title: Effects of oral rivastigmine on cognitive domains in mild-to-moderate Alzheimer's disease.
abstract: Rivastigmine has beneficial effects on cognitive functioning in Alzheimer's disease (AD). Effects of cholinesterase inhibitors, particularly rivastigmine, on AD Assessment Scale-cognitive subscale (ADAS-cog) domains and individual items have rarely been analyzed. Results from 4 randomized, double-blind, placebo-controlled, 26-week rivastigmine capsule trials in patients with mild-to-moderate AD were pooled and ADAS-cog domains and individual items were evaluated. Data were available from 878, 1053, and 863 patients in the 1 to 4 mg/d, 6 to 12 mg/d, and placebo groups, respectively. Rivastigmine-treated groups were superior to placebo on total ADAS-cog and memory domain scores (P < or = .0001). Rivastigmine 6 to 12 mg/d was also significantly better versus placebo on language (P < .001) and praxis (P < .001); greatest treatment responses were seen on memory items (P < .0001). Although rivastigmine was associated with dose-dependent improvements in all cognitive domains, largest effects were on memory items. Evaluation of ADAS-cog domain scores provides insight into test items most likely to respond to treatment.
authors.affiliation: Indiana University School of Medicine, Indianapolis, USA. mfarlow@iupui.edu
authors.forename: Martin R
authors.initials: MR
authors.lastname: Farlow
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Cummings
authors.forename: Jason T
authors.initials: JT
authors.lastname: Olin
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Meng
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003627:Data Interpretation, Statistical; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory / Q000187:drug effects*; D009483:Neuropsychological Tests; D048448:Phenylcarbamates / Q000627:therapeutic use*; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D000068836:Rivastigmine; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D010919:Placebos; D000068836:Rivastigmine
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