Rivastigmine in the Treatment of Dementia Associated with Parkinson’s Disease: Effects on Activities of Daily Living

• Published in: Dementia and geriatric cognitive disorders Vol. 29; no. 6; pp. 510 - 515
• Main Authors: Olin, Jason T., Aarsland, Dag, Meng, Xiangyi
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2010; S. Karger AG
• Subjects: Activities of Daily Living - classification; Aged; Aged, 80 and over; Biological and medical sciences; Cardiovascular system; Cholinesterase Inhibitors - therapeutic use; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - drug therapy; Dementia - etiology; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Neurology; Original Research Article; Parkinson Disease - complications; Pharmacology. Drug treatments; Phenylcarbamates - therapeutic use; Rivastigmine; Treatment Outcome; Vasodilator agents. Cerebral vasodilators; Rivastigmine; Activities of daily living; Parkinson's disease; Nervous system diseases; Cognitive disorder; Enzyme; Psychotropic; Daily living; Enzyme inhibitor; Parkinson disease; Esterases; Antialzheimer agent; Acetylcholinesterase; Carboxylic ester hydrolases; Cerebral disorder; Treatment; Nootropic agent; Central nervous system disease; Hydrolases; Degenerative disease; Anticholinesterase agent; Extrapyramidal syndrome; Dementia
• ISSN: 1420-8008; 1421-9824; 1421-9824
• DOI: 10.1159/000305100

Aims: 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 (≧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. Conclusion: 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.