title: Rivastigmine transdermal patch and physical exercises for Alzheimer's disease: a randomized clinical trial.
abstract: OBJECTIVE
  To determine the effects of rivastigmine patch associated with physical exercise versus rivastigmine patch alone in quality of life (QOL), cognition, activities of daily living (ADL) and functional mobility in Alzheimer's disease (AD)subjects.
  
  
  METHODS
  A randomized, controlled, single-blinded trial was conducted in 40 patients with mild to moderate stages of AD. All patients were daily treated with rivastigmine transdermal patch at a stable dose of 4.6 mg and randomized into two groups: physical exercises or control. The exercise program consisted of aerobic, flexibility, strength and balance movements, twice a week for 6 months. Main outcomes were Quality of Life in Alzheimer's disease scale (QOL), Activities of Daily Living Questionnaire (ADL), Mini-Mental State Examination (MMSE) and "Time Up and Go Test".
  
  
  RESULTS
  Thirty-four patients completed the study. After 6 months, there was a significant improvement in QOL of patients randomized to physical exercise group (P< 0.05). In both groups, there was an improvement on caregivers QOL (P>0.05). When considering cognitive functions, there was no difference between groups. The ability to perform ADL worsened in the group enrolled to RTP alone. There was an improvement in functional mobility in the group treated with RTP.
  
  
  CONCLUSIONS
  Our results suggest that the association between physical exercises and RTP improves QOL in patients with AD. Cognition remained unchanged in both groups. Regarding the effect of physical exercises in ADL, further trials are necessary to confirm these results.
authors.forename: Paula
authors.initials: P
authors.lastname: Aguiar
authors.forename: Larissa
authors.initials: L
authors.lastname: Monteiro
authors.forename: Ana
authors.initials: A
authors.lastname: Feres
authors.forename: Irênio
authors.initials: I
authors.lastname: Gomes
authors.affiliation: Avenida Santa Luzia, 610, Blc 03, Apt 102, CEP 40295-050, Salvador, Brazil. asm@ufba.br.
authors.forename: Ailton
authors.initials: A
authors.lastname: Melo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D017028:Caregivers; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D048448:Phenylcarbamates / Q000008:administration & dosage*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D000068836:Rivastigmine; D012720:Severity of Illness Index; D057968:Transdermal Patch; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine