Guanfacine treatment for prefrontal cognitive dysfunction in older participants: a randomized clinical trial

Nicole M. Barcelos, Peter H. Van Ness, Allison F. Wagner, Martha G. MacAvoy, Adam P. Mecca, George M. Anderson, Mark Trentalange, Keith A. Hawkins, Mary Sano, Amy F.T. Arnsten, Christopher H. van Dyck

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

This study evaluated the effect of the alpha-2A-adrenoceptor agonist guanfacine on prefrontally mediated cognitive functions, as well as quality of life and global function in healthy older participants. One hundred twenty-three participants aged 75 years and older were randomly assigned to guanfacine 0.5 mg, 0.1 mg, or placebo daily for 12 weeks. The primary outcome measure was the change in z-score for 6 prefrontal executive function tasks over 12 weeks (PEF6). Neither dose of guanfacine improved PEF6 z-score relative to placebo. The rate of mean change (95% confidence interval) in PEF6 z-score over 12 weeks was 0.270 (0.159, 0.380) for placebo, compared with 0.121 (0.011, 0.232) for guanfacine 0.1 mg (p = 0.06, compared to placebo) and 0.213 (0.101, 0.324) for 0.5 mg (p = 0.47). Neither dose of guanfacine improved the quality of life or global function relative to placebo. Among common adverse events, only dry mouth was significantly more frequent on guanfacine compared to placebo. Guanfacine failed to ameliorate prefrontal cognitive function in older individuals, who were cognitively normal for age.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalNeurobiology of Aging
Volume70
DOIs
StatePublished - Oct 2018

Keywords

  • Brain aging
  • Cognitive aging
  • Executive function
  • Guanfacine
  • Prefrontal cortex

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