Evaluating rivastigmine in mild-to-moderate Parkinson's disease dementia using ADAS-cog items.
Rivastigmine has been shown to improve cognition in patients with Parkinson's disease dementia (PDD). To further explore the impact of anticholinesterase therapy on PDD, Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) items were assessed in a retrospective analysis of a 24-week, double-blind, placebo-controlled trial of rivastigmine. Mean changes from baseline at week 24 were calculated for ADAS-cog item scores and for 3 cognitive domain scores. A total of 362 patients were randomized to 3 to 12 mg/d rivastigmine capsules and 179 to placebo. Patients with PDD receiving rivastigmine improved versus placebo on items: word recall, following commands, ideational praxis, remembering test instructions, and comprehension of spoken language (P < .05), with standardized mean differences ranging from 0.04 to 0.30. Rivastigmine also showed significant effects versus placebo on all domains: memory, language, and praxis. The ADAS-cog is sensitive to broad cognitive changes in PDD. Overall, rivastigmine was associated with improvements on individual cognitive items and general cognitive domains.
Schmitt
Frederick A
FA
Department of Neurology, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40536, USA. fascom@email.uky.edu
Aarsland
Dag
D
Brønnick
Kolbjørn S
KS
Meng
Xiangyi
X
Tekin
Sibel
S
Olin
Jason T
JT
D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy*; D048448:Phenylcarbamates / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D000068836:Rivastigmine; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine
Neurology. 2005 Oct 25;65(8):1239-45
16247051
Neurology. 2005 Dec 27;65(12):1907-13
16282276
J Neurol Neurosurg Psychiatry. 1996 Sep;61(3):324-5
8795611
Neuropsychology. 2000 Apr;14(2):233-46
10791863
Int J Geriatr Psychiatry. 2001 Jul;16(7):653-66
11466744
Neuropsychology. 2002 Oct;16(4):577-90
12382995
Neurology. 2007 Jan 30;68(5):326-37
17261678
Am J Alzheimers Dis Other Demen. 2010 Mar;25(2):142-8
19359706
Arch Neurol. 2003 Mar;60(3):387-92
12633150
Lancet Neurol. 2004 Oct;3(10):622-6
15380159
Neurology. 2005 Nov 22;65(10):1654-6
16301500
Int J Clin Pract. 2009 May;63(5):799-805
19392927
J Neurol Neurosurg Psychiatry. 1985 May;48(5):413-21
3998751
N Engl J Med. 2004 Dec 9;351(24):2509-18
15590953
J Clin Exp Neuropsychol. 2001 Oct;23(5):592-8
11778636
Neuropsychology. 2005 Jan;19(1):106-14
15656768
J Comp Neurol. 2003 Aug 11;463(1):25-43
12811800
J Neurol Neurosurg Psychiatry. 2008 Apr;79(4):368-76
18344392
Brain. 1992 Dec;115 ( Pt 6):1727-51
1486458
Curr Alzheimer Res. 2007 Jul;4(3):277-93
17627485
Mov Disord. 2006 Nov;21(11):1899-907
16960863
Int J Geriatr Psychiatry. 2007 May;22(5):456-67
17380489
J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1064-8
17287236