[Evaluation of the therapeutic effects in individual patients with Alzheimer disease].
Rivastigmine was recently licensed for treatment of Alzheimer's disease on the basis of large double-blind placebo-controlled clinical trials. However, it is difficult to determine the clinical relevance for individual patients from the results of this type of clinical trial. With the help of standardised measurements in individual patients the clinical relevance can be better established. In order to avoid extra burden on patients, caregivers and doctors, these measurements should be simple. A combination of three clinimetrical scales for cognition, ability to perform daily activities and behaviour, which takes about 15 min to complete, appears to be efficient. Comparison of these data with data from a group of untreated Alzheimer's patients can give an impression of the efficacy of the medication. With the use of goal-attainment scaling, measurements can be individualised even more. This approach allows the clinician, in consultation with the caregiver and the patient, to make an informed decision about whether or not to continue treatment.
Richard
E
E
Academisch Medisch Centrum, afd. Neurologie, Meibergdreef 9, 1105 AZ Amsterdam.
Lemstra
A W
AW
Walstra
G J
GJ
van Gool
W A
WA
D000203:Activities of Daily Living / Q000523:psychology; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D002219:Carbamates / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D006801:Humans; D009426:Netherlands; D018697:Nootropic Agents / Q000627:therapeutic use*; D048448:Phenylcarbamates; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D000068836:Rivastigmine; D012720:Severity of Illness Index; D012919:Social Behavior; D016896:Treatment Outcome
D002219:Carbamates; D018697:Nootropic Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine