title: Acetylcholinesterase inhibitor in combination with cognitive training in older adults.
abstract: To determine if donepezil, an acetylcholinesterase (AChE) inhibitor, improved the assimilation of cognitive training by older adults with memory complaints, we gave 168 nondemented, community-dwelling volunteers with memory complaints either 5 mg of donepezil (Aricept) or placebo daily for 6 weeks in a randomized, double-blind, placebo-controlled trial. The dosage rose to 10 mg daily for another 6 weeks before a 2-week course of cognitive training and was maintained for the remainder of a year. Cognitive training improved performance; donepezil was well tolerated. However, there were no significant benefits of donepezil compared with placebo. An additional dose-ranging study with a starting dose of 5 mg a day suggests that the high dose was not the reason. Physiological tolerance may occur with chronic donepezil treatment and may increase AChE levels; this may be why short-term studies have shown the benefit of AChE inhibitor use in nondemented participants whereas chronic use has failed to enhance cognition.
authors.affiliation: Palo Alto Veterans Affairs Health Care System, Palo Alto, CA, USA. yesavage@stanford.edu
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Yesavage
authors.forename: Leah
authors.initials: L
authors.lastname: Friedman
authors.forename: J Wesson
authors.initials: JW
authors.lastname: Ashford
authors.forename: Helena C
authors.initials: HC
authors.lastname: Kraemer
authors.forename: Martin S
authors.initials: MS
authors.lastname: Mumenthaler
authors.forename: Art
authors.initials: A
authors.lastname: Noda
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hoblyn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D000077265:Donepezil; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007189:Indans / Q000008:administration & dosage*; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D011613:Psychotherapy / Q000379:methods*
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil