Predicting cognitive decline in Alzheimer's disease: an integrated analysis

Alzheimers Dement. 2010 Nov;6(6):431-9. doi: 10.1016/j.jalz.2010.04.003.

Abstract

Background: Numerous patient- and disease-related factors increase the risk of rapid cognitive decline in patients with Alzheimer's disease (AD). The ability of pharmacological treatment to attenuate this risk remains undefined.

Methods: Pooled data from 14 randomized clinical studies of donepezil in the treatment of AD (N = 3748) were analyzed to identify predictors of fast decline and determine the effect of donepezil on the risk of fast decline.

Results: Young age and more severe baseline cognitive, global, or behavioral status were identified as independent predictors of faster decline in placebo-treated patients. Multivariate models indicated that donepezil treatment was associated with a 39% to 63% reduction in the risk of faster decline.

Conclusions: These results correspond with previous findings, indicating relationships between age or baseline disease severity and rates of cognitive decline. Furthermore, they suggest that symptomatic therapy for AD could reduce the likelihood of faster decline in treated patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / epidemiology
  • Cholinesterase Inhibitors / therapeutic use
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / drug therapy*
  • Cognition Disorders / epidemiology
  • Disease Progression
  • Donepezil
  • Female
  • Humans
  • Indans / therapeutic use*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Piperidines / therapeutic use*
  • Predictive Value of Tests
  • Prognosis
  • Randomized Controlled Trials as Topic / methods*
  • Risk Factors

Substances

  • Cholinesterase Inhibitors
  • Indans
  • Piperidines
  • Donepezil