Preserved cognitive function after 12 months of treatment with rivastigmine in mild Alzheimer's disease in comparison with untreated AD and MCI patients

被引:34
作者
Almkvist, O [1 ]
Darreh-Shori, T
Stefanova, E
Spiegel, R
Nordberg, A
机构
[1] Huddinge Univ Hosp, Div Clin Geriatr B84, Dept Geriatr Med, S-14186 Huddinge, Sweden
[2] Karolinska Inst, Neurotec Dept, Div Clin Geriatr, Stockholm, Sweden
[3] Karolinska Inst, Neurotec Dept, Div Mol Neuropharmacol, Stockholm, Sweden
[4] Novartis Pharma AG, Nervous Syst, Clin R&D, Basel, Switzerland
[5] Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden
关键词
Alzheimer's disease; attention; cholinesterase inhibition; cognition; rivastigmine; treatment;
D O I
10.1046/j.1468-1331.2003.00757.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Cholinesterase inhibitors (ChEIs) have shown positive symptomatic effects on cognition, activities of daily living, and behavior in patients with Alzheimer's disease (AD). Rivastigmine is a slowly reversible ChEI that inhibits acetylcholinesterase and butyryleholinesterase. We evaluated the effects of long-term rivastigmine treatment on cognitive function and plasma levels of ChE activity, and the relationship between ChE activity and cognition. Patients with mild AD (n = 11) treated with rivastigmine for 12 months were compared with matched groups of untreated patients with AD (n = 21) or mild cognitive impairment (MCI; n = 22) representing the natural course of the pre-clinical and very early stage of disease. For untreated AD patients, neuropsychological assessment was made at baseline and 12 months. Determination of ChE activity in plasma and assessment of global cognition, episodic memory, visuo-spatial ability, and attention were performed at 0 (baseline), 3, 6, and 12 months for treated AD patients and untreated MCI patients. At 12 months, cognitive function was slightly improved or maintained in mild AD patients treated with rivastigmine. In contrast, cognition was markedly worsened in untreated AD patients and unchanged or slightly worsened in untreated MCI patients. In the group of treated AD patients, there was a significant correlation between plasma ChE inhibition and cognition, particularly in relation to attention. This effect was most apparent at 3 months of treatment. In conclusion, a clear beneficial effect of rivastigmine was shown on cognitive function for patients with mild AD and plasma values of ChE inhibition were associated with attention.
引用
收藏
页码:253 / 261
页数:9
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