Predicting cognitive decline in Alzheimer's disease: an integrated analysis.
BACKGROUND
Numerous patient- and disease-related factors increase the risk of rapid cognitive decline in patients with Alzheimer's disease (AD). The ability of pharmacological treatment to attenuate this risk remains undefined.


METHODS
Pooled data from 14 randomized clinical studies of donepezil in the treatment of AD (N = 3748) were analyzed to identify predictors of fast decline and determine the effect of donepezil on the risk of fast decline.


RESULTS
Young age and more severe baseline cognitive, global, or behavioral status were identified as independent predictors of faster decline in placebo-treated patients. Multivariate models indicated that donepezil treatment was associated with a 39% to 63% reduction in the risk of faster decline.


CONCLUSIONS
These results correspond with previous findings, indicating relationships between age or baseline disease severity and rates of cognitive decline. Furthermore, they suggest that symptomatic therapy for AD could reduce the likelihood of faster decline in treated patients.
Department of Neurology, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA. lopezol@upmc.edu
Oscar L
OL
Lopez
Elias
E
Schwam
Jeffrey
J
Cummings
Serge
S
Gauthier
Roy
R
Jones
David
D
Wilkinson
Gunhild
G
Waldemar
Richard
R
Zhang
Rachel
R
Schindler
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D018450:Disease Progression; D000077265:Donepezil; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012307:Risk Factors
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil