Identification of responders and reactive domains to rivastigmine in Alzheimer's disease.
OBJECTIVE
Presently, it is unclear which patients suffering from Alzheimer's Disease (AD) respond to rivastigmine and if rivastigmine acts on specific cognitive domains. The aims of this study are thus to investigate treatment effects of rivastigmine on specific cognitive domains and to find possible responsive subpopulations to rivastigmine cognitive effects.


METHODS
Mini Mental State Examination (MMSE) and Cambridge Cognitive Examination (CAMCOG) were administered at baseline and after 6 months in 83 rivastigmine users and 96 historical controls, representing natural decline. Treatment effects on different subsections of the CAMCOG and in different subpopulations were investigated by linear regression analyses.


RESULTS
Rivastigmine showed effectiveness on total CAMCOG (p < 0.001), CAMCOG non-memory subsection (p < 0.001) and subscales of language (p = 0.002), attention/calculation (p = 0.043), abstract thinking (p < 0.001) and perception (p = 0.031). In patients with baseline MMSE < or =19 rivastigmine showed significant and favourable effects compared to historical controls on total CAMCOG (p < 0.001) and both non-memory (p < 0.001) and memory subsections (p = 0.002).


CONCLUSIONS
Rivastigmine showed primarily effectiveness on the non-memory section of the CAMCOG and patients with a baseline MMSE < or = 19 appeared to show greater responses to rivastigmine compared to patients with baseline MMSE > or = 20.
Frankfort
S V
SV
Department of Pharmacy & Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands. apsfr@slz.nl
Appels
B A
BA
de Boer
A
A
Tulner
L R
LR
van Campen
J P C M
JP
Koks
C H W
CH
Beijnen
J H
JH
Schmand
B A
BA
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D003072:Cognition Disorders / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use; D009483:Neuropsychological Tests; D048448:Phenylcarbamates / Q000627:therapeutic use*; D011446:Prospective Studies; D000068836:Rivastigmine; D013997:Time Factors; D016896:Treatment Outcome
D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine