Rivastigmine in the treatment of dementia associated with Parkinson's disease: effects on activities of daily living.
OBJECTIVE
To investigate the effects of rivastigmine capsule 3-12 mg/day over 24 weeks on activities of daily living (ADLs) in patients with dementia associated with Parkinson's disease (PDD).


METHODS
Post hocanalysis of a prospective, multicenter, randomized, double-blind, placebo-controlled trial in patients with PDD (>or=50 years) randomized to rivastigmine 3-12 mg/day (capsules bid) or placebo over 24 weeks. This analysis was carried out with three subscales derived from a factor analysis of the 23 items in the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale. These subscales were basic ADLs (10 items), high-level function ADLs (eight items) and autonomy ADLs (five items).


RESULTS
541 patients were randomized (362 to rivastigmine, 179 to placebo) and 410 (75.8%) completed the study. Rivastigmine was associated with significantly better outcomes in basic ADLs (-0.5 +/- 6.19 vs. -1.7 +/- 5.46; p = 0.025; effect size 22.1%) and high-level function ADLs (0.1 +/- 4.95 vs. -1.0 +/- 4.49; p = 0.017; effect size 22.9%) compared with placebo, at week 24.


CONCLUSIONS
In patients with PDD, treatment with rivastigmine may show beneficial effects on overall ADLs, as well as modest, statistically significant improvements in basic ADLs and high-level function ADLs.
Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Jason T
JT
Olin
Dag
D
Aarsland
Xiangyi
X
Meng
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D048448:Phenylcarbamates / Q000627:therapeutic use*; D000068836:Rivastigmine; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine