title: Effects of 21 months of cholinesterase inhibitors on cognitive and functional decline in demented patients.
abstract: OBJECTIVE
  The aim of this study was to assess, in a natural setting, the development of cognitive, behavioral and functional performance of elderly dementia patients treated with cholinesterase inhibitors (ChEIs) during a 21-month follow-up. Another aim was to compare patterns of clinical changes in relation to patients' level of cognitive impairment at the beginning of therapy.
  
  
  METHODS
  Of the 1987 elderly demented patients seen at our unit, 143 met the inclusion/ exclusion criteria, were followed for at least 21 months, and were thus included in the study. At baseline and each control point (up to 21 months), patients were scored for Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).
  
  
  RESULTS
  After 21 months' treatment with ChEIs, patients showed a significant reduction in MMSE, ADL and IADL values. The MMSE score decreased by 1.7 points/year (95% CI -2.1; -1.3), irrespective of initial cognitive level, and was lower than that expected in non-treated patients (-3/-4 points/year).
  
  
  CONCLUSIONS
  ChEI therapy is effective in slowing the progression of dementia, even in the long term, irrespective of baseline cognitive level.
authors.affiliation: Division of Geriatrics, Department of Medicine, DI-MED, University of Padova, Padova, Italy. alessandra.coin@unipd.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coin
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.forename: Sara
authors.initials: S
authors.lastname: Catanzaro
authors.forename: Marco
authors.initials: M
authors.lastname: Mosele
authors.forename: Marina
authors.initials: M
authors.lastname: De Rui
authors.forename: Agostino
authors.initials: A
authors.lastname: Girardi
authors.forename: Emine Meral
authors.initials: EM
authors.lastname: Inelmen
authors.forename: Elena Debora
authors.initials: ED
authors.lastname: Toffanello
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001519:Behavior / Q000187:drug effects*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D002800:Cholinesterase Inhibitors