Donepezil in Alzheimer's disease: what to expect after 3 years of treatment in a routine clinical setting.
OBJECTIVE
Clinical short-term trails have shown positive effects of donepezil treatment in patients with Alzheimer's disease. The outcome of continuous long-term treatment in the routine clinical settings remains to be investigated.


METHODS
The Swedish Alzheimer Treatment Study (SATS) is a descriptive, prospective, longitudinal, multicentre study. Four hundred and thirty-five outpatients with the clinical diagnosis of Alzheimer's disease, received treatment with donepezil. Patients were assessed with Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), global rating (CIBIC) and Instrumental Activities of Daily Living (IADL) at baseline and every 6 months for a total period of 3 years.


RESULTS
The mean MMSE change from baseline was positive for more than 6 months and in subgroups of patients for 12 months. After 3 years of treatment the mean change from baseline in MMSE-score was 3.8 points (95% CI, 3.0-4.7) and the ADAS-cog rise was 8.2 points (95% CI, 6.4-10.1). This is better than expected in untreated historical cohorts, and better than the ADAS-cog rise calculated by the Stern equation (15.6 points; 95% CI, 14.5-16.6). After 3 years with 38% of the patients remaining, 30% of the them were unchanged or improved in the global assessment.


CONCLUSIONS
Three-year donepezil treatment showed a positive global and cognitive outcome in the routine clinical setting.
Wallin
Asa K
AK
Clinical Memory Research Unit, Department of Clinical Sciences, Malmo, Lund University, Malmo, Sweden. asa.k.wallin@skane.se
Andreasen
Niels
N
Eriksson
Sture
S
Båtsman
Stellan
S
Nasman
Birgitta
B
Ekdahl
Anne
A
Kilander
Lena
L
Grut
Mikaela
M
Rydén
Marie
M
Wallin
Anders
A
Jonsson
Mikael
M
Olofsson
Hasse
H
Londos
Elisabeth
E
Wattmo
Carina
C
Eriksdotter Jonhagen
Maria
M
Minthon
Lennart
L
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D003071:Cognition / Q000187:drug effects*; D018450:Disease Progression; D000077265:Donepezil; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D013548:Sweden; D016896:Treatment Outcome
D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil