resulted in better improvement in Alzheimer's Disease Assessment Scale-Cognitive subscale (P = .027) and Mini-Mental State Examination (P = .012). Further study is required to replicate the finding, and it might be useful for clinicians to decide the medication based on the patients' CYP genotypes.

The prevalence of depressive symptoms among elderly Chinese private nursing home residents in Hong Kong.

BACKGROUND: Privately-owned Nursing homes (PNH) in Hong Kong present a unique setting of institutional care where elderly with the whole spectrum of health status live together. OBJECTIVES: This cross-sectional descriptive study aimed to determine the prevalence of significant depressive symptoms in a group of Cantonese-speaking Chinese private nursing home elderly living in Hong Kong, and to identify associated psychosocial and health factors. METHODOLOGICAL RESULTS: Two hundred and forty five residents fulfilled the inclusion criteria. Using the Chinese version of the Geriatric Depression Scale--Short Form (GDS-SF), we detected significant depressive symptoms in 29% of subjects. Univariate analysis revealed some associated socio-economic risk factors including current non-Comprehensive Social Security Assistance (CSSA) recipients, education levels and low abilities for social activities. Low vision, swallowing difficulties and low levels of basic activities of daily living (BADL) as reflected by the total Modified Barthel Index of less than 61 were important health predictors. Depression was also associated with features of self-perception of financial inadequacy, life dissatisfaction, poor self-perceived health, poor attitudes towards living arrangement and suicidal thoughts. Stepwise logistic regression identified swallowing problems, current non-CSSA recipient and low BADL ability as independent risk factors. CONCLUSION: The high prevalence of depressive symptoms in the nursing home elderly requires the attention of Government authorities, health care and social service providers.