Boyle

Some poor evidence of improvement in measures of cognition in dementia patients with a combination of hyperbaric oxygen and acetazolamide

Clinical Bottom Line

1. Some improvement in cognition following combined treatment with acetazolamide and hyperbaric oxygen which trended back to starting values over 8 weeks.
2. True impacts of either agent difficult to define.

Citation/s:1.Boyle E, Aparico A, Canosa F, Owen D, Dash HH. Hyperbaric oxygen and acetazolamide in the treatment of senile cognitive functions. In: Trapp WG, Bannister EW, Davison AJ, Trapp PA, eds. Proceedings of the Fifth International Hyperbaric Conference. Burnaby, Canada: Simon Fraser University, 1974:432-438
Lead author's name and fax: Boyle. Miami Heart Institute Research Division, Miami Beach, Florida

Three-part Clinical Question:For patients with senile dementia, does the application of either hyperbaric oxygen or acetazolomide result in improved cognition.
Search Terms: Acetazolamide; cognition; dementia

The Study:Non-blinded randomised controlled trial without intention-to-treat.
The Study Patients: “Aged senile subjects.”
Control group (N = 21; ? analysed): Breathing 13% oxygen at 3 ATA for 30 minutes to a total of 10 sessions over two weeks.
Experimental group (N = 30; ? analysed): As above but breathing 100% oxygen at 3 ATA and given acetazolamide 250mg orally for the same 10 day period.

The Evidence:

Non-Event Outcomes

Time to outcome/s

Control group

Experimental group

P-value

Bender-Gestalt Test

8 weeks

120 to 130

109 to102

??

Weschler Memory Scale

8 weeks

116 to 125

110 to 115

??

Reaction time

8 weeks

    ??

Comments:
1. Old study poorly conducted and reported by modern standards.
2. Probably an open label study, incomplete randomisation and an undefined number of crossover patients at eight weeks.
3. Results are not easily interpreted given undisclosed drop-outs and interrupted comparisons.
4. No details of the meaning of the numerical outcomes

Appraised by:Mike Bennett, m.bennett@unsw.edu.au ; Saturday, 22 August 2020
Kill or Update By: August 2025

 

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