Impact of Alzheimer's disease and rivastigmine treatment on activities of daily living over the course of mild to moderately severe disease.
OBJECTIVE
To investigate the relationship between activities of daily living (ADL) impairment and Alzheimer's disease (AD) severity in mild to moderately severe AD patients receiving the cholinesterase (ChE) inhibitor rivastigmine.


METHODS
ADLs were evaluated using the Progressive Deterioration Scale (PDS). Disease severity was assessed with the Global Deterioration Scale (GDS). Patients were participants in one of three double-blind, placebo-controlled trials with rivastigmine.


RESULTS
Baseline PDS scores differed significantly (P<.001) by disease severity. At Week 26, PDS declines from baseline for placebo patients were significantly different at all disease stages. Specific ADL affected were disease stage-dependent. Rivastigmine treatment (6-12 mg/day) resulted in total PDS scores being significantly improved compared with placebo at all disease stages, although the effect on individual items differed by severity.


CONCLUSIONS
ADL impairment differs across the stages of AD. Greater impairment in total ADL scores is observed with increasing severity of illness. However, the stage of illness determines the type of ADLs lost. Treatment response to rivastigmine occurs with mild, moderate and moderately severe AD, with the largest effect in patients with advancing severity of disease.
Brain Imaging Center, Department of Psychiatry and Human Behavior, University of California, Irvine 92697, USA. sgpotkin@uci.edu
Steven G
SG
Potki
Ravi
R
Anand
Richard
R
Hartman
Jeffrey
J
Veach
George
G
Grossberg
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D000704:Analysis of Variance; D002219:Carbamates / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D048448:Phenylcarbamates; D000068836:Rivastigmine
D002219:Carbamates; D048448:Phenylcarbamates; D000068836:Rivastigmine