Report of ten years' activity in an Alzheimer's disease assessment unit.
OBJECTIVE
After ten years' treatment with cholinesterase inhibitors (AcheI) in Alzheimer's disease (AD), we report here the activity of the Alzheimer's Disease Assessment Unit of IRCCS C. Mondino, Pavia, Italy.


METHODS
From September 2000 to December 2007, 794 out-patients (of 2236 referred to our Assessment Unit for cognitive disturbances) with AD of mild to moderate degree were treated with cholinesterase inhibitors (M/F: 273/521, mean age 73.6+/- 8.4 yrs, range 52-85 yrs). Outcome measures were scores on Mini Mental State Examination (MMSE), ADL, IADL and Neuropsychiatric Inventory (NPI).


RESULTS
Mean treatment duration was 36.9+/-16.1 months. After three months' treatment, MMSE scores remained stable (responders) in 60% of cases and improved (increase of 3 or more points - good responders) in 15%, with good preservation of autonomy. After 15 months, the percentage of "good responders" decreased to 7%, while after 15, 27 and 39 months the percentage of responders progressively decreased to 40%, 30% and 8%, respectively; greater impairment in instrumental with respect to basic everyday activities was noted. No variables capable of predicting the response to treatment were detected. The onset of behavioral disturbances caused significant (p<0.02) worsening of both cognition and function and, in 12% of cases, suspension of treatment.


CONCLUSIONS
Our results therefore confirm the efficacy of AcheI in AD of mild to moderate degree even in a nonselected population; efficacy also seems to persist in long-term treatment. This report, although brief and mainly descriptive, can make a contribution to better knowledge of the usefulness of these drugs in AD of mild to moderate extent in everyday clinical practice.
Sinforiani
Elena
E
Alzheimer's Disease Assessment Unit/Laboratory of Neuropsychology, IRCCS C. Mondino, Institute of Neurology, Via Mondino 2, 27100 Pavia, Italy. elena.sinforiani@mondino.it
Zucchella
Chiara
C
Pasotti
Chiara
C
Bartolo
Michelangelo
M
Nappi
Giuseppe
G
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010045:Outpatients; D026684:Personal Autonomy; D012044:Regression Analysis; D012189:Retrospective Studies