title: Five-year outcome of cholinergic treatment of Alzheimer's disease: early response predicts prolonged time until nursing home placement, but does not alter life expectancy.
abstract: Fifty consecutive outpatients with Alzheimer's disease (AD) received treatment with the cholinesterase inhibitor tacrine in an open longitudinal study. Assessments using Mini-Mental State Examination, Alzheimer's Disease Assessment Scale - cognitive subscale, and a global rating were made at baseline and at 6, 12, 24, 36, 48 and 60 months. Three outcome groups were characterized: responders, unchanged and deteriorated. Additional outcome measures were time until nursing home placement, and mortality rate. At 6 months -75%, at 12 months -42%, at 24 months -20%, and after that 10% of the patients still on medication had improved or remained stable. The mortality rate did not differ between the outcome groups. Response to tacrine treatment at 6 or 12 months was found to predict a prolonged time until nursing home placement. No predictors for a positive treatment response could be identified at baseline.
authors.affiliation: Department of Psychiatry, Neuropsychiatric Clinic, Malmö University Hospital, Malmö, Sweden. asa.k.wallin@skane.se
authors.forename: A K
authors.initials: AK
authors.lastname: Wallin
authors.forename: L
authors.initials: L
authors.lastname: Gustafson
authors.forename: M
authors.initials: M
authors.lastname: Sjögren
authors.forename: C
authors.initials: C
authors.lastname: Wattmo
authors.forename: L
authors.initials: L
authors.lastname: Minthon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008017:Life Expectancy; D008111:Liver Function Tests; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D011379:Prognosis; D011594:Psychometrics; D016019:Survival Analysis; D013619:Tacrine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D013619:Tacrine